June 2012 Volume 1, Issue 5
UMMC Nursing Newsletter Important Changes to Medication Administration Practices What Nurses Need to Know… With a focus on improving quality and timeliness of care delivered in hospitals, the Centers for Medicare & Medicaid Services (CMS) has recently published new standards for the timely administration of certain critical medications in the hospital setting.
What is a Time Critical Medication? Time Critical medications are ones that must be administered within 30 minutes before or after the scheduled administration time. Time critical medications include rapid, short-acting, and ultra short-acting insulins, oral hypoglycemics, and scheduled doses of analgesics (opioids and nonopioids—with the exception of transdermal products.
Examples of each Medication type include: (the list is NOT all-inclusive) Oral Hypoglycemics may include:
Ultra Short-acting Insulins
• • • • •
• Humalog or Lispro • Novolog or Aspart • Apidra or glulisine
Rapid or Short-acting Insulins • • •
Humulin R Novolin Velosulin (insulin pumps)
Opioid analgesics may include: • • • • • •
Morphine Fentanyl Codiene Oxycodone Hydromorphone Hydrocodone
Metformin Glyburide or Glimepiride Avandia or Actos Acarbose or Miglitol Natinglinide ot Starlix
Non-opioid analgesics • • • •
Acetaminophen (Tylenol) Ibuprofen Naproxen Toradol
So, What About Non– Time Critical Scheduled Medications? Frequency Daily, of dose Weekly, or Monthly Time due window
Within 2 hours of scheduled time
> Daily < every 4 hours
One Time Dose
On-Call dose & PRN
STAT
Within Within 60 ASAP, and Within 1 hour of 2 hours minutes of within 1 hour of Scheduled of order indicated identified need time need
NOW
Routine
Within 2 hours of order
Next Standard Admin time
For additional Information, see policy MM-005—Medication Administration Policy 1