PCA (patient controlled analgesia) Chart – adult Education Slide Presentation A presentation prepared by the Pain Interest Group Nursing Issues in association with the Agency of Clinical Innovation Pain Management Network Please direct comments to: March 21, 2013 Emily Edmonds Coordinator State Pain Forms Pain Interest Group Nursing Issues CNC Acute Pain Service Blacktown Hospital Phone: 9881 7649 Email: [email protected]Jenni Johnson Manager Pain Management Network Agency for Clinical Innovation (ACI) Phone: 9464 4636 Email: [email protected]OR
PCA (patient controlled analgesia) Chart – adult Education Slide Presentation A presentation prepared by the Pain Interest Group Nursing Issues in association with the Agency of Clinical Innovation Pain Management Network Please direct comments to:. Jenni Johnson Manager - PowerPoint PPT Presentation
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
PCA (patient controlled analgesia) Chart – adult
Education Slide Presentation
A presentation prepared by the Pain Interest Group Nursing Issues
in association with the Agency of Clinical Innovation Pain Management Network
Please direct comments to:
March 21, 2013
Emily EdmondsCoordinator State Pain Forms
Pain Interest Group Nursing IssuesCNC Acute Pain Service Blacktown Hospital
The PCA prescription and observation chart for adult patients has been developed by a team of experts in the field of acute pain including clinical nurse consultants, anaesthetists and pharmacy representatives.
This PCA chart is not suitable for use in paediatric patients.
Standardisation of this chart promotes best practice in prescribing, pain assessment and management of adverse effects in those patients receiving an opioid via PCA.
3
Aim of this presentation:
This presentation aims to explain how to use the chart for prescribing a PCA how to record the administration and discard of
drugs used for PCA how to complete the clinical observations guidelines on the management of patients receiving
PCA including the management of adverse effects
4
PCA chart - adultBooklet format
Prescription valid for 4 daysObservation pages for 4 days
Page 1Management guidelines
Page 1 Page 2Page 3
Page 2PCA prescription- PCA program
- Neuraxial opioid + PCA- Naloxone prescription
Page 3PCA drug administration
- Drug discard- Naloxone administration
5
Inside pages:Observation pages for up to 4 days
PCA chart - adult
Inside pages
Back page:Clinical Review and
Rapid Response Criteria(Between the Flags)
Back page
6
Prescription page:
Page 2
Patient label and allergy adverse
reactions
PCA prescription
PCA program- Allows for 2 further
changes to the program
Record of administration of aneuraxial opioid
Prescription for naloxone OR ‘sticker affixed’ stating
existing standing order
7
PCA prescription:Below is an EXAMPLE prescription
Refer to hospital PCA policy for local guidelines on PCA prescribing
SMITH 22/4/13PSmith
Prescriber to complete patient allergy and ADR
section in full
Handwrite patient details OR affix patient label
(First prescriber to check patient label is correct)
Private patients: require a
signature from the referring
Doctor to the Pain Service
PLEASE REFER TO YOUR LOCAL HOSPITAL POLICY FOR
PCA DRUG SOLUTIONS
8
PCA prescription:Below is an EXAMPLE prescription
Refer to hospital PCA policy for local guidelines on PCA prescribing
A PCA prescription is for one opioid only.When changing from one opioid to another, a new PCA chart must be
commenced
Morphine 60 mg NILIV 60 mL
22/04/13 SMITHTSmith
PCA prescription to include route, primary drug (e.g. morphine or fentanyl),
total amount in mg or microgram and total volume
Space is provided for an additional drug to be added
if necessary
Space provided for pharmacist
reconciliationPrescriber’s signature
and printed name
9
PCA program:Below is an EXAMPLE programRefer to hospital PCA policy for
local guidelines on PCA prescribing
Morphine 1mg 1mg 15
mins NIL10:0022/04/13
2mg 25
mins 1mg09:0023/04/13
SMITHTSmith
JACKS.JackMorphine 1mg 1
Primary drug and concentrationState: mg or
microgram per mL
Two additional rows are provided for changes to
the PCA program
PCA bolus dose (state unit of
drug and volume)
Lockout interval in minutes
Background infusion (State mg or microgram
and mL per hour)
Prescriber’s signature and
print name
Date and time
When changing from one opioid to another, a new
PCA chart must be commenced
10
Neuraxial opioid + PCA:
IF a dose of opioid has been administered via the spinal or epidural route during a
procedure, AND the patient is to receive a PCA, the following is to be completed