Pharmacists,

As we continue to focus on TJC and trying our best to eliminate pharmacy-related issues, such as duplicate medication orders, I have received several questions about what is or is not considered a duplicate. I have discussed with Michele and David and we wanted to send out some clarification. 

Many of the questions I have gotten are related to powerplans such as perioperative powerplans that tend to introduce a lot of duplicates, including fluids, SSI, n/v, pain medications, etc but are intended to be active on the profile for a very short time for a specific procedural area. If you d/c the duplicates as our policy describes (oldest order is d/c'd) then you risk not having that fluid, SSI, prn med order, etc once the ANES or other peri-procedural powerplan is d/c'd. Therefore, our stance on this issue is that medications should not be considered duplicates, and therefore do not need pharmacist intervention or adjustment, if the duplicate is being created by a peri-procedural powerplan that is intended to be active for a short period of time and intended for use in a specific area. You are welcome to add comments or other clarification in certain situations that may introduce some ambiguity (add comment that says "for use while on PCA only", etc). Please use your clinical judgement as every situation is not easily defined. 

Let me, Michele or David know if you have any questions.