eStar update: Last line antimicrobials to require second signature at Monroe Carell

1.     Primary team pages ID pager requesting approval

2.     ID reviews and if appropriate, provides verbal approval

3.     ID attending’s name is selected as approving provider in the order

§  New Process

·       During business hours, from 0700 – 2200

1.     Primary team pages ID with request for order

2.     ID grants verbal approval, if appropriate

3.     Primary team places order. This order remains inactive UNTIL

4.     ID team cosigns order. The order becomes active at this point.

5.     Pharmacy receives order and dispenses it.

·       Overnight, from 2200 – 0700

1.     Once orders may be ordered and dispensed for restricted antibiotics needed overnight without a cosign.  ONLY one-time orders for restricted antimicrobials will be ordered and dispensed from the pharmacy WITHOUT prior ID approval or cosign.

2.     After a one-time dose is ordered overnight, a scheduled dose should be put in for the following morning.  A cosign will be provided during business hours in order to make the order active.  If the frequency requires more than one dose to be given during overnight hours, order a second one-time dose.   A cosign is ALWAYS required for orders with a scheduled frequency (q24h, q12h, etc).

·       Meropenem will still be available to the intensive care units and through the sepsis order panel for acute care patients for 48 hours without ID approval.