Thoroughly analyse the following coronial case study below, ALL DATA IS PRESENTED BELOW: Charles Nelson is a 38 year old
Posted: Wed May 18, 2022 7:46 pm
Thoroughly analyse the following coronial case study
below, ALL DATA IS PRESENTED BELOW:
Charles Nelson is a 38 year old
male who was admitted to ward 5B with a 3-day
history of headache (in the occipital region), which he
describes as throbbing and continuous in nature.
Charles is married and has 3 young children, and his family
describes him as a man with a great sense of humour and fun. He is
a caring and very engaging father to his sons, a loving husband, a
son and a friend. His presenting assessment
findings were that, he has a headache accompanied
with neck pain and stiffness with increasing severity of headaches
for over 3 days. He is febrile with a temperature
of 38.3 degrees Celsius, GCS 15/15 and
pupils are equal and accomodating to light. His
past medical history includes: viral
meningitis (4 years ago), severe obstructive sleep apnoea
(diagnosed 3 years ago) and generalised anxiety disorder.
His normal medications include: Diazepam and Sertraline.
On admission to the ED (Day 1: Date - 7/7, Time -
1440), the nursing notes were: "Patient receiving
treatment for suspected viral meningitis. Lumbar puncture performed
results indicate nil increased in white cell count and CT head
reported as normal with no evidence of intracranial haemorrhage. 10
mg IV morphine administered for headache (pain rating = 8/10) with
effect (pain rating of 5/10), GCS 15/15, pupils equal and reactive
to light and accomodating. Episode of desaturation (SpO2 79%)
recorded at 1920 hours, spontaneously reversed on rousing patient.
Plan: to be admitted to 5W for ongoing antiviral treatment and
analgesia. Signed by: K Roberts (ED RN)."
(Provided below is the nurse medication documentation)
On ward admission to 5W (Day 2: Date - 8/7),
the nursing notes were: "Patient admitted 2015 hours with suspected
viral meningitis and history of anxiety. Patient appears anxious
and reporting severe headaches (pain rating = 8/10) -patient states
his head is pounding with neck and back soreness. GCS 15/15, nil
disturbance to visual acuity. Analgesia administered as per
medication chart with effect. Vital signs stable. Signed
by: E Simpson (EEN)
Next, Nursing Entry Day 3 (Date: 9/9/21, Time: 2130
hours), the nursing notes were: "Charles alert and
coherent, mobile and self caring over the shift. Vital signs stable
and afebrile as documented. Continues to report ongoing headaches
with pain reported as 7 or 8 out of 10, Ordine 40 mg administered
with some effect (pain rating = 6/10). Medication administered as
per chart. Appears anxious watching television in bed at time of
report. Signed by: A Greecezel (RN) Vital signs
documented at 2000 hours were Temp = 36.9 degrees Celsius, HR = 77
bpm, BP = 124/64 mm Hg, RR = 14 bpm and SpO2 = 94% on room
air."
Next, Nursing Entry at Night Shift (Date: 9/9/21 -
10/9/21, Time: 2130 - 0700 hours), the nursing notes were:
"Patient in good spirits at commencement of shift, appears happier.
Slept intermittently overnight. Headaches remain an issue -
medications administered as charted. Nil further changes. Signed
by: E Simpson (EEN) Vital signs documented at 0200
hours were PR = 95 bpm, SpO2 = 89% increased to 93% with patient
rousing on room air and RR = 14 bpm."
Next, Nursing Entry Day 4 (Date: 10/7/21) Morning
Shift, the nursing notes were: "Charles distressed this
morning reporting intolerable headache and neck stiffness,
OxyContin 40 mg administered at 0715 hours for ongoing headaches.
Dr Brokett contacted at 0750 hours to clarify PRN Ordine order - Dr
Brokett confirmed Ordine order can be administered 3rd hourly,
verbal order confirmed to RN Juan. Ordine 20 mg administered 0750
hours secondary to poorly controlled pain. Signed by: R Risedale
(RN) Vital signs documented at 0800 were Temp = 37.2 degrees
Celsius, HR = 87 bpm, BP = 118/64 mm Hg, RR = 12 bpm, SpO2 = 85%
initially, increasing to 88% on room air. 3 litres of O2 applied
with SpO2 increasing to 92%. Patient reports no prior or underlying
respiratory issues, patient does not appear to be distressed, no
evidence of cyanosis, alert and interactive."
At 1000 hours the same morning shift, the
nursing notes were: "Responding to patient call; Charles reported
increase in headache intensity, vital signs remain stable. SpO2 =
93% on 3 L/min of oxygen. 40 mg Ordine administered, with effect -
patient reporting headache improved, mobilising independently and
preparing for a shower. Vital signs at 1130 hours were Temp = 36.9
degrees Celsius, HR = 97 bpm, BP = 115/68 mm Hg, RR = 18 bpm, SpO2
= 93% on 3 L/min of oxygen."
At 1530 hours the same shift, the nursing notes
were: "Ongoing headaches over this shift, patient requesting
analgesia frequently, administered 40 mg Ordine 1340 hours and
additional oral adjuncts. Patient appears fatigued this afternoon,
requesting curtains closed and lights off. Remains alert and
orientated."
ALL Morning Shift notes of 10/7/21 are Signed by: R
Risedale (RN)
Next, Nursing Entry Day 4 (Date: 10/7/21) Afternoon
Shift, the nursing notes were: “1630 hours patient resting
this afternoon, headaches remain a concern - patient reports
headache as severe, 40 mg Ordine administered with paracetamol 1 g.
Nasal prongs reapplied and repositioned - patient finding them
irritating, remains alert and interactive. Vital signs at 1600
hours were Temp = 37.7 degrees Celsius, HR = 100 bpm, BP = 120/72
mm Hg, RR = 18 bpm on 2 L/min oxygen delivered via nasal
prongs.
At 2000 hours, patient alert and orientated,
resting this evening. Medications administered as charted.
Headaches remain severe +++. Vital signs at 2000 hours were Temp =
37.1 degrees Celsius, HR = 102 bpm, BP = 130/84 mm Hg, RR = 20 bpm
on 2 L/min oxygen delivered via nasal prongs.”
ALL Afternoon Shift notes of 10/7/21 are Signed by: A
Greecezel (RN)
Lastly, Nursing Entry Day 4 (Date: 10/7/21) Night
Duty, the nursing notes were: “At Midnight: patient
appeared in good spirits this evening at commencement of shift.
Changes to analgesia made by treating doctor earlier this
afternoon, patient continues to report headaches with some
decreased intensity. Visual checks performed - patient asleep and
snoring. SpO2 was at 92% on room air.” Signed by E Simpson
(EEN)
11/7/21: At 0200 hours visual check performed
patient asleep and snoring intermittently. E Simpson (EEN)
11/7/21: At 0440 code blue initiated, patient
found unresponsive and pulseless on assessment. CPR performed at
0442 hours, Guedel airway inserted at 0440 hours.
11/7/21: At 0515 hours resuscitation efforts
ceased. Patient declared deceased at 0515 hours.
Patient Medication Chart (Once Only Medications) shown in Figure
1 below.
Figure 1: Patient Medication Chart (Once Only
Medications)
Patient Medication Chart (Regular Medications) shown in Figure 2
below.
Figure 2: Patient Medication Chart (Regular
Medications)
PRN Medications Administered shown in Figure 3 below.
Figure 3: PRN Medications Administered
ANSWER THE FOLLOWING:
A) Analyse the coroner’s case to identify the issues
(what happened and why it happened) in care delivery that
contributed to a failure to recognise and respond to clinical
deterioration. Discuss how the issues identified, in conjunction
with the patient presentation, medical history, and underlying
pathophysiological processes led to the clinical
deterioration. NOTE: Remember, it is important NOT to
point fingers but rather, what are the overarching issues that
contributed to the failure to recognise and respond to the clinical
deterioration (for example (do not use this example if it is NOT
appropriate in this case), personal patient centred care was
neglected. You are then to discuss and support why this is an issue
by pulling out an example of where was personal patient centred
care was neglected in the case study itself and justify and discuss
why it led to the clinical deterioration).
B) Based on contemporary evidence
analyse the clinical actions that the registered nurse(s)
implemented, how this contributed to the patient’s clinical
deterioration, and discuss what action should have been undertaken
to potentially prevent the clinical deterioration.
C) Based on issues identified in the Coroner’s report
apply contemporary research to discuss the communication barriers
in the escalation of care and how these may be addressed to improve
future care.
Given by Pharmacy Once only and nurse initiated medicines and pre-medications Date Medicine Date/time of Prescriber/Nurse Initiator (N) Time Route Dose prescribed (print generic name) dose Signature Print your name given 717/21 Morphine IV 14 KR Z Roberts Z Roberts ) 11/21 Morphine IV 5mg 7/7:15:05 17:15:05 Z Roberts Z Roberts 0 15:05 77/21 Morphine SC 5mg 77:18:10 Z Roberts Z Roberts 18:10 5mg 7/7:34:30 10 14:30 KR JD
Dose KR Once only and nurse initiated medicines and pre-medications Date Medicine Prescriber/Nurse Initiator (NI) Date/time of Route Time Given by prescribed dose (print generic name) Signature Pharmacy Print your name given 7/7/21 Morphine IV 5mg 14:30 7/7:14:30 Z Roberts Z Roberts 7/7/21 IV Morphine Z Roberts Z Roberts 7/7:15:05 5mg 15:05 7/7/21 18:10 Morphine SC 5mg 7/7:18:10 KR Z Roberts Z Roberts 9/7/21 19:15 C Bracknell C Bracknell Gabapentin ES 9/7:19:15 20:15 9/7/21 Movicol po 1 sachet 9/7:20:15 Nurse initiated KR po 300mg ES ΑΛΛΛΛ. Talanhana ...Abee at all
show NA Continue on discharge? No slow 0800 Regular medicines Year 20 21 Date and month PRESCRIBER MUST ENTER administration times 717 817977 1077 Date Medicine (print generic name) Tick 7/7/21 Paracetamol release Route Dose Frequency and NOW enter times 06:00 REKW. ES PO|1g QID 12:00 AB AB CF Indication Pharmacy Analgesia 18:00 KR ES RN BCL Prescriber signature Print your name Contact 24:00 REKW ES ES M WILLIAMS M Williams 171 Date Medicine (print generic name) Tick 8/7/21 oxycodone (Endone) release Route Dose Frequency and NOW enter times PO 10MG BD 15:10 18:00 ww {Ceased) Indication Pharmacy PAIN Prescriber signature Print your name Contact E ROBINSON E ROBINSON 821 Date Medicine (print generic name) Tick 8/7/21 MS CONTIN x Route Frequency and NOW enter times 0800 Dose AB AB CF PO 40MG BD 20:00 ES RN CEASED Indication Pharmacy PAIN Prescnber signature Print your name Contact S DOBSON S DOBSON 978 Medicine (print generic name) Tick slow 10/7/21 MS CONTIN lease Route Dose Frequency and NOW enter times 08:00 PO 80MG BD 20:00 Indication Pharmacy PAIN Prescriber signature Prict your name Contact S DOBSONS DONBSON 978 Vein Continue on discharge? Yes/No na? Continue on discharge? Yes/No Ini Date BC Votin Continue on discharge? Yes/No ninen Date Medicine (print generic name) Tick slow 7/7/21 ACYCLOVIR release Route Dose Frequency and NOW enter times PO 400MG BD Indication ANTI-VIRAL Pharmacy 0800 UP AB AB CF 20:00 KR ES RN BC Continue on discharge? / No Prescriber sigpat Copt PM WILLTÅMS Medicine (print generic name) Date Tick
Date Medicine (print generic name) Date 8/7 97 97 8/7/21 OXYCODONE Route Dose Hourly frequency Max PRN dose/24 hrs PO 5MG Time 22; 08 12 PRN 100 100 100 Indication Pharmacy Dose 5MG5MG 5MG pain Route PO PO PO Prescriber signature Print your name Contact E Robinson E Robinson 821 Sign RF GA KL Date Medicine (print generic name) 8/7/21 ORDINE (MORPHINE) Date 917 97 97 10171017 10171017 10171017 10171017 Route Dose Hourly frequency Max PRN dose/24 hrs PO 20-40MG Time 14:35 17:15 20:00 22:00 07:15 07:50 10
3016:30 21:00 22:15 PRN Indication Pharmacy Dose 40 20 40 40 40 40 40 40 40 40 40 PAIN Route po po pol pol polpo po po po po po Prescriber signature Print your name Contact er rt pl jiwmdra ef E Robinson E ROBINSON kw pj sr Sign wd of ww rp kwsn pk bg mn ef kc Date Medicine (print generic name) Date Yes/No days Qty... Duration: Yes/No Dispense? PS / No Continue on discharge? Yes/No Continue on discharge? Yes / No days Qty es/No Dispense? Duration:
below, ALL DATA IS PRESENTED BELOW:
Charles Nelson is a 38 year old
male who was admitted to ward 5B with a 3-day
history of headache (in the occipital region), which he
describes as throbbing and continuous in nature.
Charles is married and has 3 young children, and his family
describes him as a man with a great sense of humour and fun. He is
a caring and very engaging father to his sons, a loving husband, a
son and a friend. His presenting assessment
findings were that, he has a headache accompanied
with neck pain and stiffness with increasing severity of headaches
for over 3 days. He is febrile with a temperature
of 38.3 degrees Celsius, GCS 15/15 and
pupils are equal and accomodating to light. His
past medical history includes: viral
meningitis (4 years ago), severe obstructive sleep apnoea
(diagnosed 3 years ago) and generalised anxiety disorder.
His normal medications include: Diazepam and Sertraline.
On admission to the ED (Day 1: Date - 7/7, Time -
1440), the nursing notes were: "Patient receiving
treatment for suspected viral meningitis. Lumbar puncture performed
results indicate nil increased in white cell count and CT head
reported as normal with no evidence of intracranial haemorrhage. 10
mg IV morphine administered for headache (pain rating = 8/10) with
effect (pain rating of 5/10), GCS 15/15, pupils equal and reactive
to light and accomodating. Episode of desaturation (SpO2 79%)
recorded at 1920 hours, spontaneously reversed on rousing patient.
Plan: to be admitted to 5W for ongoing antiviral treatment and
analgesia. Signed by: K Roberts (ED RN)."
(Provided below is the nurse medication documentation)
- Thoroughly Analyse The Following Coronial Case Study Below All Data Is Presented Below Charles Nelson Is A 38 Year Old 1 (183.57 KiB) Viewed 36 times
the nursing notes were: "Patient admitted 2015 hours with suspected
viral meningitis and history of anxiety. Patient appears anxious
and reporting severe headaches (pain rating = 8/10) -patient states
his head is pounding with neck and back soreness. GCS 15/15, nil
disturbance to visual acuity. Analgesia administered as per
medication chart with effect. Vital signs stable. Signed
by: E Simpson (EEN)
Next, Nursing Entry Day 3 (Date: 9/9/21, Time: 2130
hours), the nursing notes were: "Charles alert and
coherent, mobile and self caring over the shift. Vital signs stable
and afebrile as documented. Continues to report ongoing headaches
with pain reported as 7 or 8 out of 10, Ordine 40 mg administered
with some effect (pain rating = 6/10). Medication administered as
per chart. Appears anxious watching television in bed at time of
report. Signed by: A Greecezel (RN) Vital signs
documented at 2000 hours were Temp = 36.9 degrees Celsius, HR = 77
bpm, BP = 124/64 mm Hg, RR = 14 bpm and SpO2 = 94% on room
air."
Next, Nursing Entry at Night Shift (Date: 9/9/21 -
10/9/21, Time: 2130 - 0700 hours), the nursing notes were:
"Patient in good spirits at commencement of shift, appears happier.
Slept intermittently overnight. Headaches remain an issue -
medications administered as charted. Nil further changes. Signed
by: E Simpson (EEN) Vital signs documented at 0200
hours were PR = 95 bpm, SpO2 = 89% increased to 93% with patient
rousing on room air and RR = 14 bpm."
Next, Nursing Entry Day 4 (Date: 10/7/21) Morning
Shift, the nursing notes were: "Charles distressed this
morning reporting intolerable headache and neck stiffness,
OxyContin 40 mg administered at 0715 hours for ongoing headaches.
Dr Brokett contacted at 0750 hours to clarify PRN Ordine order - Dr
Brokett confirmed Ordine order can be administered 3rd hourly,
verbal order confirmed to RN Juan. Ordine 20 mg administered 0750
hours secondary to poorly controlled pain. Signed by: R Risedale
(RN) Vital signs documented at 0800 were Temp = 37.2 degrees
Celsius, HR = 87 bpm, BP = 118/64 mm Hg, RR = 12 bpm, SpO2 = 85%
initially, increasing to 88% on room air. 3 litres of O2 applied
with SpO2 increasing to 92%. Patient reports no prior or underlying
respiratory issues, patient does not appear to be distressed, no
evidence of cyanosis, alert and interactive."
At 1000 hours the same morning shift, the
nursing notes were: "Responding to patient call; Charles reported
increase in headache intensity, vital signs remain stable. SpO2 =
93% on 3 L/min of oxygen. 40 mg Ordine administered, with effect -
patient reporting headache improved, mobilising independently and
preparing for a shower. Vital signs at 1130 hours were Temp = 36.9
degrees Celsius, HR = 97 bpm, BP = 115/68 mm Hg, RR = 18 bpm, SpO2
= 93% on 3 L/min of oxygen."
At 1530 hours the same shift, the nursing notes
were: "Ongoing headaches over this shift, patient requesting
analgesia frequently, administered 40 mg Ordine 1340 hours and
additional oral adjuncts. Patient appears fatigued this afternoon,
requesting curtains closed and lights off. Remains alert and
orientated."
ALL Morning Shift notes of 10/7/21 are Signed by: R
Risedale (RN)
Next, Nursing Entry Day 4 (Date: 10/7/21) Afternoon
Shift, the nursing notes were: “1630 hours patient resting
this afternoon, headaches remain a concern - patient reports
headache as severe, 40 mg Ordine administered with paracetamol 1 g.
Nasal prongs reapplied and repositioned - patient finding them
irritating, remains alert and interactive. Vital signs at 1600
hours were Temp = 37.7 degrees Celsius, HR = 100 bpm, BP = 120/72
mm Hg, RR = 18 bpm on 2 L/min oxygen delivered via nasal
prongs.
At 2000 hours, patient alert and orientated,
resting this evening. Medications administered as charted.
Headaches remain severe +++. Vital signs at 2000 hours were Temp =
37.1 degrees Celsius, HR = 102 bpm, BP = 130/84 mm Hg, RR = 20 bpm
on 2 L/min oxygen delivered via nasal prongs.”
ALL Afternoon Shift notes of 10/7/21 are Signed by: A
Greecezel (RN)
Lastly, Nursing Entry Day 4 (Date: 10/7/21) Night
Duty, the nursing notes were: “At Midnight: patient
appeared in good spirits this evening at commencement of shift.
Changes to analgesia made by treating doctor earlier this
afternoon, patient continues to report headaches with some
decreased intensity. Visual checks performed - patient asleep and
snoring. SpO2 was at 92% on room air.” Signed by E Simpson
(EEN)
11/7/21: At 0200 hours visual check performed
patient asleep and snoring intermittently. E Simpson (EEN)
11/7/21: At 0440 code blue initiated, patient
found unresponsive and pulseless on assessment. CPR performed at
0442 hours, Guedel airway inserted at 0440 hours.
11/7/21: At 0515 hours resuscitation efforts
ceased. Patient declared deceased at 0515 hours.
Patient Medication Chart (Once Only Medications) shown in Figure
1 below.
- Thoroughly Analyse The Following Coronial Case Study Below All Data Is Presented Below Charles Nelson Is A 38 Year Old 2 (160.08 KiB) Viewed 36 times
Medications)
Patient Medication Chart (Regular Medications) shown in Figure 2
below.
- Thoroughly Analyse The Following Coronial Case Study Below All Data Is Presented Below Charles Nelson Is A 38 Year Old 3 (440.45 KiB) Viewed 36 times
Medications)
PRN Medications Administered shown in Figure 3 below.
- Thoroughly Analyse The Following Coronial Case Study Below All Data Is Presented Below Charles Nelson Is A 38 Year Old 4 (312.46 KiB) Viewed 36 times
ANSWER THE FOLLOWING:
A) Analyse the coroner’s case to identify the issues
(what happened and why it happened) in care delivery that
contributed to a failure to recognise and respond to clinical
deterioration. Discuss how the issues identified, in conjunction
with the patient presentation, medical history, and underlying
pathophysiological processes led to the clinical
deterioration. NOTE: Remember, it is important NOT to
point fingers but rather, what are the overarching issues that
contributed to the failure to recognise and respond to the clinical
deterioration (for example (do not use this example if it is NOT
appropriate in this case), personal patient centred care was
neglected. You are then to discuss and support why this is an issue
by pulling out an example of where was personal patient centred
care was neglected in the case study itself and justify and discuss
why it led to the clinical deterioration).
B) Based on contemporary evidence
analyse the clinical actions that the registered nurse(s)
implemented, how this contributed to the patient’s clinical
deterioration, and discuss what action should have been undertaken
to potentially prevent the clinical deterioration.
C) Based on issues identified in the Coroner’s report
apply contemporary research to discuss the communication barriers
in the escalation of care and how these may be addressed to improve
future care.
Given by Pharmacy Once only and nurse initiated medicines and pre-medications Date Medicine Date/time of Prescriber/Nurse Initiator (N) Time Route Dose prescribed (print generic name) dose Signature Print your name given 717/21 Morphine IV 14 KR Z Roberts Z Roberts ) 11/21 Morphine IV 5mg 7/7:15:05 17:15:05 Z Roberts Z Roberts 0 15:05 77/21 Morphine SC 5mg 77:18:10 Z Roberts Z Roberts 18:10 5mg 7/7:34:30 10 14:30 KR JD
Dose KR Once only and nurse initiated medicines and pre-medications Date Medicine Prescriber/Nurse Initiator (NI) Date/time of Route Time Given by prescribed dose (print generic name) Signature Pharmacy Print your name given 7/7/21 Morphine IV 5mg 14:30 7/7:14:30 Z Roberts Z Roberts 7/7/21 IV Morphine Z Roberts Z Roberts 7/7:15:05 5mg 15:05 7/7/21 18:10 Morphine SC 5mg 7/7:18:10 KR Z Roberts Z Roberts 9/7/21 19:15 C Bracknell C Bracknell Gabapentin ES 9/7:19:15 20:15 9/7/21 Movicol po 1 sachet 9/7:20:15 Nurse initiated KR po 300mg ES ΑΛΛΛΛ. Talanhana ...Abee at all
show NA Continue on discharge? No slow 0800 Regular medicines Year 20 21 Date and month PRESCRIBER MUST ENTER administration times 717 817977 1077 Date Medicine (print generic name) Tick 7/7/21 Paracetamol release Route Dose Frequency and NOW enter times 06:00 REKW. ES PO|1g QID 12:00 AB AB CF Indication Pharmacy Analgesia 18:00 KR ES RN BCL Prescriber signature Print your name Contact 24:00 REKW ES ES M WILLIAMS M Williams 171 Date Medicine (print generic name) Tick 8/7/21 oxycodone (Endone) release Route Dose Frequency and NOW enter times PO 10MG BD 15:10 18:00 ww {Ceased) Indication Pharmacy PAIN Prescriber signature Print your name Contact E ROBINSON E ROBINSON 821 Date Medicine (print generic name) Tick 8/7/21 MS CONTIN x Route Frequency and NOW enter times 0800 Dose AB AB CF PO 40MG BD 20:00 ES RN CEASED Indication Pharmacy PAIN Prescnber signature Print your name Contact S DOBSON S DOBSON 978 Medicine (print generic name) Tick slow 10/7/21 MS CONTIN lease Route Dose Frequency and NOW enter times 08:00 PO 80MG BD 20:00 Indication Pharmacy PAIN Prescriber signature Prict your name Contact S DOBSONS DONBSON 978 Vein Continue on discharge? Yes/No na? Continue on discharge? Yes/No Ini Date BC Votin Continue on discharge? Yes/No ninen Date Medicine (print generic name) Tick slow 7/7/21 ACYCLOVIR release Route Dose Frequency and NOW enter times PO 400MG BD Indication ANTI-VIRAL Pharmacy 0800 UP AB AB CF 20:00 KR ES RN BC Continue on discharge? / No Prescriber sigpat Copt PM WILLTÅMS Medicine (print generic name) Date Tick
Date Medicine (print generic name) Date 8/7 97 97 8/7/21 OXYCODONE Route Dose Hourly frequency Max PRN dose/24 hrs PO 5MG Time 22; 08 12 PRN 100 100 100 Indication Pharmacy Dose 5MG5MG 5MG pain Route PO PO PO Prescriber signature Print your name Contact E Robinson E Robinson 821 Sign RF GA KL Date Medicine (print generic name) 8/7/21 ORDINE (MORPHINE) Date 917 97 97 10171017 10171017 10171017 10171017 Route Dose Hourly frequency Max PRN dose/24 hrs PO 20-40MG Time 14:35 17:15 20:00 22:00 07:15 07:50 10
3016:30 21:00 22:15 PRN Indication Pharmacy Dose 40 20 40 40 40 40 40 40 40 40 40 PAIN Route po po pol pol polpo po po po po po Prescriber signature Print your name Contact er rt pl jiwmdra ef E Robinson E ROBINSON kw pj sr Sign wd of ww rp kwsn pk bg mn ef kc Date Medicine (print generic name) Date Yes/No days Qty... Duration: Yes/No Dispense? PS / No Continue on discharge? Yes/No Continue on discharge? Yes / No days Qty es/No Dispense? Duration: