House Staff Manual - Winthrop University Hospital

PRESCRIBING DRUGSPrescriptions may only be written by House Staff, attending physicians, dentists, podiatrists and otherauthorized practitioners licensed to practice in the State of New York. Any prescription written by amedical student must be immediately countersigned by a physician. The signature as well as the body ofthe prescription must be legible using only approved abbreviations and must have specific instructions (useof ranges is prohibited, i.e., every 2-4 hours). Physician Assistant in-patient orders need to be countersignedwithin 24 hours.1. Inpatient Prescriptions: All orders for drugs for an inpatient must be made in the patient's chart. Thefollowing information is required:-Name of drug (generic name preferred)-Strength-Directions for use-Signature of prescriber-Date and time of day2. Controlled Substances: Part 80 regulations of the New York State Department of Health regardingcontrolled substances limits the prescribing of such substances to the usual course of the physician'sprofessional practice, acting only within the scope of his or her employment in the institution.Part 80.22 of the same code requires that the institution shall operate a system to disclose to the Departmentof Health any suspicious orders, i.e., forged prescriptions, unusual frequency, unusual quantities.At Winthrop-University Hospital the prescribing of any drug by a resident shall be within the scopeof his or her duties as a member of the house staff. This does not include prescriptions for relativesor friends, or for employees of the hospital who are not seen in your supervised practice.Prescribing is thus limited to inpatients, emergency room patients, and ambulatory patients seen as part ofsupervised training. The resident’s name and degree must be stamped on the prescription pad in keepingwith New York State laws.In accordance with the laws of the United States Department of Justice, all members of the House Staffshall be assigned an identification number to be used when prescribing medications to an outpatient thatare in schedules II, III, IV, or V of the Controlled Substances Act.All members of the House Staff are assigned an identification number by the Pharmacy duringOrientation.Inpatient prescriptions for controlled substances shall be written on the patient's chart and do notrequire the assigned identification number.Outpatient prescriptions for controlled substances shall include the patient's name, address, age;the name of the drug, strength, amount, and definite dosage regime ("as directed" is not to beused); the date, prescribing doctor’s signature, and full name clearly printed, Winthrop-UniversityHospital's DEA number, and the prescribing doctor's identification number.If a House Staff member has received a DEA number privately from the government, he or she isto forego its use while employed by Winthrop-University Hospital, and use the Winthrop-University Hospital assigned identification number. Upon completion of service at WinthropUniversity Hospital the House Staff member's identification number shall become void.WUH DEA numbers and institution specific identifiers are not to be used when moonlighting.3. Total Parenteral Nutrition: To order total parenteral nutrition (TPN), the prescribing physician forcentral or peripheral venous nutrition must complete the pharmacy Parenteral Nutrition Order Form.Rev. 1/08