Dual Signatures Required for High-Risk Medication Rate Changes

For All Inpatient Nurses
Dual Signatures Required for High-Risk Medication Rate Changes

As a reminder, dual signatures are required for rate changes on select high-risk IV medications and dosage levels to ensure patient safety. This is for administration of drug therapies, regardless of pump integration.

Epic will prompt a dual signature before accepting the change (see screenshot below) when a rate change for identified medications is entered.

Identified medications include:

• Anticoagulants, IV: argatroban, bivalirudin, heparin

• Antithrombotic agents: alteplase (except for catheter clearance)

• Benzodiazepines, IV: lorazepam, midazolam

• Concentrated electrolytes: magnesium doses of 4 grams or more

• Epidural and PCA pain management: fentanyl, HYDROmorPHONE, morphine

• HYPERtonic solutions: sodium chloride with concentrations greater than 0.9%

• Neuromuscular blocking agents infusions: cisatracurium, nimbex, rocuronium

• Prostacyclin, IV: epoprostenol (Flolan®) / (Veletri®); treprostinil (Remodulin®)

For more information, please refer to High Risk Medication guidelines in Policy Tech.