PCAMedications for PCA infusions include: Demerol, Morphine, Nubainand Dilaudid Standard PCA orders or specific orders may be used by the physician. The PCA Syringe Count must be verified by two licensed nurses at initiation, shift change, syringe change, dose change, and transfer of care. At the change of shift, the on-coming and off-going licensed nurses should check the amount left in the syringe and the amount the computer says remains. Document these amounts on the end of shift PCA syringe count form. If the amounts do not match within 3 ml, complete the PCA discrepancy form.
PCA (continued)The maximum amount of medication that is delivered within a4 hour time frame is the 4 hour limitThe time period during which the patient administered dosecannot be activated by the patient is called the Limit Dose Time
PCA (continued)To chart PCA medication shift totals or 4 hour totals as EFFECTIVE: • From PCA screen, touch “Effective” • Option to change the protocol • Enter amount left in syringe, amount or amount wasted • Click on OK and OK at bottomTo chart medication as INEFFECTIVE: • Touch “Ineffective “ • Select the ineffective reason • Enter amount left in syringe, amount used • Click on OK and OK at bottom * Always enter assessment data on PAGE 2 *
PCA (continued)To discontinue the PCA medication: • When the syringe volume is charted as being zero, system will prompt to discontinue the order • Touch the D/C Order Box to change to “Y” • Touch the OK Box and Update the information, and the PCA will be discontinuedTo load a new syringe: • Update default protocol or make necessary changes • When the syringe volume is charted as being zero, the system will prompt you to discontinue* PATIENT MAY NOT LEAVE THE UNIT WHILE ON PCA *
PCA (continued)When there is an order to change medications on a PCA, the nurse willdiscontinue the first medication by documenting the amount receivedand/or amount wasted in the PCA application of CPSI and then selectingthe Y in the final box “DISCONTINUE ORDER”. Once updated, the medication is discontinued and the PCA Medication Selection menu will display. Choose the new medication, verify the protocol, and update. Have another nurse verify the medication and protocol with you before removing from the Pyxis.