Dream Factory by TruBridge Ideas Portal
On the MAR to document IV rate change-the only option now is "Titrate"-this is incorrect just to document a rate change. It would require an order from a provider that is a nursing order-not necessary to "Modify" the IV order because this enters a new order and looks as though an additional IV is being hung. All of the IV documentation is in one place just like all med administrations.
Please tell me this is urgent???
I am writing to urgently address a significant issue that could result in insurance fraud, which I believe has been a known ongoing issue since at least 2022. I am concerned that no changes have been made to resolve this matter despite its severity.
Situation:
When Normal Saline is administered at 100mL/hr and the provider subsequently orders it to be reduced to 50mL/hr, there is no way to document this change accurately using the titration option. Titrating would not reflect the provider’s actual order and could lead to medication errors when the next nurse reverts the infusion back to the original rate of 100mL/hr. Consequently, we are forced to navigate to Order Chronology > Modify, which discontinues the old order and enters a new one. However, when the new order is charted, it causes the medication to be charged again for a bag that has already been billed. This is clearly an issue of duplicate billing and constitutes insurance fraud.
Proposed Solution:
To resolve this, I recommend adding an option within the medication charting system. When the nurse clicks into the medication to chart (without scanning the bag, since it is already hanging), an "Action" section should include an option labeled “Continue Bag Hanging.” When this option is selected, it would trigger a "no charge" condition, thus preventing the second charge for the same bag.
I have attached a visual reference for your review.
I strongly urge that this issue be escalated to the appropriate change-makers for urgent resolution, as the implications of this situation are serious. Please confirm receipt of this message and provide an update on the next steps.
Thank you for your attention to this matter. I look forward to your prompt response.