Concept explainer
Medication schedules
Explains how each ordered dose becomes a scheduled task with a due time, and the outcome a nurse records against every dose given or withheld.
A medication order sets out a course of doses over time. When a clinician places that order in Forge, Quest turns each ordered dose into a scheduled task with a due time, and you record what happened to each dose as care is delivered.
From order to schedule
A medication order carries a drug, a dose and how often it is given. Quest reads that schedule and lays out each dose as its own task. Each dose gets a due time on the clock, so the course becomes a row of due tasks rather than one open instruction.
The schedule follows what was ordered. If the catalogue changes later, the doses already scheduled stay as they were placed, because the order holds a snapshot of exactly what was ordered. Read how that snapshot works in medication orders.
The due time
Each dose has a due time, and it sits on the due list of whoever is on shift. A dose due now sits at the top. A dose coming up later sits below, so you see the next few hours of the course at a glance.
If a dose falls due while you are with another patient, it waits on the list until you reach it. The list holds the dose rather than dropping it.
Recording the outcome of a dose
When the moment comes, you record what happened to the dose. There are six outcomes, and each stays in the history. You record the first four at the bedside. Quest records a missed dose when the due time passes with nothing charted, and a dose given in error is recorded when someone corrects an earlier entry.
| Outcome | What it means | What is recorded |
|---|---|---|
| Given | The dose was administered to the patient. | Your name, the time, and the administration detail. |
| Held | A clinical instruction meant the dose was not given, such as a doctor's hold or nil by mouth. | Your name, the time, and the reason for the hold. |
| Refused | The patient declined the dose. | Your name, the time, and the reason recorded for the refusal. |
| Unavailable | The drug had not reached the ward in time, so the dose could not be given. | Your name, the time, and the reason the drug was not to hand. |
| Missed | The due time passed with no outcome recorded. | The dose, its due time, and that it passed without an outcome. |
| Given in error | A dose was charted by mistake and has been corrected. | The original entry, the correction, and who made it. |
Three of those outcomes separate by cause. Held is a clinical decision, refused is the patient's decision, and unavailable means the drug was not on the ward. Missed is the absence of all three. The due time passed and no one recorded anything, so the gap reads as a gap rather than as a decision. The next person on shift sees which of them it was.
Safety at administration
A dose task carries the safety steps the ward already works to. The five rights are verified at administration. A controlled drug requires a witness. A high-alert drug requires a second check before the dose is given.
Each dose names who gave it
Every given dose records the person who administered it and the moment they did. On a shared ward workstation, you sign in as yourself, so each administration stays attributed to the person who acted.
How a dose is charged
Medication is charged per dispense, for each strip or vial issued, rather than per dose on the schedule. So the count of scheduled doses and the count of charges read as two separate things. Read how a dispense becomes a charge in how a charge is created.
Common questions
Does a missed dose disappear from the record?
A missed dose stays in the history with its due time. The gap is visible to the next person on shift and to anyone reading the course afterwards.
What is the difference between held and missed?
Held is a decision. A clinical instruction said the dose was not to be given, and the reason sits with it. Missed is the absence of a decision. The due time passed and no one recorded an outcome. Both stay in the history.
What do I record when a patient refuses a dose?
Record the dose as refused, with the reason. A refusal is the patient's decision and stays in the history as one, separate from a hold made on a clinical instruction.
Does changing the catalogue change a scheduled dose?
The doses already scheduled hold the snapshot of what was ordered. A later catalogue change leaves them as they were placed.
Read how to work through the doses due to you in your due list.