PHYSICIAN AND CLINICIAN QUESTIONS
Q – How do I order the device for my patient?
- A – In some venues nurse practitioners and physician assistants may execute orders for
the MOD® device as well as physicians. The preprinted order sheet or CPOE order will
be similar to that of the IV-PCA. You will be asked to specify the drug name, dose,
lockout interval in hours, and when to start the first dose. You can also indicate
additional or “bolus doses” for pain not relieved with a prn dose of medication or prior to
physical therapy, if part of the treatment plan. Extra doses can be ordered in the device
program. Nursing will obtain the filled medication tray from the automated dispensing
cabinet on the unit and program the device according to your order. The patient will be
instructed on how to use the device and should be required to agree to their
responsibilities for the device prior to beginning its use.
Q – Why do you recommend a lower lockout interval in hours than the usual four hour
- A – Similar to the IV-PCA logic, the device allows single, more frequent doses of
medication. For usual dosing it is recommended that the patient be able to access a
dose of medication every two hours if needed. This is in contrast to manual dosing by
nursing which is usually one or two tabs every four hours as needed. By allowing access
more frequently, the patient can avoid the peaks and troughs of medication levels within
the blood stream and achieve a more consistent blood level of medication with better
pain control. For a detailed discussion of this topic, see the Avancen White Paper
entitled “A Better Way to Deliver Oral PRN Pain Medication in Today’s Hospitals” on the
Avancen website under Resources and Healthcare Professionals.
Q – Does the MOD® device deliver medication according to the pain score?
- A – With manual dosing, the amount of medication delivered, i.e., one or two tabs,
usually is determined by the patient-reported pain level. It has been reported when using
this system, that patients may elevate their pain score in order to obtain an adequate
dose of medication. The MOD® device works differently. The patient is notified by a
green light on the device when the lockout interval has passed. The medication will be
available for the patient when the green light illuminates. In order to obtain the
medication, the patient enters a pain score by pressing one of the numeric pain score
buttons on the device. This action activates the Radiofrequency Identification (RFID)
reader inside the device. The patient then holds their registered RFID wristband within
an inch of the front of the device. If the reader recognizes the wristband, the device
dispenser wheel turns to expose a single dose of medication for the patient to remove
and self-administer. Patients are encouraged to enter an honest pain score at the time of
medication delivery since with any score they will be able to obtain a dose of medication.
This allows the patient to manage their own pain when they feel they need the
medication. It puts them in charge of the process and generates high levels of patient
satisfaction with their pain management.
Q – Which patients are eligible to use the device?
- A – An individual hospital’s policy and procedure will describe the criteria for patient
selection. Appropriate patients must be:
- Alert and able to understand how to use the device.Able to demonstrate to the nurse’s satisfaction that they understand how to use the device.
- Without any swallowing problems.
- Have no physical limitations that would prevent them from taking the tab out of the device and self-administering the medication.
- Able to agree to be responsible for the device security and rules of use described by nursing.