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Draft first-dose response requirements

Ambulatory Safety Monitor, February 16, 2006

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JCAHO standard M.M.6.10 requires that your ambulatory facility have a process for monitoring patients' responses to first doses of medications that are new to them when they are under direct care of the organization.

Draft a first-dose policy that includes the following requirements:

• The patient is monitored for the effects of the medications administered to them and prescribed with particular attention to medications that are new to the patient. This monitoring may include
  
  • educating patients about side effects and adverse reactions.
  • teaching patients what to do if they experience side effects.
  • asking patient perception of side effects and efficacy during the visit and at follow-up visits as appropriate.
  • reviewing information in the patient's medical record, relevant lab data, clinical response, and medication profile.
• Information about drug monitoring is available in the database.
• Following injections of antibiotics, allergy shots, and other medication as necessary, the patient will wait in the clinic for 30 minutes.
• Following injections of epinephrine and Valium, the patient will remain in the clinic until deemed stable by the physician.

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