PCCU Order Writing Standards
General Principles

Date and time on ALL orders

Use generic drug names only.

Orders that do not meet these standards will not be implemented. The nurse, in
consultation with the pharmacist if required, will contact the prescriber for further orders.
Admission/transfer Orders

On admission to PCCU, all previous orders are automatically discontinued.

Transfer orders will be used only after transfer from the PCCU.
Abbreviations

Drug names must be written in full, do not use abbreviations for drug names. (Examples:
levo, MSO4, MgSO4, HCTZ).

Write “once daily” or “q24h instead of QD or OD.

Write out the word microgram or use mcg, do not use g.

Write out the word unit, the letter U has been misinterpreted as a 0, resulting in a 10-fold
overdose.
Dosing

Write the patients weight on each order

Include the intended dose per kilogram on each order.

Specify dose (in mg or microgram, units etc.) not volume when ordering medications.
Exceptions are

Co-trimoxazole (trimethoprim/sulfamethoxazole), racemic epinephrine and lactulose.

Always place a zero in front of a decimal point (e.g. .2mg should be 0.2 mg) and never
place a decimal and a zero after a whole number (e.g. 4.0 mg should be 4 mg).
Electrolytes
In addition to the above, all orders for parenteral electrolytes must include:

volume and type of diluent

rate or duration for infusion

Order magnesium in grams or mg of magnesium sulfate

Order calcium in grams or mg of calcium gluconate or calcium chloride

Order potassium phosphate as mmol of phosphate and mmol of potassium.
Continuous Infusions of Medications
All orders for medications to be given by continuous infusion must include:

patient’s weight

amount of drug (in mg, microgram, units etc, NOT mL)

type of diluent

total volume of infusion solution

starting dose (not IV rate)

IF order includes the provision for titration, specific parameters and a maximum dose
must be given.
Example: Wt = 30 kg, add 90 mg of dopamine to a total volume of 50 mL NS, run at 5
microgram/kg/min, titrate to keep MAP greater than 70 mmHg. Maximum 20 mcg/kg/min.
Jordan Closs, Pharmacist
McMaster Children’s Hospital
July 2013