Titration Orders for Medications

PUBLISHED: Apr 4, 2017
Relevant to: Hospitals

The Joint Commission (TJC) recently addressed a question about titration orders in a standards FAQ. According to TJC, when titration orders are allowed by the organization, there are specific elements that must be included in the titration order:

  • Medication name
  • Medication route
  • Initial or starting rate of infusion (dose/min)
  • Incremental units the rate can be increased or decreased
  • Frequency for incremental doses (how often dose(rate) can be increased or decreased
  • Maximum rate (dose) of infusion
  • Objective clinical endpoint (RASS score, CAM score, etc.)

The Joint Commission suggests that the following goals for the safe administration of medication be considered when titrating medications:

  • Maintaining compliance with manufacturer’s Instructions For Use (IFU) for safe administration
  • Having polices that ensure consistent administration practices among nurses and other practitioners
  • Having a clear goal for patient response and ensure that the goal is achieved/sustained
  • Ensuring that orders are written in a way that does not conflict with a nurses scope of practice, i.e., orders shall not place nursing in a position of making dosing/administration decisions
  • Ensure that medication administration documentation reflects order changes, patient assessments, and achievement/sustained goals

Joint Commission requirements for titrating medications are located at standard MM.04.01.01. Included with today’s notice is an example policy related to titrating medications. Organization should also check state law and state pharmacy and/or nursing board practice guidelines for any additional requirements related to the titration of medications.

Want to read the full alert and receive alert emails?

Browse Additional Alerts