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Figure 6-3.DOD Prescription form
FILLING PRESCRIPTIONS

Hospital Corpsman Revised Edition - Complete Navy Nursing manual for hospital training purposes
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SIGNA.—The signa, not to be confused with the prescriber’s signature, is the part of the prescription that gives the directions for the patient. This portion is preceded by the abbreviation “Sig.” Prescriber Signature Block Finally, the prescriber signature block, located at the bottom of the form, must contain a legible signature of the prescriber, as well as the prescriber’s full name, rank, corps, and service, stamped, typed, or handprinted. Mimeographed, preprinted, or rubber-stamped prescriptions may be used, but signatures must be original and in the handwriting of the prescriber. Facsimiles are not acceptable. AUTHORIZED PRESCRIBERS According to the MANMED, the following persons are authorized to write prescriptions:  Medical and Dental Corps Officers  Medical Service Corps optometrists, physician assistants, and podiatrists  Civilian physicians employed by the Navy  Independent duty Hospital Corpsmen  Nurse practitioners (may prescribe when authorized in writing by the commanding officer)  Nurse anesthetists and midwives (may prescribe within the scope of their practice when authorized in writing by the CO or delegated representative) Prescriptions written by civilian prescribers, other than those employed by the Navy, may be filled for authorized beneficiaries, provided the prescribed item is on the medical facility’s formulary (a published listing of medications) and the prescribed quantity is within limitations established by the command. With the exception of the polyprescription, prescriptions are limited to one item per prescription. The quantity of the drug prescribed should be a reasonable amount needed by the patient. Excessive or unrealistic quantities should not be prescribed. Erasures on prescriptions are prohibited, and interlineations (information inserted between lines of writing) must be initialed. 6-22 Figure 6-4.—Polyprescription form.







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