vanc troughs... (original) (raw)

So this morning I had a patient who had 1gm vanc due at 0500. It was 0530 and I called lab asking if they drew the trough level, and the lab tech told me they did. So I waited. They called back and said they missed the draw :banghead:, so they sent another tech up to the floor to draw the gold top. Sent down...still no trough level. I called lab again and then they couldn't find the order, so I reordered it ...all they saw was a trough level due for 1630 today. I called our remote pharmacy because our in-house pharmacy isn't available on nights and asked what I should do because it has already been 90 minutes...by now I figured the vancomycin would have to be retimed. The pharmacist told me if I get the trough back soon to still go ahead and hang it, it will be fine. 0700 rolls around and still no trough...so I called our in-house pharmacy since they are now open, and whoever I spoke to (not sure if it was a pharmacist or tech) was real snippy and told me next time not to wait "hours" for a trough level. It was retimed for 0700 this morning, no big deal.

I have had it drilled in my head to look at the trough level before hanging vanc. And I'm thinking if I wasn't diligent and just went ahead and hung the vanc anyway, it could have been potentially harmful because if I didn't hassle lab about it they wouldn't have ever drawn the trough in the first place! So it's not like they could have called me with a potentially too-high result if I had already started it...

Did I do the right thing or did I mess up somewhere? I spoke with my colleagues/charge nurse and said I did everything I could and that they have had issues with getting their troughs in the past and simply had to call pharmacy and have them retime the antibiotics.