Does block charting during the administration of titrated medications take the place of an order?

Any examples are for illustrative purposes only.

Use of block charting is a documentation option that may be used when rapid titration of medication is necessary in specific, urgent/emergent situations. It is permissible to use block charting to document the multiple dose/rate changes made to an infusion over a period of time and within the parameters of the glossary definition. 

Block charting is defined as a documentation method that can be used when rapid titration of medication is necessary in specific urgent/emergent situations defined in an organization's policy. A single "block"  charting episode does not extend beyond a four-hour time frame. If a patient's urgent/emergent situation extends beyond four hours and block charting is continued, a new charting "block" period must be started.  The following minimum elements must be documented in each block charting episode:

• Time of initiation of the charting block
• Name(s) of medications administered during the block
• Starting rates and ending rates of medications administered during the charting block
• Maximum rate (dose) of medications administered during the charting block
• Time of completion of the charting block
• Physiological parameters evaluated to determine the administration of titratable medications during the charting block

This information was also published in the June 2020 edition of Perspectives.