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  1. Pasero, Chris MS, RN-BC, FAAN
  2. Manworren, Renee C. B. MS, RN-BC, CNS
  3. McCaffery, Margo MS, RN-BC, FAAN


Patients have the right to adequate and safe pain relief in hospitals, but many continue to experience unrelieved pain. Range orders for the delivery of IV opioids give nurses the flexibility needed to treat patients' pain in a timely manner while allowing for differences in patient response to pain and to analgesia. To ensure safety and effectiveness, and to meet the requirements of accreditation agencies, hospitals should develop prescribing guidelines for IV opioid range orders and clear protocols for their implementation. Range orders should, for example, take into consideration the patient's age, pain intensity, and comorbidities; avoid frequency ranges; and prescribe a maximum dose that is at least two times but no more than four times the minimum dose in the range.