Scan medications in the ER using Meditech and T-system

We do. And in my opinion its just plain silly. It takes more time and our scanners don't work half the time. Often with critical care patients we just use the meds and ignore Meditech, just state in our T notes that it was an emergent situation and so no scanning. I've gotten flak from ICU RNs then about the need to scan all meds but my argument is "Hey, you can read and hear right? I just told you what I gave and when in report and its written in the notes so deal with it." When its crazy busy you can't go to your charge and say, "Oh, I didn't give that pt meds for over an hour because I was having Meditech scanning problems." To me at at least, its double documentation.

D

love t-system
hate meditech
dont scan meds in the er.

worked at a place that used e-mar on the floors and icu
none of us wanted it in the er. especially because the hospitals policy had something to do with pharmacy entering all the meds in to the computer- would be a HUGE delay in that er setting.
floated to the icu several times and had to use e-mar.
told my er manager if we ever went to that system i would quit.
it still has not been implemented. THANK GOD

we're starting next month.... grrrrrr.... what a stupid concept in the ER. Time, equipment error/malfunction, dead batteries... it's bad enough with the IV pumps, or lattice for printing lab labels, defibrillators, and anything else that we have to use that is electronic... geez!! It's hard enough to find a moment to pee at work, just to add on something to take up more time.

AND, we're supposed to scan all ER orders to the pharmacy BEFORE pulling the meds... yeah, right. I might if I am not giving the meds right then, but most of the time it's just a step in my way of getting to that med. It's all about being efficient and adding another electronic thing in the ER is beyond ridiculous. THe only people that might endorse this are the manufacturers of whichever system they are using, and non clinical people. Oh and perhaps people that work on the floor.

I will post back in a month or so to update on how it is actually going. I don't expect much - but positive or negative, I'll post back what my own experiences are...

Did some agency time at an ER that had similar problems and they created a "code-box" with RSI/ACLS meds, and a "cardiac box" with heparin, nitro, asa, etc etc...might help in your situation as well.

We have been resisting the scanning system but all the hardware is in place. We also use Tsystem's but have Pyxis as our med system...all of our meds are overrides which is nice, can pull out any med on any pt at any time...

all I've ever used is Pyxis - can't imagine not being able to over ride for those meds you need right then... Benadryl, Solu Medrol, Ativan, Haldol, Cardizem, Dig, etc.... You must have access - I can see scanning to the pharmacy for proper accountability - but that shouldn't interfere with life saving interventions.

At one place I worked, I counted what I considered X5 documentation for a med..

1) scanning in Emar

2) nurses notes (written)

3) signing off on the ER orders

4) signing off on the CP pathway sheet

5) signing off on the admit orders (as "first dose given in ER")

All for a dang aspirin....gah! Ironically, it took as long to scan it as it did to write it in the four other places. Total madness.