[Mandee]

We have a comfort kit but would like to maybe change it some, so I was wondering what other hospices have in your comfort kits, I have heard of different kits for different diagnosis, ie: specific kits for COPD and a different kit for Ca patients. Thanks!

Mandee

[Severina]

We are with Hospice Pharmacia and they have 2 kits, a general comfort pack and a seizure kit.
The comfort pack has the following:
6 ABHR suppositories (ativan, benadryl, haldol, reglan)
6 650mg Tylenol suppositories
15 ml Haldol liquid 2mg/ml
10 Levsin tabs
10 1mg Ativan tabs
15ml Roxanol 20mg/ml
6 10mg Compazine tabs
6 25mg Compazine suppositories

Seizure Kit
5 2mg Ativan suppositories
3 Dilantin 200mg suppositories
3 Dilantin 400mg suppositories

I've never really examined these kits closely since I work in the residence so this is a good exercise for me.

Severina

[momcats3]

We also use Hospice Pharmacia, and they've added a Cardiac Comfort kit..Unfortunately, I'm not sure what meds are in it (I left my MUGS book @ work..)

[DMB FAN2]

We also use Hospice Pharmacia- The Cardiac ComfortPak has:
ABHR (ativan, benadryl,haldol, reglan) supps, APAP supp, haldol liq., hyoscyamine tabs, ativan tabs, MS liquid, prochlorperazine tabs and supps, lasix tabs and injectible, nitroglycerin sublingual, ASA tabs, and MS injectable-

I hope that helps!! If you need the doses- I will post them too!!

[Mandee]

Originally Posted by DMB FAN2

We also use Hospice Pharmacia- The Cardiac ComfortPak has:
ABHR (ativan, benadryl,haldol, reglan) supps, APAP supp, haldol liq., hyoscyamine tabs, ativan tabs, MS liquid, prochlorperazine tabs and supps, lasix tabs and injectible, nitroglycerin sublingual, ASA tabs, and MS injectable-

I hope that helps!! If you need the doses- I will post them too!!

Thanks for the input!

Mandee

[stbernardclub]

and also scapolomine gel is included in ours.

[rockchalk_jayhawk]

We do not currently have "comfort pacs", but we want them. What are your protocols? Our pharmacies are willing to make them up for us and want to know about CII accountability and monitoring? If drugs are not used prior to patient expiring or dismissal or drug expiration, how are drugs disposed of? Is there any in home drug accountability? Do you as the nurse using the med, sign out for it?

Completely sort of unrelated issue.... What are your Hospices standing orders and would you mind sharing them?

Thanks... Peajay

[Severina]

Originally Posted by rockchalk_jayhawk

We do not currently have "comfort pacs", but we want them. What are your protocols? Our pharmacies are willing to make them up for us and want to know about CII accountability and monitoring? If drugs are not used prior to patient expiring or dismissal or drug expiration, how are drugs disposed of? Is there any in home drug accountability? Do you as the nurse using the med, sign out for it?

Completely sort of unrelated issue.... What are your Hospices standing orders and would you mind sharing them?

Thanks... Peajay

The drug disposal thing is a weighty issue for us working in a residence/facility. This is with respect to narcs. Other meds are just logged on a sheet and sent back to pharmacy, if thats where they came from, or just disposed of, if they came from home. With narcs, the state law says that after someone dies we have to dispose of them that day. Our policy is to put them into a locked cabinet and then two nurses (the charge nurse and staff nurse) dispose of them on the midnight shift. The thing is, we have continual problems with miscommunication leading to pharmacy not getting us meds on time for when patients need them. This leads us to "borrowing", signing out meds as "wasted", from one patient for another; or, hoarding certain narcs from deceased patients that take a long time to get here, or which we are continually short. A lot of nurses have a problem with the drug disposal law because it leads to so much waste. It seems that pharmacy either sends us too little of something, or too much. It seems terrible to destroy 60 or so DRA gel packets when they have to be compounded by HP and take 2-3 days to get here. We know that we could get a new patient, or one of our patients could develop sudden intractable N/V which would be greatly helped by starting this med right away.

As for standing orders, we have a whole lot of them. We have several standing orders for almost any symptom that presents itself. The ones that we institute most often are: Roxanal, compazine, ducolax suppositories, haldol, ativan (which leads to much controversy between the nurses and the medical director), atropine, scopalamine patches, Morphine inj., and procedures such as, wound care and foley catheters (also leading to controversy).

Severina

[angieRN]

We have an "ER" kit which includes:
3 cc Roxanol
3 cc Haldol
phenergan tabs
levsin tabs
ativan tabs
compazine supp
tylenol supp
When the patient dies, all meds are destroyed in home and witnessed by someone whether it be other staff or family. We document all this on the discharge summary.