Fentanyl patch & witnessing - page 3

by gtmoore | 10,404 Views | 24 Comments

Hello My facility does not require a 2nd RN to sign off when a fentanyl patch is removed and wasted. An RN today was surprised that this was the case and said everywhere she has worked, the removal of the patch needed to be... Read More


  1. 0
    Quote from elkpark

    Like you, the DEA prefers the "cut 'n flush" method of disposal, as I noted, but the DEA official I spoke to did say that the water authorities in some communities object to this -- because of the fentanyl going into the water supply, not because of the "pieces of plastic" -- and, if that is the case for a particular hospital, then it is also acceptable to store the used patches in an "inaccessible" locked container to await incineration.
    I realize you have all the experience in this area but it just sounds crazy. When flushing fentanyl does it not become so diluted that it is inert? Why on earth would any water authority not want fentanyl to mix with raw sewage?
  2. 0
    Are you sure about the DEA's preference for disposing of patches? That's why we have the med waste boxes, because of the DEA and OSHA.
  3. 0
    Our last JCAHO survey(2005) the "correct" answer to the disposal of a fentanyl patch was to flush it. We don't have to witness a disposal.
  4. 0
    It has come to the attention of NYS that people are hoarding the used patches and in conjunction, taking the "leftovers". Ew. Our facility has strict rules on placing and removal, we must check for placement every shift, and witness the disposal. We put it right in the sharps, as this is a locked unit that is destroyed. We dont put it in a seperate container, as anyone could walk away with that container, and consider it yummy.
    Any normal way of disposing of a narcotic drug is acceptable, we just opted for the sharps. And the patches must be written on when you place them, so you dont put an old one on, say its new and take a walk.
    And this is all written into the policy. I think thats why there are differences, it depends on your policy. Flushing, tossing, cutting... all policy issues. I dont believe there is a mandate on how it is destroyed/disposed of, so long as it is.
    Hope this helps.
  5. 0
    Quote from gtmoore
    My facility does not require a 2nd RN to sign off when a fentanyl patch is removed and wasted. An RN today was surprised that this was the case and said everywhere she has worked, the removal of the patch needed to be witnessed. What are other facilities policies on this?
    I'm an LVN at a large long term care facility. I am permitted to remove and waste used Fentanyl pain patches without another nurse having to witness the act. Usually I just throw the used patches in the regular wastebasket with the rest of the garbage.

    When applying a new Fentanyl patch to someone's chest wall, I always sign and date the patch.


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