Following the P and P.

[ohbet]

Facilities have policy and procedures in place to guide our practice..

The P and P regarding Med pass I try follow religiously,I dont like making med errors,even though an error may not be harmful to the patient. Consequently Im slow getting my meds out and dont get to other things as quickly as others. Other nurses , complain that Im slow and ask whats taking me so long? I respond with "Im following the facilities Policy and Procedures". After Ive said that some nurses look at me as if Im from another planet.

So whats up with this? I thought the P and P is important ,a standard to guide nurses practice. Am I taking it to seriously? Am I being anal retentive? If a patient will not be harmed by not following the P and P should I just find a faster way of doing things?

Its interesting to note that when the inspectors are at the hospital,all nurses are slow getting meds out,why is that?

[CATHYW]

This is what you need to do:

Keep in mind the 5 rights: right med, right dose, right time, right patient, right mode of administration. No hospital P & P is going to encompass more than that. If it does, you just need to focus on the 5 rights, PLUS whether someone is allergic or not.

You don't state if you are a new nurse or not, but it sounds like you might be. Keep a Nurse's Drug Handbook on your Med cart, and if you have any questions about compatability or interactions, try to look them up-WITHOUT consuming too much time. If you are really unfamiliar with meds, make a list of the ones most commonly used on your unit (regular and PRN's) and use your handy little reference book at home one weekend to become more familiar with what you are administering.

When you are looking at the MAR (medication administration record), be sure you have the right room & the right patient name on it. Be sure you do not give a one-time only or D/C'd med. Otherwise, get your med cup out & write the name & bed number on it, open the med drawer, and put the little unit-dose packets in the med cup. If you use a tray, do each patient on your team the same way. Then, carrying your little tray, pass the meds, opening the meds at the bedside, and being sure that the patient swallows and does not "cheek" the meds. NEVER leave meds for patients to take by themselves. If they are in the bathroom, come back to them.

If you are using a med cart, do the same little med cup process, and do both patients at one time. That way you only have to go into the room once.

Also, check your MAR at the beginning of your shift and periodically through the day. If there are IVPB's that need to be obtained from Pharmacy, or mixed on the Unit, or need to be removed from refrigeration to warm up a little, be sure to do it so they will be ready to hang at the appropriate time.

By all means, if you have questions, ask another nurse, or call Pharmacy. If you do all of these things, you can just about forget the P & P book. Of course, if you have an odd med to administer, or an unusual protocol, it is always best to check the book, to be sure.

Good luck on being a more productive, accurate, med-passer! (-;

[ohbet]

Thats my problem,I do follow the 5 rights,thats why Im slow. And we have a P and P that encompasses more than those 5 rights

[BadBird, BSN, RN]

when you say too slow remember you usually have 1 hr before and after ordered to be considered timely. How many patients are you taking care of. If you have 6 patients it is workable, if you have 18 then nothing will be done on time. Always do the 5 rights and if it bothers other nurses tell them feel free to help.

Good luck

[Cindy_A]

I say keep doing what you're doing, eventually, you will get faster. I am a slow med passer too, but this is LTC and passing meds to around 30 pts. I'd rather be slow and right than fast and wrong!!

[Stargazer]

ohbet, as someone who writes clinical protocols and P&P's, first of all let me congratulate you on 1) actually knowing what the P&P says, and 2) following it. Too many of our nurses and docs wouldn't know the proper P&P for any daily task even if they tripped over it. And wouldn't care if they weren't following it.

That said, it is HARD to write a P&P that is clear, concise, and says exactly what it means to say and no more. Do you have a Shared Governance committe that reviews P&Ps, and have they looked at the med pass one lately? Have you asked the other nurses why they don't follow it? Are they just lazy or careless, or do they find the P&P hard to follow, or calling for additional unnecessary steps?

It's worth investigating. If there's ever a bad outcome, you can bet one of the first things asked in a lawsuit will be, "Was the nurse following the institution's documented policy and procedure?" An answer of "No, 'cause nobody ever does" or "No, 'cause I didn't know there was a P&P" or "No, 'cause it's badly written and out of date and doesn't make sense" by the employee could signal BIG liability for the institution.

[ohbet]

Thanks guys for the supportive replies,now I feel its not just me.

Stargazer, we dont have a Shared Government committe to review the P and P,I think the PandP gets reviewed only after an event occurs.

[teeituptom, BSN, RN]

Howdy Yall

from deep in the heart of texass

No matter what keep abiding by following your P and P religiously and to the letter. It protects the patient and it protects you as long as you adhere to it unfailingly.

keep it in the short grass yall

teeituptom