Medication administration, not following the rules - page 4

Hi, I'm a recent grad with little nursing experience. Graduated in May 2009, worked at a rest home for 4 weeks and a summer camp for 2 weeks. Both places dispensed medications not according to the rules, i.e., pre-packed meds.... Read More

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    Quote from Joyfull77
    This is an interesting thread! I think it depends on the facility. For example, I work in an Assisted Living Facility, and we have to prepare all the meds for all the residents before we go on the floor to administer them. Our building is three stories high with four different wings and there is no way we could push around a med cart and give everyone their meds on time if we didn't prepare them (pre-pour, or prepackage) before hand. In addition to that, I sign out the meds as soon as I prepare them, because there are various people that may be working with the same MAR that I am working with and if I don't sign it out before hand, its assumed that I didn't prepare them or administer them.
    thats weird, do you just have one med cart for all those people? i work in ALF too and we only have two floors. floor one has about 10 residents, floor two has like 28 i think. each floor has its own cart and pca/lpn to give meds. i have never "pre-poured". i take the cart to each room do my triple check against the MAR, put them in a cup, lock my cart, go in the room and give the meds, make sure they swallowed them all, come back out and sign the MAR. repeat.

    im not sure if i am fully understanding this "pre-pour" phenomenon. it seems like an easy way to make more mistakes. i think it would confuse me..

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    There were things I was concerned about. We have a one hour window on each side to give 8am meds, well for 34 resident that aint gonna happen sorry. One of the nurses that oriented me said it perfectly "the expectations are unrealistic". But pre-pouring is a no-nooo!!! So easy to get them mixed up, yes I know you write their names down or what not, but its bad practice. I pass meds to a lot of people and I dont and wont do that. Thats just asking to get fired and putting your license on the line. Yes the real world of nursing is much different from school, but use your judgement to decide what is safe and what is not.
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    No we have have four carts for all of the residents, but two people do the main med pass while there is a third person to also do the med pass and do most of the paperwork. On top of that there are two nurses on duty and another person who is within health services that can pass meds, so communication is really key among all of us when it comes to passing meds. I always make sure to sign the MAR, however, others I work with don't. To be honest, one of the reasons I sign the MAR after each pill is prepared, is so that I can avoid med errors by ensuring that I actually punched that pill. And our meds are prepared in little cups with lids, and each lid has the room number, resident name, and time for the med, on the med cup. It would be great if our building was small enough to push the cart around, but with 3 stories and four wings, one med pass would take us forever.

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