Monitoring the med. pass

Nurses General Nursing

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Every year at about this time the SNF where I work starts to panic. The State survey is just around the corner. Mandatory meetings increase. Everyone checking everything including each nurse's med pass. This year it has been decided that the consultant pharmacist will monitor the med pass.

Our pharmacists are always there for us. Answer any and all questions that we might have, but monitor the med pass!

When has a pharmacist ever done a med. pass? Knowing which drug to give before , with or after a meal. Which meds to crush etc: is not the beginning and end of the med pass. Any suggestion that a nurse should monitor a pharmacist when filling, packaging prescriptions would be considered ludicrous.

Perhaps I am wrong. Would appreciate your opinions.

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Very interesting!!

Never heard it done before. They are spending a lot of money having a pharmacist do this.

We have a computer system...the pharmacist puts in the drug order and automatically it comes up...when to give Rx...with or without food....alerts allergies...alerts drug interaction. -- maybe they should look into that??

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Specializes in MedSurg, LTC.

Our pharmacy came in and monitored portions of our med passes. I thought it was very helpfull practice for the state survey and they gave us a few tips on how to improve our routines. It was more like a fine-tuning than anything else.

But then state came in on the 2-10:30 shift (mine), The day shift clinical manager decided to change some times on narcotic admins that AM and not tell anyone (like me), a nurse called in and was not replaced :( and we didn't get any extra help for the aides. The supervisors even stayed home. So I had to fly thru the med pass, fly thru the txs just like on a "normal" evening but with somebody watching.

Oh, well, got my eval couple days later and I'm pretty much walking on water and so it goes.

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Originally posted by askater11

Very interesting!!

Never heard it done before. They are spending a lot of money having a pharmacist do this.

The pharmacist visits once a month and reviews all charts. The med. pass is an extra job for him. This pharmacist is one of several who work for the company that supply the facility drugs and since this company and our facility are owned by the same people (Is this a conflict of interest?) it costs them exactly nothing!

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The facility where I worked had the pharmacist come in one year to watch the med pass to prep the nurses for state inspection. Because the pharmacist sits in with the other department heads for the quality control meetings once a week and also reviews the MARS for correct transcription (at least at our facility), it was not out of the ordinary having him watch the med pass. Pharmacist are trained to know which meds should not be crushed or given with certain food or juices. They are also trained to know how to administer eye drops, etc. If they can do customer training at the pharmacy desk when a prescription is picked up (Wal-Mart pharmacy always speaks with the customer to review how the med should be taken etc), then they are qualified enough to recognize if the meds are being passed correctly. Plus, they can read MARS and should have copies of the orders as they received them in the pharmacy to compare that the transcription to the MARS match the doctor's orders. Many companies have this overview as provision in their contracts with the facility. Or, the facility can work out a fee for service type payment with the pharmacist to conduct the informal review.

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I worked in LTC for 21 of the 25 years I was in nursing. I have never understood why they wait until it is getting close to survey time to start making sure everything is in order. I have always thought that it would be a lot easier if they made sure that everything was in order all the time. You need to nurse every day just like you would if you expected them 24/7. If each LTC worked like that then they would always be ready and they would not have to rush around trying to get ready when it got close to time for survey.

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Specializes in LTC,Hospice/palliative care,acute care.

Our pharm consultant comes in monthly also..He has only monitored narc count not a med pass..We apparently got cited for not having meds to administer in several instances.At this facilty we nurses must order all meds-each box has a label on it that we must peel off and fax to the pharm after a certain date...So it's all our fault when something is missing? No...we saw that coming and have documented on the back of the MAR every time we notify the pharmacy for a med delivery and did not receive it when promised...Back in the day the pharm techs came at the end of the month and switched the med drawers-fresh stock for the next month...Now they make an even bigger profit on us since we do part of their job for them....And the print on those labels is soooo small....The whole label thing adds long minutes to a big med pass-you have to take the box out of the drawer to check the date on the SIDE OF THE BOX-not on the top....That would be TOO CONVENIENT...Our pharm makes alot of mistakes,too....Wrong med-right label stuff-scary

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Been there KTWlpn. and totally agree with you.

Same with disablednurse. You are right. If things were kept up all year, there wouldn't be a hurried rush when inspection time rolled around.

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