Forgetting to chart prn narcotics or other prn meds

Yes to all four.

My hospital recently switched to a system called PPID(positive patient identification). It's quite simple. Every med is barcoded. You bring a computer to the bedside with your meds, open the pt profile, scan the pt's wrist band(which is also barcoded), scan the med, administer to the pt, and presto you have charted! Each Nurse is tracked with their compliance and unfortunately written up if they don't follow the rules. It has worked out really well preventing med errors. It takes some getting used to, but overall it is a great system. We use the computer for report and can see on our task list that a med isn't charted, so we can call a Nurse on it right there.

I do the narcotic audits on my unit daily, randomly tracking Nurse's and Intensivists to see if they are charting the meds as well as getting witnesses to wastes, etc. I rarely have to write up someone, so my point is the system has improved how we administer and chart meds.