med pass observation

[nursenel]

Our facility uses the Education nurse to do med pass audits. The way it is set up is that the med nurse is observed and mistakes are writen in a Plan of Action format. Any nurse who gets the plan of action, must be observed for the second time. If there any furthur mistakes, the nurse is writen up. CAN YOU TELL ME HOW YOUR FACILITY HANDLES MED PASS OBSERVATIONS AND DO YOU THINK IT'S A FAIR WAY TO HANDLE IT? Yes, we also have the pharm come in and do an observation. But the Education nurses' observation is ONGOING and on all three shifts. { this has been going on for about a year now } Thanks for any feed back you can give me!!!!!

[duckie]

This is done by many facilities because the state surveyers are very strict and they want to find any problems before "the real survey." Our facility does this too and I find it very valuable. It is a learning tool for new nurses and it helps them get used to being followed so they don't panic when state is there. Just learn it the right way and make it a practice and you won't have any problems. Have a great day!

[night owl]

WOW!

I'm glad my facility is run by the Federal government and they don't do any observations of the sort that I know of...Sounds like it's a good practice to keep everyone one their toes. The only thing that observes us is that computer. It tells you if it's the wrong med, it asks you if it's the right pt., it wants to know how much Lactulose you gave the pt. even though it told you to give 30cc, you still have to enter 30cc given. Then when you're all through, you printout a list of missed medications, and it tells you what drugs you didn't give to what pt that was due at that time, and it tells you if you did his TX's or not...Modern technology....SHEESE! If any of it wasn't entered, it's considered not given or not done. Med error...Then you're dead! It automatically shoots you right between the eyes...Just kidding:D

[Tim-GNP]

I agree with the concept, but not the way it is handled by your facility.

The entire thing should be VERY positive and educational. The entire thing should be a reciporcal learning experience. The individual being observed should learn about lapses in technique and identify ways to prevent them, and the observer should learn about the problems that can be encountered during a med pass, and brainstorm ways with staff to avoid them.

The unfortunate thing is that most LTC facilities hire an RN to do education; yet, they have little if any preparation in education.

[Tim-GNP]

I agree with the concept, but not the way it is handled by your facility.

The entire thing should be VERY positive and educational. The entire thing should be a reciporcal learning experience. The individual being observed should learn about lapses in technique and identify ways to prevent them, and the observer should learn about the problems that can be encountered during a med pass, and brainstorm ways with staff to avoid them.

The unfortunate thing is that most LTC facilities hire an RN to do education; yet, they have little if any preparation in education.

[catlady, BSN, RN]

As a former staff development coordinator and nursing instructor, I am distressed by your description. It is very important that the supervisory/disciplinary process and the educational process be kept separate. If your nurses see the "education nurse" coming for medication audits and are afraid of what she might do to them and their careers, their learning curve when she approaches them as an educator will be nonexistent. By all means, let her observe the med pass, using the stringent criteria your facility wants the nurses to meet. But for pity's sake, don't write them up. They're nervous, and they're human, and they need to be educated. The need for education should, however, be documented, as well as the response to education.

[nursenel]

Thanks so much for your views!!! I thought I was the only on distressed by the way this is handled.

I certainly believe that due to the nature of human errors, that this should be dealt with in a much more positive manner. The write up serves what purpose? I am not an ignorant person and I know I do not go out of my to get into difficulties on my job. However the way my facility handles this, the difficulties seem to be following me. { the absolute worse part of this is that the education person could not do a pass with someone standing over her.......I don't mind being instructedby a peer, but please be able to do it yourself!!!!!}

Again, thanks...I will try my best to bring changes in the way this is handled....WISH ME LUCK!!!!!!!

[MassLPN]

I've worked in a lot of LTC facilities, and most use similar systems, short of the disciplinary action (unless, of course, a nurse is observed making an error repeatedly that causes harm, or has the potential/ or the nurse is not getting the hang of the education).

Since I "do agency" I've been followed by a lot of SDC nurses and several different pharmacies. The SDC nurses seem to do it differently, as if they are, in fact, looking to punish. I find the pharmacy auditors to be very valuable learning tools! Instead of getting nervous and blowing the whole deal, I always ask questions about what's right and wrong, etc, and they've never hesitated to answer. So, when it came time for state surveys (and trust me, they head for the pool nurses first), I'm always confident, and have always gotten 100% accuracy.

Hopefully your SDC can learn from the pharmacy auditors, and you can too (take advantage of them, even if the SDC is a pain in the butt!! )

[ktwlpn, LPN]

Other then the 5 rights of med admin and infection control issues what have you found to be the focus of the surveyors? Our staff develpoment person can barely keep up with her duties-no-one does a med pass observation on us...Thru the yrs I have worked in LTC I have only been observed once by a surveyor-Lucky I guess...

[Nurse Jenni]

Wow! Since I've changed jobs I hadn't realized that my new facility doesn't use observation. I've only been here 5 months, bt I've only ever heard of Pharmacy coming in to Audit. They control everything from the obvious of ordering and filing 'scripts to where we put eye drops in the cart! And if they're not right we get written up. I've only ever 'cleaned up' a cart there once, won't happen again I don't care how cluttered it is. Being on 3-11 we avoid the headache of audit and restock!