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medication strip packs



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Jul 02, 2009 01:49 PM

medication strip packs


I work in LTC. Our meds come weekly from pharmacy in a strip pack (little plastic baggy with all 0800 meds in one bag and then all 1200 in another etc).
So for eg. 0800 bag would have Digoxin, calcium, metoprolol
1200 bag would have calcium
1600 bag would have coumadin, alprazolam
these are just a made up example.

My question is what system do you use in LTC?


ALSO, when our strip packs come in, they make 2 RN's check them. So we go through the MAR and compare the MAR to the actual strip pack to verify that the strip packs are correct, we do this for each resident before we put the strip packs in the med cart. Of course meds are checked by the person giving them at the time-obviously.

This is the only LTC facility I worked in that does that. I think it's unnecessary.
What do you think?

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15 Comments
No. 1
from kcochrane
Old Jul 02, 2009, 02:36 PM

Default Re: medication strip packs
We have med carts that are stocked by pharmacy every Wed. Each resident has their own drawer (or drawers if needed), with stock items (tylenol, colace, etc) having their own little drawers. I've never hear it done the way your described, but it seems like a lot of work intially - not so much for the person passing meds.
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No. 2
from ajaxgirl
Old Jul 02, 2009, 02:57 PM

Default Re: medication strip packs
Pharmacy prepares these strip packs. The nurse giving meds still needs to do her 3 checks though. I find this very redundant-the checking beforehand.
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No. 3
from PAERRN20
Old Jul 02, 2009, 03:38 PM

Default Re: medication strip packs
I don't see any problem with 2 RN's checking the meds and then of course the final check before actually giving the med. Wouldn't you want the nurse to check your meds throughly, even if it meant a "very redundant" extra check? As we all know, the pharmacy makes mistakes too.

I'm not trying to be mean or harsh, but that's how I feel.
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No. 4
from ajaxgirl
Old Jul 02, 2009, 03:47 PM

Default Re: medication strip packs
Originally Posted by PAERRN20 View Post
I don't see any problem with 2 RN's checking the meds and then of course the final check before actually giving the med. Wouldn't you want the nurse to check your meds throughly, even if it meant a "very redundant" extra check? As we all know, the pharmacy makes mistakes too.

I'm not trying to be mean or harsh, but that's how I feel.
OK
I have worked for 3 LTC facilities and they all had strip packs but we never did this step. It can't hurt. It is just a bit foreign to me -I guess.
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No. 5
from Cynop
Old Jul 02, 2009, 06:28 PM

Default Re: medication strip packs
I have never heard of or seen either of the two systems mentioned above - the strip packs and the little drawers are totally foreign to me.

We get our meds in the bubble packs. They are placed into the cart, divided by pt. room. They are almost always all mixed up in a big jumble...not separated by med time or anything like that.

Sometimes I try to organize the meds by time but it never works out because of the BIDs and TIDs...the next shift pulls everything out of order during their med passes.

All the stock meds are kept in bottles in the top drawer of the cart.

Honestly, I do think it's a bit unnecesary for two RNs to verify the strip packs, unless the nurse giving the meds was just going to give them without doing her own three checks.
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No. 6
from CapeCodMermaid
Old Jul 02, 2009, 09:25 PM

Default Re: medication strip packs
We use blister packs. One for each medication. When I passed meds I tried to arrange them in the drawer in the order they were written on the MAR since it saved so much time. Apparently no one else saw the wisdom in that since the meds were always in a jumble the next morning. I did see at an AL meds packed in individual bags...all the 8ams in one little bag, the 12s in one. It looked like a great idea but the chance for a mistake on the pharmacy's part seemed high.
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No. 7
from levisandtees
Old Jul 03, 2009, 08:11 PM

Default Re: medication strip packs
I have only worked at one facility that did this; actually utilized CNAs to assist with putting meds in the correct order per MAR (by patient with different sections for AM, NOON, PM, HS, NOC). At my current facility everyone dreads refill day because pharmacy stocks the drawers and they are never in order by name, time, etc. and med pass takes much longer (they inevitably forget a container and we're running to contingency throughout med pass, putting meds in order, calling pharmacy with corrections, trading meds between halls because even though a resident switched rooms a month ago they're still being stocked in the other cart, etc.). Maybe the dual nurse check is overkill for normal meds (not a bad idea for narcs) but I would definitely appreciate it if they were in some semblance of order at the start of shift.
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No. 8
from NurseKatie08
Old Jul 04, 2009, 12:43 AM

Default Re: medication strip packs
My facility uses bubble cards as well--two nurses to sign in narcs, but regular meds go into their respective spaces after a card with the pt's room number. This strip system sounds like it could cause a lot of errors.
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No. 9
from bluegeegoo2
Old Jul 05, 2009, 07:30 AM

Default Re: medication strip packs
We use the bubble cards as well. Pharmacy doesn't stock squat, I do. The meds all come in a big grey "totes" that are zip-tied shut, and I have to go though each one and check them off on the med inventory sheets that come with them to ensure we rec'd everything they said they sent. The narc's are also thrown in there. They are "packaged" in a brown paper sack that is stapled shut with the pt tag on the outside proclaiming it's contents. The count sheet is rubber-banded to the card. I am required to sign an electronic device that the courier carries that simply proves the courier brought the boxes to us. After I check off everything, I sign the inventory sheets and put them in the DHS's box. Then, lucky me, I get to put them all away. Our med carts have the spaces with the room numbers as well. It's especially fun when we've had 3 or 4 admits for the day.
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