Pharmacy is now doing our MARS...

  1. Pharmacy has now taken over our MARS. Effective 6/1... After one week it is unbelievable the ERRORs that have been made. Medications not listed. They have completly changed the times. My huge 5p pass is now an even more huge 9p pass because it now includes the HS meds. BIDs are now given at 9&9 So yea, BID lasix is given to these poor old residence at 9pm, and we are now waking residence up to give them the ativan that they needed at 5pm. Also the way the order is written on the MAR is not at all clear at all unless you read a whole "chapter" (Each discription is no less then 12-15 lines) For example it will say Tegretol 100mg, then 3 or 4 lines lines down it will say take 3 tablets to equal 300mg. Its a nightmare to say the least. Say if a Resident got Tegretol TID but diff. dosages like 300mg @ 9a and 5p and 400mg @ 9p they have the 5p dosage to be given at 9p also, so there is 2 diff orders one stating Tegretol 200mg then later say give 2 tablets to equal 400mg the other stating Tegretol 100mg give 3 tablets both sched at 9p. Thats 700mg. to be given at 9pm on 2 diff. orders. These are just a few examples

    Thankfully I know my cart and my Res. and know what they get for the most part and have been able to prevent errors on my shift, but OMG the time that it has consumed is unbelievable!

    Anyways, just venting, if anyone wants to share their nightmares or perhaps tell me that it will get better I will be glad to listen
  2. Visit Finallydidit profile page

    About Finallydidit

    Joined: Nov '09; Posts: 142; Likes: 132


  3. by   CoffeeRTC
    Um....why are they doing this?

    Pharmacy prints our orders each month and then we review them and correct them and adjust the times as needed.
  4. by   classicdame
    somebody needs to talk to the Pharmacist. All that can be altered. Should be for the patient's well being, not anyone's convenience.
  5. by   Herman22
  6. by   Finallydidit
    As far a WHY.. It was a company wide policy change.
    What I was told as far as the times was this is the way their "computers" are set up, BID is q12/hrs period and we are not allowed to change the times.
    The DON asked that we just go with it and give her a few months to get it straightened out.
    Meanwhile, nightshift is now changing and toileting residents all night, when Res should be sleeping.
    Residents that don't have dementia are flipping out that they are not getting their right medications, and how their medications can be changed without them talking to the Dr.
    Im sure that it will get worked out eventually, but right now it is a huge huge headache.
  7. by   cebuana_nurse
    Our MAR's are also being printed from an affiliated pharmacy. So far, we don't have any problems with it but our new management is trying to get rid of them pretty soon and will be having those computerized med carts. I think with the times, we are allowed to change them especially if patient A who is 84 yrs old gets Lasix at 2100, there's no way that old lady would have a good sleep through the night. Is there a way that you could ask the doctor to have the times changed? Or talk to the pharmacist instead?
  8. by   KaroSnowQueen
    If you have a house dr, ask him if he could write standing orders that certain meds be given at 9a & 5p, such as lasix. Then fax those for each patient to the pharmacy. They will cry and whine but most likely they will be changed on the next round of mars.
  9. by   ♪♫ in my ♥
    Quote from Finallydidit
    this is the way their "computers" are set up, BID is q12/hrs

    "This is the way we're doing it because that's how the computer is set up." Well, change the set up... it's not that hard.

    If the doc means q12, they'll write q12.

    2100 Lasix... yikes. I'm looking for your falls to start spiking.
  10. by   ktwlpn
    Quote from Finallydidit
    Pharmacy has now taken over our MARS. Effective 6/1...
    who is your pharmacy?
  11. by   morte
    This is UTTERLY ridiculous....check your P+P and see if this is not already covered, if not you need to get with the house doc and get it straightened out ASAP! BID lasix should be 6a and 2p, and other things should not be Q12 either....from this point forward, the docs need to write the orders with specific times. some ATB therapy needs ATC spacing, some needs to begiven around food. this is a VERY bad case of "cockie cutter" practice.
    i am just screaming at my computor at this point!
  12. by   silentRN
    Some of the units that I have floated too in my hospital has the pharmacy doing their MARS too...I don't like it because the printouts are only for 24 hrs. Another thing that I don't like is that we in the ICU just switched over too computerized orders instead of the hand written orders...I also don't like that...ha! If it's not broke then why fix it? Things are always changing...except for my pay!!!!

  13. by   caliotter3
    I see absolutely no reason why your managers do not allow you to manually change the times. It may take forever to get it ironed out otherwise, meanwhile the residents are suffering because of someone's stupidity and stubbornness.
  14. by   Nascar nurse facility is scheduled to begin having the pharmacy do MAR's next month. I have been dreading it prior to reading this thread but now I'm really worried.

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