- 0May 28, '12 by CapeCodMermaid, RNMy company is trying to find ways to cut down on the nursing budget. HR and the business office just hired two new people but we're supposed to find a way to decrease the budget. One discussion was about hiring med techs but they aren't allowed in Massachusetts and if the MNA has its way, they'll never be allowed.The second thing discussed was to have the pharmacy package meds in little sealed bags...all the morning meds in one bag, afternoon meds in another.No one can explain to me how the nurse signs off the meds. I wouldn't sign off something I hadn't personally poured, but I've been told I'm old fashioned.Do any of you use this system?
- 0May 28, '12 by Ruas61, BSN, RNNo TMA to be ever allowed? Wow, that's too bad. They have been a great thing here. I don't see how handing out medications in baggies is a help. I would still be checking it as a nurse even prepacked from the PX- they are not fool peoof. Maybe trimming some shift hours?
- 0May 30, '12 by txredheadnurseThe only places I have seen the med paks used is in Assisted Living and community based group homes where there are unlicensed people giving meds. The idea behind using them in those settings is to reduce med errors because of misidentification of meds when in individual bottles or blister packs.
I don't think they are suitable in a skilled or even ICF because of the issue of nurses administering pre poured meds which flies in the face of standard nursing practice. In addition if there are changes in the meds then the packs are not useful because even if the discontinued med(s) are to be removed that means nurses would be trying to identify generic meds without a generic PDR available. Even the pharmacy would need one of those if meds were out of their original packaging.
Perhaps if the medication times are not confined to set hours but rather in times of day there would be less stress on the nurses and one nurse would be able to pass to more residents since there would be a time frame of 3-4 hours to do so. In other words instead of 1 nurse per 30-40 residents one nurse might be able to do 40-60 residents if the "morning pass" was from 6:30 AM to 11 AM. This could free up some nursing hours overall or even offer a 75% position of say 28-32 hours a week for a dedicated med pass nurse for both days and evenings.
- 0May 30, '12 by Nascar nurse, ASN, RNDepending on the acuity of the unit I think you would still run into multiple problems with mid week medication order changes (I guess I'm "assuming" that pharmacy would deliver these med packages on a weekly basis). What happens to all the mid week new antibiotic orders, the coumadin dosage changes, the never ending PRN's, etc. By the time all of this is taken into account, have you really saved any time?
Can you send discontinued medications back to pharmacy for credit in your state? We can send some back in mine but I wonder if they are packed as you describe if you could ever send anything back. Just something else to think of.
- 1Jun 7, '12 by JZ_RNI wouldn't want a med tech who doesn't know the A&P/nursing part of drugs and how they effect patients, plus how they work, plus the parameters, plus the patient's medical issues to be passing meds and working under my license, though I do hate that I spend way too much time (in my opinion) just passing meds. And I would never use pre-packed meds. Though I usually would be able to tell what pill is what, what do I do if there's 10 pills, a coreg and a lopressor, I take the person's BP and it's 80/50 with a pulse of 56? I can't say for positive which pill is the BP med, I can't not give them all the other meds, I can't give them anything to make them more hypo... I just don't think pre-poured med packs are a good idea. If we're smart enough to be nurses and responsible for all we have to do, I think we can read packages and bottles and get the right meds. I do like txredheadnurse's suggestion for eliminating "specific hours" and establishing a morning, afternoon, evening system. Obviously this doesn't work for all meds but would make the job less stressful. And instead of cutting staffing in nursing, your management should fire the bozo who wants to cut nurses, period. That will save some money and headaches since more nurses equal better care and more yesmen who only care about the budget and wanna slash it by implementing bad ideas costs lots for no benefit.
- 0Jun 7, '12 by RingaLingIn a previous facility, we used a LTC pharmacy called Millenium. The meds were packaged in little bags like you talked about for each admin. time, and the bag had bar codes on it that represented the meds in the bag. They had a great computer system that made the whole administration process very smooth. Pull the bag, shoot the bar codes, and the MAR would be automatically populated with the admin. info (nurses initials, and her digital signature).
I *loved* this pharmacy, and wish we had it at my current facility.
- 1Jun 13, '12 by EmTheNewRNMy facility (I'm in orientation) has a unit that dispenses the little baggies. There are no more than 3 meds per bag and each comes with the med name, strength, # of pills, and the med's physical description. It is very simple to identify & withhold a specific med if needed. The pharmacy is responsible for reprogramming the machine regularly, and there is some extra stock in it so that if Mrs. Smith's warfarin has just been increased from 3 mg to 4 mg, you punch a few buttons and it spits out your 4 mg tablet for today.