Reapply a Fentanyl Patch? - page 5

by wifeandmomoftwo

First of all sorry for the miss spelling. Just noticed and can't figure out how to edit that part :( About 30 minutes before the end of my shift I had a CNA come to me and say "Ms. Smith's patch came off. I tried to stick it... Read More


  1. 1
    Quote from dajulieness
    To prevent possible abuse.

    People are that desperate for drugs that they will use a patch thats been on someone elses skin for 3 days.
    Not only will they use it, they will eat the gel inside to get the residual drug all at once. Google it and you can see all kinds of "how to" discussions. Barf. At my former facility, we had to put used Fentanyl patches in the sharps container.
    loriangel14 likes this.
  2. 0
    Quote from AtomicWoman
    Not only will they use it, they will eat the gel inside to get the residual drug all at once. Google it and you can see all kinds of "how to" discussions. Barf. At my former facility, we had to put used Fentanyl patches in the sharps container.

    Yes I realise that, although I think it's a bit harder to get at the drug in that way since they changed the formulation away from the gel type patch. We put our used patches in the sharps too.

    Just saying I don't think making the staff call the doctor before replacing a patch that's fallen off is an effective way of preventing or addressing possible abuse. The controlled drug register or pharmacy records will show if patches are 'falling off' frequently.
  3. 0
    Quote from CompleteUnknown
    Yes I realise that, although I think it's a bit harder to get at the drug in that way since they changed the formulation away from the gel type patch. We put our used patches in the sharps too.

    Just saying I don't think making the staff call the doctor before replacing a patch that's fallen off is an effective way of preventing or addressing possible abuse. The controlled drug register or pharmacy records will show if patches are 'falling off' frequently.
    Bingo!
  4. 2
    Regardless of whether a patch that has fallen off is reapplied with an occlusive dressing or a new patch is used, it should be placed in the same location as the one that came off.

    If the patch is placed in a new location, the patient will have to wait for a new skin depot of the drug to form before the medication is released into their system, causing a break in pain relief.

    Source: Medscape News
    netglow and leslie :-D like this.
  5. 0
    Once they have fallen off and been put back on, do they adhere well enough to receive appropriate amounts of the medication? That would be my biggest concern with putting the old one back on.

    I never knew about reapplying the patch in the same place...thanks for posting that!
  6. 0
    I have only skimmed replies, but as a long-time pain patient, I can tell you any effort to tape down or reglue, etc., a patch that has come off is completely useless, both for generic and brand name, gel or plastic patch. Once that initial bond is broken, taping it next to skin will not help, the meds will not absorb. And let me tell you...it is agony when it happens and the patch is pretty new, and no one will help get an extra so you can go ahead and apply the new one early. You may be ok from meds in system from that or previous patches, but the gap in time will make a difference, and at some point the old meds will be out of the pt system while the new patch is waiting to be applied or even work.
  7. 0
    When I worked in LTC an MD order would be needed to reapply a new patch if the old one fell off prior to the change date so insurance would pay for the extra dose. Pharmacy only sends exactly what a resident will need. If you use an extra patch than the facility will have to pay unless you have an order.

    Either way, if you can't replace the patch you need to call for an order (in a LTC) don't leave it for the next shift to get around to since the resident could be without the correct pain meds and technically that would be an error. It's not right to substitute more than an hour or so with different meds for pain when there are specific orders.

    Please OP, next time just call the doc right away, they get paid to take weekend call and would YOU like to be in that bed unable to have adequate pain control?
  8. 0
    Don't let this nurse drag you down. You did what you thought was best for the patient. This nurse should have more patients with you because you are a new grad. Never forget this experience, because, someday you'll be a seasoned nurse and can help and encourage a new grad. Nurses eat their own because most nurses are unhappy and really don't like themselves. Lets turn this around by helping each more, and being more understanding instead on being judgmental. We are all part of the human race. Let's always make it about the patient. If nurses are good to each other, then that will always be good for the patient.
  9. 1
    We don't call the MD for this. We write the order Q72 hours/PRN just for this purpose.
    Hospice Nurse LPN likes this.
  10. 0
    Quote from thehipcrip
    Regardless of whether a patch that has fallen off is reapplied with an occlusive dressing or a new patch is used, it should be placed in the same location as the one that came off.

    If the patch is placed in a new location, the patient will have to wait for a new skin depot of the drug to form before the medication is released into their system, causing a break in pain relief.

    Source: Medscape News
    I know this is an old thread, but I have a question about this. If we should apply a replacement patch in the same location to prevent a break in pain relief due to inadequate skin depot, wouldn't the same principle apply to regular patch changes?


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