A few questions on medicines management

[tinkerbell419]

Hello All,

I have a few questions and appreciate that things may be a little different in the US but im a bit stuck on a couple of things.

Im trying to understand what is a pre packed medicine and what type of pre packed medicines would be available on a neonatal unit.

Does pre packed mean pre labelled, like antibiotic vials? Would they be pre packed?

Also how do you maintain your stock levels on your units? How do you order in your oral medications and controlled drugs?

Honestly any help is better than no help. Its not easy. I cant find all the answers unfortunately.

[NicuGal, MSN, RN]

We use a Pyxis system and pharmacy keeps it stocked. Most things that are pre-packaged are over the counter things, Vit K injections, eye ointments/drops, really anything that doesn't need mixed or diluted. Those are placed in individual patient drawers in a separate cabinet.

[Baby Wrangler]

Do you mean prepacked as in stock meds? That's what we call the medications that are in our med room that are not prepared in a specific dose for a specific baby. We generally only use them on admits on nights. Otherwise, pharmacy prepares all the meds for the babies. They come in specific labelled doses for specific babies and are delivered to their room in that baby's own med bin. We do have ampicillin, tobramycin, flagyl etc in stock for admits during the night. Other stock meds that we have are like epinephrine, narcan, adenosine and other emergency meds. Our intubation meds are all prepacked in that way.

For narcotics, the nurse carrying the keys for that day will accept the pharmacy delivery of narcotics for that day and cosign the delivery with the pharmacy tech. We're only allowed to have a certain number of narcotics in the med room at one time and it's the resus nurse that usually keeps track of the number of narcotics needed and how many babies are on narcotics at a time and they let pharmacy know when we need more. For all other medications it's pharmacy that keeps track of stock.

I'm curious as to how it works in the UK, tinkerbell419. Pretty much the same?

[tinkerbell419]

Hi I honestly have got no idea what pre-packed means and I asked another nurse who is very experienced who confused me further by saying "well isnt medicine pre packed anyway" so not entirely sure. Does this mean that every medicine is pre packed like multivitamins, iron medication, sodium, joules phosphate, antibiotics, caffeine citrate. We keep all this stuff as stock like antibiotic vials, vitamin K ampoules, sodium ampoules, potassium chloride.

I am quite confused. I will keep asking staff.

The problem with the booklet im working on is that i feel it was originally aimed at nurses working on adult wards.

[tinkerbell419]

Ok would pre packed be referring to emergency drugs then?

[NICU Guy, BSN, RN]

Pre-packaged (from manufacturer) are anything that comes from our Pyxis and needs to be drawn up. Everything else is baby specific created by pharmacy (antibiotics, caffeine, etc) and placed in the baby's bin either in medicine cabinet or refrigerator.

[Coffee Nurse, BSN, RN]

I've never heard the term "pre-packed" referring to medication working in either the US or the UK. Can you provide any more context from the booklet?

[tinkerbell419]

Im afraid the question just asks you what pre packed medication is? No context as such, its a booklet with lots of questions on medicines management. I have read our policy and there is no definition provided. I have now been told that it isnt applicable to our unit and if the experienced nurses dont know then im not going to either.