Comfort kits

We are with Hospice Pharmacia and they have 2 kits, a general comfort pack and a seizure kit.

The comfort pack has the following:

6 ABHR suppositories (ativan, benadryl, haldol, reglan)

6 650mg Tylenol suppositories

15 ml Haldol liquid 2mg/ml

10 Levsin tabs

10 1mg Ativan tabs

15ml Roxanol 20mg/ml

6 10mg Compazine tabs

6 25mg Compazine suppositories

Seizure Kit

5 2mg Ativan suppositories

3 Dilantin 200mg suppositories

3 Dilantin 400mg suppositories

I've never really examined these kits closely since I work in the residence so this is a good exercise for me.

Severina

We also use Hospice Pharmacia, and they've added a Cardiac Comfort kit..Unfortunately, I'm not sure what meds are in it (I left my MUGS book @ work..)

We also use Hospice Pharmacia- The Cardiac ComfortPak has:

ABHR (ativan, benadryl,haldol, reglan) supps, APAP supp, haldol liq., hyoscyamine tabs, ativan tabs, MS liquid, prochlorperazine tabs and supps, lasix tabs and injectible, nitroglycerin sublingual, ASA tabs, and MS injectable-

I hope that helps!! If you need the doses- I will post them too!! :kiss

We also use Hospice Pharmacia- The Cardiac ComfortPak has:

ABHR (ativan, benadryl,haldol, reglan) supps, APAP supp, haldol liq., hyoscyamine tabs, ativan tabs, MS liquid, prochlorperazine tabs and supps, lasix tabs and injectible, nitroglycerin sublingual, ASA tabs, and MS injectable-

I hope that helps!! If you need the doses- I will post them too!! :kiss

Thanks for the input!

Mandee

We also use Hospice Pharmacia- The Cardiac ComfortPak has:

ABHR (ativan, benadryl,haldol, reglan) supps, APAP supp, haldol liq., hyoscyamine tabs, ativan tabs, MS liquid, prochlorperazine tabs and supps, lasix tabs and injectible, nitroglycerin sublingual, ASA tabs, and MS injectable-

I hope that helps!! If you need the doses- I will post them too!! :kiss

Thanks for the input!

Mandee

and also scapolomine gel is included in ours.

and also scapolomine gel is included in ours.

We do not currently have "comfort pacs", but we want them. What are your protocols? Our pharmacies are willing to make them up for us and want to know about CII accountability and monitoring? If drugs are not used prior to patient expiring or dismissal or drug expiration, how are drugs disposed of? Is there any in home drug accountability? Do you as the nurse using the med, sign out for it?

Completely sort of unrelated issue.... What are your Hospices standing orders and would you mind sharing them?

Thanks... Peajay:nurse:

We do not currently have "comfort pacs", but we want them. What are your protocols? Our pharmacies are willing to make them up for us and want to know about CII accountability and monitoring? If drugs are not used prior to patient expiring or dismissal or drug expiration, how are drugs disposed of? Is there any in home drug accountability? Do you as the nurse using the med, sign out for it?

Completely sort of unrelated issue.... What are your Hospices standing orders and would you mind sharing them?

Thanks... Peajay:nurse:

The drug disposal thing is a weighty issue for us working in a residence/facility. This is with respect to narcs. Other meds are just logged on a sheet and sent back to pharmacy, if thats where they came from, or just disposed of, if they came from home. With narcs, the state law says that after someone dies we have to dispose of them that day. Our policy is to put them into a locked cabinet and then two nurses (the charge nurse and staff nurse) dispose of them on the midnight shift. The thing is, we have continual problems with miscommunication leading to pharmacy not getting us meds on time for when patients need them. This leads us to "borrowing", signing out meds as "wasted", from one patient for another; or, hoarding certain narcs from deceased patients that take a long time to get here, or which we are continually short. A lot of nurses have a problem with the drug disposal law because it leads to so much waste. It seems that pharmacy either sends us too little of something, or too much. It seems terrible to destroy 60 or so DRA gel packets when they have to be compounded by HP and take 2-3 days to get here. We know that we could get a new patient, or one of our patients could develop sudden intractable N/V which would be greatly helped by starting this med right away.

As for standing orders, we have a whole lot of them. We have several standing orders for almost any symptom that presents itself. The ones that we institute most often are: Roxanal, compazine, ducolax suppositories, haldol, ativan (which leads to much controversy between the nurses and the medical director), atropine, scopalamine patches, Morphine inj., and procedures such as, wound care and foley catheters (also leading to controversy).

Severina

We have an "ER" kit which includes:

3 cc Roxanol

3 cc Haldol

phenergan tabs

levsin tabs

ativan tabs

compazine supp

tylenol supp

When the patient dies, all meds are destroyed in home and witnessed by someone whether it be other staff or family. We document all this on the discharge summary. :)

Dear Rock-Chalk,

I am not a nurse, but rather a family member/caretaker of someone who just started receiving hospice services at home. Today, a pharmacy delivery truck pulled up to the house, and they delivered a small box that's sealed shut and labeled "for use by hospice nurse or physcian only". It is also labeled "not child-proof." They told us to refridgerate it, and, when we asked the hospice nurse about it today, she replied that it's not for us (the family) to use but rather just for the nurse in an emergency. She offered no further explanation. From reading several web sites, I assume it is either a comfort pack or a cardiac pac, and I now know the contents of both.

Quite frankly, I can offer a family member's perspective by saying that I don't like having something in our fridge without knowing what it is or how it's to be used, and I worry about potential liability because we pay for three other caregivers during the day who are in and out of the house, including one who lives close and has young children. And, per your astute question, I don't know what the heck we'd do with it if my dad were to pass. We had no further instructions other than basically not to touch it!

Primarily because of the poor communication, I'm on the verge of calling hospice and telling them to take us off the list and get their stuff out of our fridge!

Your sister Jayhawk (but displaced to a land with less coordinated health care),

pjkt

Dear Rock-Chalk,

I am not a nurse, but rather a family member/caretaker of someone who just started receiving hospice services at home. Today, a pharmacy delivery truck pulled up to the house, and they delivered a small box that's sealed shut and labeled "for use by hospice nurse or physcian only". It is also labeled "not child-proof." They told us to refridgerate it, and, when we asked the hospice nurse about it today, she replied that it's not for us (the family) to use but rather just for the nurse in an emergency. She offered no further explanation. From reading several web sites, I assume it is either a comfort pack or a cardiac pac, and I now know the contents of both.

Quite frankly, I can offer a family member's perspective by saying that I don't like having something in our fridge without knowing what it is or how it's to be used, and I worry about potential liability because we pay for three other caregivers during the day who are in and out of the house, including one who lives close and has young children. And, per your astute question, I don't know what the heck we'd do with it if my dad were to pass. We had no further instructions other than basically not to touch it!

Primarily because of the poor communication, I'm on the verge of calling hospice and telling them to take us off the list and get their stuff out of our fridge!

Your sister Jayhawk (but displaced to a land with less coordinated health care),

pjkt

Oh my goodness! I always let the family know the the E-Kit is going to be delivered and to just store in in a safe place and I'll explain it all when I make my next visit. I break the seal and teach them how to measure the morphine (and a return demonstration). I re-seal the box and have the family put it away. If something is needed during the middle of the night, I want to be able to tell the family over the phone what to give and what to expect. Sometimes one dose of medicine will do the trick and we all (family and myself) can go back to sleep. If not, I can head out to make a visit, but at least one dose of medicine will have already been given.

Our E-kits are simple:

Roxanol 20mg/ml

diazepam 5 mg

scopal patch

If anything else is needed when can have it delivered the same day. As far as destroying meds: for my home pts, I dispose of all narcs and have a family member witness it and sign the med destruction form. For nsg home pts, the facility is responsible for destroying narcs. Hope this helps.