Do you sign out breast milk?

[dawngloves, BSN, RN]

And/or do you have to have another nurse co sign? Is this a JCHAO standard?

[BittyBabyGrower, MSN, RN]

We have to have MBM cosigned here too....it is a body fluid and it should be checked like blood...I believe that this is Jch.

We like to kid around and say...hey I can give you a med that can kill you in a minute, but I can't feed my kid without you double checking LOL

Also, if a mom has freshly pumped, it has to still be labeled, etc and then co-signed.

Also, did you know that in the fridge, MBM has to go on the bottom shelf and formula on the top?

[dawngloves, BSN, RN]

I did not know that! I do know not to store it in the door shelf.

That's my problem withthis signing out thing. No one has to double check when I give KCL or Ca! (But I personally have someone double check)

[nekhismom]

No, we don't have to sign EBM out here, but we do have to have another nurse double check all meds, even TPN, Polyvisol, NS, etc. :)

[VickyRN, MSN, DNP, RN]

On the PED's floor in which we are having clinicals this summer, breast milk is stored in a special refrigerator (where all special formulas are made up and stored). Each is in a container with a screw-on top (looks like a small urine container) with a patient label on it. No checks are required on this unit. The breast milk is just being stored on whatever shelf is available (not in the door) and interspersed with the formulas and there is an expiration of 24 hours (just like the formulas). Interesting question, though. Had not even thought about it.

[mac23]

On our unit we have a place on our chart where we sign then have another person co-signs. We have a huge freeze just for BM and a refigeratoer just for BM. I don't mind. This policy went in place after a few babies got BM that wasn't their mother's and the mothers found out because the bottle was sitting at the bedside labeled as someone else's. Needless to say they were not happy. :chair:

On the PED's floor in which we are having clinicals this summer, breast milk is stored in a special refrigerator (where all special formulas are made up and stored). Each is in a container with a screw-on top (looks like a small urine container) with a patient label on it. No checks are required on this unit. The breast milk is just being stored on whatever shelf is available (not in the shelf) and interspersed with the formulas and there is an expiration of 24 hours (just like the formulas). Interesting question, though. Had not even thought about it.

[DawnE]

We double check MBM...at least in theory. Our system is rediculous. I take a baby's label, get the milk from the nutrition room, put what I need in a syringe or bottle, label the syringe or bottle and then have another nurse in my pod check that the label matches the baby. No one checks the milk as I get it from the fridge. Then we both initial on the chart.

I believe there should be a check, but our system doesn't check anything except that I got the right patient label.

[gypsyatheart]

We have to "check" our MBM w/another nurse, before we put it in the syringe or volufeeder, or whatever. No signing...kinda like the honor system, I guess. But we all do it. LOL! ALL meds have to be double checked w/another RN and charted w/the other nurses name.

[TiffyRN, BSN, PhD]

We have to get double check on EBM, initialed on flowsheet. We have to get another nurse's initials on a bottle if we pour two or more bottles together. Kinda makes you resent breastmilk even though you know it's good for the babies.

We take this milk thing seriously. Getting your milk signed is one of our continuous improvement projects so it is checked all the time. I know of only one occurrance of EBM mix-up and it resulted in the nurse getting fired. Baby was unharmed fortunately.

[kids]

When my grandson was in the NICU his EBM had to be signed x2 if it came from the fridge but not if mom handed over freshly pumped milk to be fed right then.

When he went to the PICU post op it was NOT signed for.

When he returned to the feeder/grower side of the NICU it had to be signed for x2...except...

Both units had dedicated refrigerators and sent "extra" EBM home to be frozen.

Both units required the bottle be sealed with a label signed by by mom.

[Gompers, BSN, RN]

We do the honor-system thing. We need to show the milk to another nurse and have her compare it to the baby's label (MR# and name). We don't initial the flowsheet or anything. The dieticians who make up our formulas each day sometimes use breastmilk to mix with HMF or Neosure powder. I believe they have to check it with each other and compare it to the printed labels they get to stick on the prepared syringes of milk.

[dawngloves, BSN, RN]

Dieticians to mix your formulas and fortified breast milk?! *sigh* Sounds like a dream!