Dropped pills

MJB2010 · Oct 3, 2012

I would probably have documented exactly what happened just to cya, but I am sure you will probably not hear about it again. Gross! Hospital floors are icky!

Asystole RN · Oct 3, 2012

I would not have filled out an incident report but I would have definitely documented it somewhere.

Anna Flaxis, BSN, RN · Oct 3, 2012

I wouldn't worry too much about it! The patient took it upon herself to pick up the pills off the floor and ingest them. There is no appropriate place in the medical record to document this. I wouldn't fill out an incident report, either.

mandaaRN · Oct 3, 2012

Or document it? Although I didn't. But for future reference, god for bid it happened again

Anna Flaxis, BSN, RN · Oct 3, 2012

Why would you document it? How is it pertinent to the patient's nursing diagnosis, plan of care, or response to treatment?

I suppose if the patient was admitted for a spinal cord injury and was suddenly able to get out of bed and retrieve dropped pills off the floor, it would be significant. If the patient had been obtunded all day and was suddenly alert enough to climb out of bed and pick some pills up off the floor, then it would be significant.

If there was no significant change in the patient's status, why would this be pertinent information to document in the medical record?

kiszi, RN · Oct 4, 2012

Random comment: I recall a Microbiology class where we took swabs of various surfaces, and the floor actually had a low rate of microbe growth in comparison to, say, faucet handles... or people's hands.

When I worked LTC years ago I had an occasional pt insist on taking pills that were dropped. If it didn't bother them, didn't bother me.

hiddencatRN, BSN, RN · Oct 4, 2012

Why would you document it? How is it pertinent to the patient's nursing diagnosis, plan of care, or response to treatment?
I suppose if the patient was admitted for a spinal cord injury and was suddenly able to get out of bed and retrieve dropped pills off the floor, it would be significant. If the patient had been obtunded all day and was suddenly alert enough to climb out of bed and pick some pills up off the floor, then it would be significant.
If there was no significant change in the patient's status, why would this be pertinent information to document in the medical record?

If the patient later complains that the nurse made her take pills off the floor or develops mouth MRSA or starts doing other bat poo crazy things, I'd sure be glad to have documented something.

Anna Flaxis, BSN, RN · Oct 4, 2012

The patient can complain that the nurse made her lick the doorknob or some equally silly thing. Should the nurse document in order to prevent every potential complaint? The answer is no. That is not the purpose of the patient care record.

The mouth is not a common site for MRSA infection, due to the mouth's own defenses. Sure, it's possible but not highly likely. If the person did develop a MRSA infection in her mouth at some later date, there is no way to know whether it was caused by taking those pills or drinking from a contaminated faucet, or touching her friend's oozing pustule and then sticking her finger in her mouth, or any other cause. The cause would not change the course of treatment anyway.

If the patient starts behaving erratically, then it would be worth documenting. But an alert and oriented person choosing to take pills that have been dropped on the floor is not really "crazy". People drop pills on the floor all the time at home and still take them. That doesn't make them mentally ill.

You're free to document whatever you like, but I don't think it was necessary in this case.

LVN2RNMom, ASN, BSN, LVN · Oct 4, 2012

I wouldn't have documented it & as Stargazer has said, where would you document such an event? It has happened several times at my psych facility & it has never been a big deal. I usually pick up the dropped meds or the patient does then I wipe them off before he/she takes them. I think once did a patient demand a new pill and I gave them a new pill. I really don't see a need to document this.

Susie2310 · Oct 4, 2012

The patient can complain that the nurse made her lick the doorknob or some equally silly thing. Should the nurse document in order to prevent every potential complaint? The answer is no. That is not the purpose of the patient care record.
The mouth is not a common site for MRSA infection, due to the mouth's own defenses. Sure, it's possible but not highly likely. If the person did develop a MRSA infection in her mouth at some later date, there is no way to know whether it was caused by taking those pills or drinking from a contaminated faucet, or touching her friend's oozing pustule and then sticking her finger in her mouth, or any other cause. The cause would not change the course of treatment anyway.
If the patient starts behaving erratically, then it would be worth documenting. But an alert and oriented person choosing to take pills that have been dropped on the floor is not really "crazy". People drop pills on the floor all the time at home and still take them. That doesn't make them mentally ill.
You're free to document whatever you like, but I don't think it was necessary in this case.

You have a good sense of humor Stargazer - I am still laughing after reading this post and your previous one.

hiddencatRN, BSN, RN · Oct 4, 2012

I wouldn't have documented it & as Stargazer has said, where would you document such an event?

We have a place to chart narratives everywhere I've worked. "Patient updated on plan of care, given meal tray, ate pills off floor at own insistence. Family at bedside."