My hospital has just came up with YET another form for the ER nurses to worry with. This is a home medication form, on which we must write EVERY home medication IN LONG hand. No abbreviations at all. (ex. HCTZ 25 mg 1 tab po q day must be wriiten as follows: Hydrochlorothiazide 25 milligram tablets--take one (1) tablet by mouth every day.) Floor nurse do not have to use these forms
This may not seem like a lot of writing, but when you get a nursing home pt who has 20 meds, you have to write each med out. We can no longer use copies of the NH MARS. Sometimes this takes up to 30 mins to re-write. This just bites my butt!!!
I had 2 cases this past week where pts came from NH w/ incorrect hand written MARS.
Another ex. pt was on Reglan. NH MAR stated Reglan 0 mg. 0.5 mg tab per PEG tid. Excuse me Reglan comes in 10 mg tabs. And how are you gonna give 1/2 mg from a 0 mg tab? Another me on the same pt was Procrit 000units to be given in dialysis. Needless to say, I had to call NH for clarification.
Then had a pt taking approx 30 meds (another 30+ mins). When pt was released from ER, I called report to NH and was asked if pt should continue Percocet for pain. I had no listing for percocet on NH MAR and told NH nurse this. She stated, " Oh, did I send the old MAR". All ths time I spent writing the meds down was out the window.
Sorry not trying to turn this into a hospital v/s NH debate. Just venting a little (LOL)
I guess this is another way of trying to cut down on med errors, but isn't there a better way than all this writing for busy ER nurses? Granted I work in a small ER but still, we do get critical pts, and all this writing takes time from pt care. No one likes these forms and we have told our unit manager. Maybe the forms committee will decide not to use theses forms.
I know we had to write home meds before these forms, but at least we could us abbreviations. Now, we can't.
Jan 7, '06
This med reconciliation form is another JCAHO initiative and you are right - it is to cut down on med errors. In our ER, we do computer charting and we are expected to update at each visit.
Jan 7, '06
Computer charting is the answer. However, at a small facility, you may not ever see it.
Jan 7, '06
I feel your pain, nursepenny.
I worked in a NH, part time, for a couple of years in addition to my regular job.
This NH's med sheets were horrible for errors.
I'm not trying to down NH's....I'm just stating the facts about this particular one.
It was something else trying to decipher those MARs.
They had a computer system, but a computer system is only as good as the person using it to enter information.
Everyone had their own idea how to enter information for doctor's orders, and ultimately something would get misprinted or certain important information would get left off, as you gave examples of.
Scary place to work. I quit. Couldn't take it, among many other reasons.
Shame, too, because I could make alot of extra money, as this place is just around the corner from my house, cost me NO gas or travel expenses, just a couple of minutes to get there.
But I just couldn't take it. I'm not perfect by any means, but it's hard to work in a place like that when it seems everyone is pulling AGAINST each other instead of TOGETHER to help each other and to help reduce errors.
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