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Excessive waste of narcotics

PACU   (227 Views 2 Comments)
by RainMom RainMom (Member)

RainMom has 7 years experience .

23,584 Profile Views; 1,087 Posts

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So my PACU just changed to electronic orders & scanning meds.  Not a big deal for the most part except for the fact that we are now only allowed to give one dose from a vial of fentanyl or dilaudid & waste the rest, even when we will need another dose in 5 minutes.  

So I may only give 25mcg fentanyl, waste 75; give another dose, waste half or more of the vial.  Our dilaudid comes in 2 mg vials but we only give 0.2-0.4, wasting up to 1.6 each time we dose our pt.  It's mindboggling how much is wasted & on a busy day, we basically have to have a free nurse help keep up with wastes at the pyxis.

Explanation from pharmacy is that these are single dose vials & cannot be scanned multiple times, even for the same pt.

Is this the same for those of you that scan meds in PACU? Thoughts?

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gingernursegirl has 1 years experience as a LPN, RN and specializes in Periop (pre, intra, PACU, post).

6 Posts; 283 Profile Views

For my PACU we scan once and when the pop-up occurs, we select the dose we are giving (25 mcg). Then as we continue dosing every 5 min we have a separate section in our charting (Cerner) for “PACU medication titration” where we chart all doses. At the end, if we used all 100mcg, we can modify the MAR to say 100mcg given. Otherwise, we modify the MAR (if needed) to say how much total was given and waste the rest. 

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