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floating medications in water to administer

The jail facility I work in just started floating medications in water for every inmate/patient whether he/she hoards or cheeks. This procedure is the new practice with the entire population. The medications being floated are everything from cardiac to phsych medications and enteric coated medications. I can understand the medications that are wanted by all.... but HCTZ? If you work in a facility that does this as practice, please give me some insight.

SinMiedo specializes in Corrections, Psych.

Wow, that seems a bit overboard. I've worked in facilities where C&F was ordered on psych/controlled meds if the inmate is suspected or confirmed to be hoarding or diverting their meds, but it seems rather unnecessary to require it for everyone. Especially for meds that are super undesirable on the "Cellblock Pharmacy" front.

I predict a fair number of greivances heading your management's way. :/

Orca specializes in Corrections, psychiatry, rehab, LTC.

This seems like a considerable overreaction. Your administration may also not realize that this does not stop the trading/selling of medication. Inmates just hold the water in their mouths, go around the corner and spit it into a cup. Gross, definitely, but it happens.

Thanks for the input. I agree we will get many grievances. Also, I am grieving the procedure with the union. I have a pharmacist in the community looking at the procedure. A lot of us nurses gave our input regarding our concerns. All that went to deaf ears. It's pretty sad. Very punitive for the environment.

valzRN specializes in LTC, Correctional Nursing.

I work at a state prison in the mental health dorm and we crush and float ALL meds... with the exception of things like Depakote, ER meds, Navane, etc... we even C&F the medical meds... These guys will hoard them and then OD on them trying to commit suicide, so it's more of a precautionary thing for us.

I am relatively new to this, but what does floating the meds in water do? I have no idea what that is. Thank you for helping me get this!!

CosmicHymns specializes in NICU; Acute psych; pediatric psych.

Floating the meds in water makes it considerably harder to cheek them.

BiggDave specializes in Corrections.

The jail I work in has also just started a facility wide crush & float policy. Does anyone know the actual legal implications of this?? By mixing multiple medications in water is this not "compounding" medications? Which I believe can only be legally done by a pharmacist.

Orca specializes in Corrections, psychiatry, rehab, LTC.

On 3/7/2020 at 1:52 AM, BiggDave said:

The jail I work in has also just started a facility wide crush & float policy. Does anyone know the actual legal implications of this?? By mixing multiple medications in water is this not "compounding" medications? Which I believe can only be legally done by a pharmacist.

It isn't compounding in the legal sense, because you are not creating or formulating new medications. The meds would be taken together anyway. My main concern about doing this is that it gives the inmate a bolus of medication by accelerating the absorption rate. There is also the issue of an inmate who wants to refuse one or more medications at a given pill pass. If everything is a jumble in a cup of water, it is impossible to separate them.

Edited by Orca

adventure_rn specializes in NICU, PICU.

On 6/29/2020 at 5:54 PM, Orca said:

It isn't compounding in the legal sense, because you are not creating or formulating new medications. The meds would be taken together anyway. My main concern about doing this is that it gives the inmate a bolus of medication by accelerating the absorption rate. There is also the issue of an inmate who wants to refuse one or more medications at a given pill pass. If everything is a jumble in a cup of water, it is impossible to separate them.

LOL, I know this post is several years old, but now I can't stop imagining all of the inmates getting their meds in brightly-colored, flavored liquid form like we do for the kiddos, slurping them up from oral syringes one-by-one.

It would address all of Orcas considerations, though.

Edited by adventure_rn

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