A question about patient medications and charges, help please?

Nurses General Nursing

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Where I work, (in a Labor/Delivery/GYN unit), there is an issue that never seems to be resolved. When we medicate patients with meds such as plain tylenol, simethicone, ibuprofen, stool softeners, or tucks/dermoplast, it seems, people are not scanning/charging for them and we are losing money and accountability.

We use Meditechs' EMAR system as our means to "scan" and charge various medications for our patients. Anyone familiar with this program, knows how very cumbersome it is----at least our version is. We have to drag around these computers on wheels and scan bands to give their meds. So, often, when a patient gets a simethicone, people tend to blow off scanning/charging for it, and just do a narrative note that the med was given as it takes so long to get it done in EMAR.

Now of course, for narcotics, these are ALWAYS scanned/charged appropriately for obvious reasons. But these other medications are being "lost" due to not being consistently charged. Patients are getting tylenol, simethicone, colace, etc. and the unit is eating these charges. And as you can guess, this is adding up to an ugly figure.

What is being discussed/proposed between my mgr and pharmacy, is we keep locked versions of "SAMS PACKS" (patient self-administration med packs) in each room. In other words, we would have a locked box that contains commonly-used medications like Motrin, Tylenol, Simethicone, Toradol, Tucks and Dermaplast (NO narcotics obviously)----and then Pharmacy would restock these boxes after the patient is discharged and missing items would be charged to the patient in that room for that time frame. It is thought this would reduce the numbers of "disappearing" medications and costs that can't be recouped due to not scanning for them-----and help make staff a bit more accountable as to whom receives what meds during their stay.

Now I/we are not looking to reinvent the wheel. I just want to know if anyone here does anything like this and if you do, how does it work? Did it fly with JCAHO, if you were surveyed, having such a system in place?

If anyone can tell me about how you do it where you work---please respond here or by Private Message ASAP so I can bring projected ideas/pitfalls to my manager when I work later this week. I am open to any suggestions/ideas that would help here!

THANKS SO MUCH!

I have a problem with the SAMS packs. Charging missing meds assumes non of the missing meds were wasted. Despite what happens pts should never (not legally) be charged for meds that were wasted for any reason.

Don't you have MARs? Every med a pt takes is on the MAR. If hospitals are really concerned about accuracy of charges then they would refer to the MAR for medication charges.

Many hospitals refer to the pixis today to keep tract. However, often we end up for one reason or another wasting a med and never record it in the pixis. Like when your pour the colace and the pt refuses or you discover they are having loose stools. Because of our abundant time we do not always go back to the pixis to record such a waste.

I thought the pt was charged for the entire SAM pack, and then they took it home. The patients seemed to like that - saved them a trip to the drug store to buy these items individually. Seems like that would be easier than going through and counting each drug and recording charges, and not knowing if it was wasted or not.

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