ADVICE...? Please help me think of a way to solve this issue.

Nurses General Nursing

Published

Could someone give me a "SIMPLE" solution to this problem....

As everyone knows in the Nursing Home Setting, medication is dipensed thru a med cart with a M.A.R. binder to sign off the medication that has been dispensed to the residents, and at the end of each shift (7-3, 3-11, 11-7) All nurses must sign off and count off on the "NARCOTICS" that have been dispensed thruout the day.

So my question is...how can I make a system up to where all my nurses need to do counts and sign off for the ENTIRE MED CART (all meds, prn, and narcotics)

Its easy to make up narcotic sheets when there's usually a few narcotics for each resident. Now that I need to have the staff sign off in the M.A.R. while dispensing and count all meds at the end of shift it gets tedious and they're going to spend too much time counting all the medications. So Im trying to create a system that would be simple yet serve the purpose intended.

***ANY OPINIONS or IDEAS ARE APPRECIATED

(if you're wondering, this was not an idea from me but from higher authority.... :))

Wow! I do not have any solution. The only thing I could think of is having some kind of manual counter that you could press each time you remove some thing from the drawer. Kind of like the old stop watches seen.

Specializes in LTC.

Counting an entire cart is time that can be better used elsewhere. Use time/date cards and punch on the number corresponding the date, each nurse initials where he/she punched. If there's a discrepancy, you can go back and trace it.

I understand you said it's not coming from you but I think that idea is pretty crazy. On some carts that contain meds for 30 patients that could take...forever, and a day. Literally I think it could take an hour. I can't imagine working under those conditions.

Does this include stock meds? Are you going to waste valuable time that could be spent with patients painstakingly counting out multivitamins and lopressors and everything else?

There gets to a point where either you believe the nurses you've hired are passing scheduled meds competently or you think they're not and omissions and med errors are running rampant. If the higher-ups believe the latter maybe they need to get all new staff. Maybe they should invest in a computerized system and a pyxsys. There has got to be a better way than counting out the entire med cart each shift.

Specializes in LTC, Hospice, Case Management.
I understand you said it's not coming from you but I think that idea is pretty crazy. On some carts that contain meds for 30 patients that could take...forever, and a day. Literally I think it could take an hour. I can't imagine working under those conditions.

Does this include stock meds? Are you going to waste valuable time that could be spent with patients painstakingly counting out multivitamins and lopressors and everything else?

There gets to a point where either you believe the nurses you've hired are passing scheduled meds competently or you think they're not and omissions and med errors are running rampant. If the higher-ups believe the latter maybe they need to get all new staff. Maybe they should invest in a computerized system and a pyxsys. There has got to be a better way than counting out the entire med cart each shift.

Upon further thinking.. a "kudos" on the above post just isn't enough! Someone has gone completely crazy to think that this is anywhere near reasonable! Count the whole med cart....jeesh, stupidity run rampant!

Specializes in LTC, Hospice, Case Management.

You also may want to get a mod to move this thread to the geriatric forum for additional responses. Maybe someone would be able to offer you a valid solution.

Specializes in Professional Development Specialist.
I understand you said it's not coming from you but I think that idea is pretty crazy. On some carts that contain meds for 30 patients that could take...forever, and a day. Literally I think it could take an hour. I can't imagine working under those conditions.

Does this include stock meds? Are you going to waste valuable time that could be spent with patients painstakingly counting out multivitamins and lopressors and everything else?

There gets to a point where either you believe the nurses you've hired are passing scheduled meds competently or you think they're not and omissions and med errors are running rampant. If the higher-ups believe the latter maybe they need to get all new staff. Maybe they should invest in a computerized system and a pyxsys. There has got to be a better way than counting out the entire med cart each shift.

Yeah, that. If you really want that tight control it's time to invest in a computerizes system. I'll think about it a bit, but my med cart is STUFFED full and if I had to count the entire thing every night I'd be there until my shift started the next day. I just don't think it's logistically feasible.

Specializes in Peds Homecare.

I think it is a waste of time. I can't fathom counting all the meds in a cart. That higher up needs to actually look at a med cart and realize that it would be impossible and a total waste of time. Wonder what dunderhead thought that up? Give me a break!:smackingf

Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

You could have the nurses initial on the med card next to the pill they pop out (bubble wrap one) as well as the MAR. That might help with tracking for the non controlled meds.

Perhaps the person who came up with this splendid plan could come out and show everyone how to quickly count the med cart.

Specializes in ER, Trauma.

No problem! You come in, take report, spend 8 hours counting the cart, give report, then you go home.

Seriously, get information from some automated systems like Pyxis. This will create a trail to account for each patients medication. It's simply not cost effective to count the entire cart at each shift change manually.

Make that kind of suggestion, then leave the higher ups to solve this Rubiks Cube they've given you.

Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.

How ridiculous! Have a bar code system with a hand held scanner......

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