medication administration short-cuts

  1. Does anyone have any opinion/references regarding the wisdom (pro or con) of "pre-setting" meds in cups for a large number of patients, labeling the cups and then going into the milieu (psych or long-term care) and passing meds from the cups? HELP - this is an issue where I work. Thanks for any feedback

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    About dmnurss

    Joined: Aug '98; Posts: 15


  3. by   Heather27
    Let's all admit it: We do it!!
    Personally, I work in LTC, and I know what my residents take and when like I know the "back of my hand". I know the residents,and they know me. I sometimes pre-pour meds, and have never had a problem with it yet. Our pharmacist, however, doesn't like it, and has said that if we must do that, to keep it to a max of three or four residents' meds. I have found that it is often LESS safe to take my med cart with me, because I know that I won't be able to keep an eye on it.
    All told, we need to keep in mind that "safe and prudent" practice. I think it depends on the situation and the policies of the particular facility that you work in.

  4. by   DottieAnn
    Everyone may pre-pour meds, but is this really the safest way to medicated our residents? It is also against our facility policies to pre-pour. I would also like to suggest that this practice could cause a major problem when the facility is surveyed for state and Medicare. Knowing our residents "like the back of your hand" is one thing but are you looking at the med book when doing this pre-pour or is this also from memory. The five rights are there for a reason. Let's not shortcut the med pass. Our residents are worth the effort.
  5. by   Heather27
    It might be against your facilitity's policy, but not mine. Of course, safe medication administration is ALWAYS first and foremost, and I am not suggesting that we can memorize what a person gets and when. I am also saying that LTC is an easier setting in which to do this, as the resident population is stable, and you don't have to be checking identification etc. if you work there regularly. So, pardon me if you feel that this is unsafe practice. What works for one might not work for another!
  6. by   DottieAnn
    In my facility we have 100 + admissions and 100+ discharges a month. It seems that even the skilled units have 1 or 2 admissions/discharges a month. We are 236 beds with a subacute and inpatient hospice units which may make the difference. Pre-pouring is still not permitted by state regs and I believe federal regs also do not permit it. Apparently the regs are different in Canada. I did ask the floor nurses today about pre-pour and they were against it.

    [This message has been edited by DottieAnn (edited 01-31-99).]
  7. by   Heather27
    Well, there ya go! I doubt I would be comfortable doing any pre-prep in your facility too!!! My facility gets ONE respite admission every two weeks. The rest of the population rarely changes. Once again, let me stress that safe med administration is always first and foremost in all our minds, and we would never do anything to jeopardize the care of our residents.
  8. by   dmnurss
    I have been following the replies to my post about the pre-setting issue with interest. It seems like everyone knows it is against protocol etc. but also knows it is more or less common practice. I would like to find it in writing somewhere - I have checked the JAHCO manual and it is not specific in this regard. Is there a "standards of practice" resource somewhere that I am not aware of? If you have any suggestions please let me know. Thanks for the input. Donna