Help, need tips for doing a much faster med pass...

new_mom26 · Jun 21, 2005

Hi. I'm a qma and when I worked the med cart the nurse I trained with told me to arrange the meds in order.. Like the meds that patient needs in the morning put in the front and then so on.. I'm like you also I get stuck with the same thing such as, right med, right dose, right patient.. When I passed meds it seems like it always took me forever... Some of the nurses would get sooo frustrated with me b/c I took forever but, I didn't want to make a mistake.. Hope this helps... :)

Bird2 · Jun 21, 2005

Presetting the meds will set you up for a med error. One day you will grab the wrong cup of meds and give it to the wrong pt. I agree with the previous poster . Have the meds in the same order as the MAR. You will more than likely be passing on the same hall so after the first few times you will know for sure that the dosage and med will be correct so you can just eye ball it. This of course is assuming that the pharmacy sends out a 30 day supply in a cartridge. 30 minutes before the med pass you might try taking all of your b/p's, pulses. After awhile you will know all of the residents and this alone will make the med pass go so much quicker. There is nothing worse than going to give a cognitively impaired person meds only to discover that they took off their name band.

lewwilann · Jun 21, 2005

First what I do is set up a plan. I work 3-11. come in get report. at 3:30, I start the blood sugars and will also give them the pills. Then I start on all the residents that are out of thier rooms and catch a few that go by my cart. Then I will start down the hall. If someone is isn bed and difficult to get positioned or awake, I will wait until the CNAs get them set up for dinner and just come in and give them thier meds then.

Make sure your cart is fully loaded before starting.

nckdl · Jun 21, 2005

I know how you feel, when i first started at my ltc facility i felt awfully slow, so i started presetting my pills. Then state was due to show up so i stopped. Now it takes me 2 hours to pass pills and do 5 treatments to 18 people. I start at 7pm just like i'm supposed to and i'm done around 9pm. I have found no way around it, and i really don't like presetting meds so i guess i'm just stuck. I do try to get my crushes out of the way first. good luck.:)

Hairstylingnurse · Jun 21, 2005

well i feel a little better everyone. i thought it was just me feeling like i'm the slowest person in the world. how do these nurses i work with get it all done so fast?????? :coollook: i've started at several different ltcf and didn't stay because i'm so worried about not keeping up. there have been too many times to mention that i didn't get to wound care and had to inform the on coming nurse in hopes she could do it. i just wish someone you pass laws where we could do our jobs as nurse's and not have to rush through pt. care and then stay over time to do my paper work and occasional left out wound car or whatever. that is why i have'nt stayed at these facilities too long because it isn't fair to the pt. :rolleyes: thanks for the tips and please keep them coming everyone.

LPN01112005 · Jun 21, 2005

Don't compare yourself to other nurses who may be getting their med pass finished quicker. They may or may not be doing a thorough job. We have one nurse who works 3-11 at my facility, who is finished and ready to go by 11 pm every night. However, I can't tell you the number of times we notice that meds are circled as not given, or they'll be signed off on the MAR as given, yet the prefilled cup will still be in the top drawer of the med cart, obviously ungiven. This same nurse will say in report "resident X's secretions from her trach are yellow with a foul odor" yet when I get ready to chart on resident X, her chart won't be flagged due to change of condition, nor will this nurse have even charted that resident X had a change of condition. It's infuriating. :angryfire. In other words, she does nothing more than med-pass and does a mediocre job of that. So, don't go beating yourself up because your med pass takes longer. Most of our 3-11 nurses start their last med pass at 8:00 and it's 10:30 before they are finished. Then they still have to chart. Most leave the facility at around 11:30. It sounds to me like you are a very conscientious nurse, kudos to you!!!!!!!!!!!

I'm sure you probably already get your med cart ready at the beginning of your shift with any thing you know you are going to need, such as suction catheter kits, formula for the tube feeders, and thickened water and applesauce. Not to mention replinishing the med cups and water cups and straws. I get to work about 15 minutes early to prepare my cart. Once I start my med passes, I start at the end of the hall and work my way forward toward the nurses station. Going from resident room in order, giving my meds in order. I have my bubble packs marked with a small red check mark in the right hand corner for easy identification of an 11-7 med. It saves time flipping through all the meds. I just pull out those with the red checks and then double check that I'm giving the right med. If a resident happens to not be in their room, I flag the chart and move on. I look for the wanders at the end of my med pass.

night owl · Jun 21, 2005

I work in a LTC facility and have about the same amt of residents to give meds to as you do and I'm always the last to give meds too no matter what shift I work and no matter what hall I pass meds in. I've often wondered why I'm always last to finish. I've noticed a few things about the others passing meds and why they are always done before me. #1. They all pre pour. #2. If a med needs to have a BP taken prior to giving they don't always take it. How do I know? the BP machines are always still plugged in at the same spot and they never move. #3. They give all the meds out then go back and scan them when they're finished giving them out. Apparently all this saves time. But you know what? I don't let it bother me because I know I'm doing it all the right way. I don't cut corners and never will.

SouthernLPN2RN, MSN, RN, APRN, NP · Jun 21, 2005

I did my first med pass to a 44 bed unit yesterday and it took me 5 hours to do the 8 am meds. I wouldn't have finished then if the other nurse hadn't helped me.

live4today, RN · Jun 21, 2005

I tried working in LTC, but cannot due to the craziness of getting things done in a "timely manner" and doing it "as safe as possible". I find it hard to believe that the "right patient" is always getting the right dose, at the right time, etc. as fast as the staff passes their meds. It's shocking to me, and no way was I going to rush through passing meds or doing treatments on a slew of patients and not know who they were. They do not wear nametags or ID bands on their wrist, so how do you all tell them apart? Don't tell me by their photo that is taken when they are admitted to the center because those photos all look alike to me. :chuckle

Hats off to all who are LTC nurses! I can't do the job! It's too hectic for me.:)

Fiona59 · Jun 21, 2005

This just made me think but discuss it with the powers that be. I've seen it used in facilities in the past.

If the resident has been in the facility for more than 30 days and their condition is stable, it wasn't always required to check BP and pulse prior to giving meds. Also if the patient lived in the community and was in for respite again the BP and pulse weren't taken because the patient or their family usually don't take it at home. Its different if its a new patient or in an acute type setting but it might be worth looking into.

NancyJo · Jun 22, 2005

When I worked LTC our med drawers were filled twice a week. Most of the time they were stuffed full and you spent most of your time digging through the drawers. It was difficult to just pull them forward as they were so full. What i did was I would place my med cup in each pt.'s drawer and would place each pill I needed in the cup leaving them in their package/wrapper. That way in the am everything was organized and I could pull out my cup and still match my meds up to the MAR wrappers still intact without digging forever. Shaved a little time off for me. Never pre-pour or open ahead of time. We once had a nurse who would open everything and actually sign all her MAR's before her med pass, naturally she was done in lightening speed. One night got injured halfway through shift and had to go to ER. The superviser who took over for her was not amused.