Home Med Documentation?

[core34]

I'd like to know if there is a protocol at other facilities for situations like this. Currently, there is none in place for mine.

Here's the scenario. Patient "Ed" is admitted from home with a bag full of bottled RX's. Some are controlled. At my facility, all we do is label them and keep them in the med room w/the other small belongings (i.e. glasses, dentures, etc). They are not locked away but merely keep in a bin. Apparently, when discharged, "Ed's" full bottle of Ativan went home with him empty. Mind you, we don't use patient's own meds (unless they are on a different formulary the hospital doesn't have).

How does your facility document meds that come in from outside? Where do you keep them? How do you document when they are sent home with the patient (given they continue on those meds)?

[Virgo_RN, BSN, RN]

On admit, if the patient has meds with them, a family member can either take them home or we can store them. The disposition of the meds is documented in the EMR. We have special security bags that the meds are placed into, along with a list of all meds and their count. The security bag is sealed with a very strong adhesive that you cannot simply open and reseal. There is a zip off tag with a number that matches a number on the bag, and is filed in the patient's chart. The security bags are sent to our floor's satellite pharmacy and placed under lock and key. When the patient discharges, the bag is given to them, and "home meds returned" is documented in the EMR.

[racing-mom4, BSN, RN]

ya we keep them in an unlocked drawer---I like Virgo_Rns program better. We have those bags for money and valuables I am going to suggest we use them for home meds.

[shoegalRN, RN]

At our hospital we can send them to pharmacy to have them verify the medication and they can take them at the hospital but they are kept in our medication cabinet locked, in the pt's room.

[BGgirl]

We usually encourage pts to either have their families take home their meds or we lock them up with security if they're controlled.

[FemmeRN]

We also send them down to the pharmacy to be verified. When they come back, they either go in the patient specific bin in the Pyxis, or if the doctor orders "at the bedside", they can be kept in the patient's room for self-administration. This way the patient can take their own med, instead of being charged for the hospital's meds.

[CoffeeRTC, BSN, RN]

Great question. Sometimes our LTC pts come in with meds, some narcs. We try to get family to take them home asap, but most often they get locked in our med room and for the most part, we don't even look at them, so you never know if you are getting a controlled or not. They just sit there in a bag. Yep....lots of potential for theft....

I'm going to have to ask when I go in next if we even have a p and p

[classicdame, MSN, EdD]

First, we discourage people having/keeping meds at the hospital. But when it is unavoidable, we make a list, give a copy to the patient and a copy in a big envelope with the meds and take it to Pharmacy for safe-keeping. A note is put on the chart and on the Kardex. When the patient is D/C we get a Pharm tech to bring the meds to the nurse's station and the nurse returns it to the patient. Amazingly enough, before we initiated this the patient's complained about the narcs being stolen. Now the list saves arguements.

[kathygray]

We don't take any home meds- upon admission we send them with the family...

[jmgrn65, RN]

We try to have the family take them back home, if that isn't possible then we document them. THe meds get sent to Pharmacy where they stay until patient is discharged.

[ECKPowers]

At our hospital we can send them to pharmacy to have them verify the medication and they can take them at the hospital but they are kept in our medication cabinet locked, in the pt's room.

That is genius! Verifying the meds.

[weezledawg]

At our hospital all meds are sent to pharmacy for verification, a note placed on the chart that meds are in pharmacy so at discharge they can be returned. If not on our formulary, then they are labeled by pharmacy, listed on mar as pts own med and placed in pt's med drawer. If controlled, placed on narc list and counted like all the others... but we dont have a good way of accounting for, say, an entire bottle taken from admission that turns out half-empty when sent to pharmacy (not that I've enocuntered thism but its possible).

There was one time in my first year of nursing, I found out a pt was taking her own dilaudid on the floor, she told me the past two days' nurses let her keep them. I'll never forget standing with the nursing supervisor counting out a total of 301 4mg pills at the bedside. They went to the pharmacy and a pink form was also filled out.