Interruptions during my med pass

[Nspirit]

I am sure this subject has been covered here but it is a problem that continues to put

patients in jeopardy.

Just yesterday, I was working the 3-11 shift at a LTC facility. We do have a policy that nurses are not to be interrupted during the med pass unless there's an emergency. It's a policy that is easily overlooked. I counted eight times during my 8 PM med pass I was interrupted and out of those eight times I had five near-misses (or near-hits) meaning I caught the med error before the patients were harmed. It really bothered me that I almost gave the wrong meds to the wrong patient because my supervisor interrupted me to ask me if a patient is wearing a cervical collar (she could've checked this herself) or a family member is in a panic because her mother didn't eat all her dinner. The crazy thing about all this is that I went along and investigated these things while I was in the middle of pouring. Next meeting, I will bring this subject up. The last facility I worked we reported near-misses as well as med errors for quality assurance. I will also make this suggestion. Any other ideas?? Thanks in advanced.

[anothergrumpyoldRN]

Keep a log for yourself of interruptions and near misses.

Report your findings in the next staff meeting.

Prepare some suggestions as to how you might improve your ability to safely administer medications to the patients.

Good luck!

[JDZ344]

At our hospital, we try to have a Nurses Aide present around the area where the nurse is passing meds. It does reduce interruptions for things like toileting, as the nurse can just call to the aide to assist the patient right away.

Worth thinking about? Supposing, of course, you have a spare NA....

[LoveNeverDies]

Currently I work in a smaller facility. If the nurse is passing meds I leave her be unless the patient might seriously be dying. If a visitor approaches the nurse with a non emergent question she politely states something along the lines of... "I am currently dispensing medication and interruptions increase the risk for a medication error. Please ask one of the aides, they should be in the kitchen/nurse's desk/breakroom at this time. I will come to your father/mother/sisters room as soon as I am finished to make sure your questions have been answered." That way you gave them an explanation, another option, and assured them that you do care about the issue and will make sure to check on their loved one later.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Where are the options for the polls? Nothing to choose from.

Anyway, with EVERYTHING falling on the nurse, even the full trash cans, it's not going to get any better. We carry hospital-issued phones so that EVERYBODY can reach us at all times; regardless of what we're doing. Having a charge nurse in my hospital is absolutely useless. I had an emergency with a patient as soon as I got to work and began the med pass. It involved security, other nurses, and the charge. The charge nurse offered to call the attending as we literally had our hands full with trying to keep this patient from pulling out lines and running down the halls. When the physician called back, she handed me the phone and proceeded to tell me what to say to the physician. REALLY???? Had I known this is what she was going to do, I could have made the call myself while she helped to hold the patient down!!! Of course, the medication pass was late, thereby legally creating one med error behind another since this event took forever to get it under control! But who gives a crap about that, right?

[Nspirit]

Sorry about the poll options. I messed that up, so disregard.

[Nspirit]

Keep a log for yourself of interruptions and near misses.

Report your findings in the next staff meeting.

Prepare some suggestions as to how you might improve your ability to safely administer medications to the patients.

Good luck!

That's a great idea. Thanks.

[HouTx, BSN, MSN, EdD]

Is it permissable to have some sort of visual reminder that you are not to be interrupted? Maybe some sort of small sign (e.g., "No interruptions please") on your med cart? I recall a facility that had a little 'flag pole' attached to the cart.... during med passes, the flag was raised. It looked decorative and did not seem to incite any comment from patients & family members.

[ktwlpn, LPN]

Working day shift we have fewer visitors then evening shift so our challenge is usually other departments and they have been asked numerous times to keep interruptions to a minimum during our med pass but they all seem to feel that their needs are always urgent. I have NO problem telling anyone in a polite and professional manner that I will get back to them when I am through and that includes shift report,not only med pass.

It's usually off the hook on weekends. If a family/visitor approaches me with a request for a cna I always instruct them to go back to their loved ones room and use the call bell. People just don't THINK. I've been in the middle of assessing an acutely ill resident more then once and had to tell folks visiting other residents to back off....Seriously-don't you see the pool of blood on the floor from the fall? Do you see the stethoscope in my ears? I can't really hear the B/P if you turn your mother's TV up to "blast".

[MunoRN, RN]

I've heard some interesting ideas, including wearing a flashing red light on your forehead (I'm serious), maybe you just need something more obvious.

[ktwlpn, LPN]

You can be as obvious as possible but the sad fact is when someone in LTC wants something they usually don't give a crap about anyone else's needs.

[DedHedRN]

I was interrupted during a med pass in LTC to "Gasp" send a lol off to the hospital who was nearly dead. They were able to save her thank goodness. But my oh my did I catch it from a resident who had to have their "finnygin" at exactly 6pm, when I explained to her that I was attending to a code, she replied "I don't care if someone was dying, my "finnygin" is due at 6!"

I do understand about being interrupted doing med pass in LTC though. I resorted to putting a notepad, and a pen on the cart, and telling people, "Write it down, I'll look at if after I finish with this pt." That way I could finish each pt without interruption. Couldn't stop the interruptions between pts though. And its my experience that management doesn't really care if your interrupted or not, even if they say that your not supposed to be.