Isolation Rooms and MARS

In our ICU, we keep a duplicate MAR at the bedside in isolation rooms.

In our ICU, we keep a duplicate MAR at the bedside in isolation rooms.

Is one for reference only or do you record in both?

This has turned into a real PIA at my facility where we have gone computerized with MARS, we are supposed to have a COW (computer on wheels) for each room with a scanner. We scan meds then the patient arm band prior to med admin, unfortunately since going live many of our COWS have gone to "pasture" and we do not have enuff. This of course leads to many iso breaks. Considering my facility is a stickler about gowning/gloving for iso patients (Cdiff, MRSA, ORSA, VRE), it amazes me that they feel that this is an effective way to pass meds and maintain isolation standards. In a perfect world we would use a sanitizer to clean the computer, and the scanner. Of course, we do this yet I wonder how clean it actually can be.

When I did my six week orientation in med surg before going to the clinic, we had an area right outside the isolation room where we would leave it for a moment before we go inside. Once the drugs are administered, we go right to it, and sign. Now, I am hearing that they have computerized MARS, and it is on the medication cart. What nurses have done is make a copy of that individual's MAR and keep it right outside the room for a moment to go in and administer, then come out and go straight to the computer to document.

We would put the MARS in a plastic bag so we could take it to the bedside. On the way out dispose of the bag. Isolation really is a pain but necessary.

We used the scanner method/computerized MAR at my old job, and what I saw being done was: Nurse dons clean gloves at cart outside room, picks up scanner, uses non-dominant hand to touch ID band and holds scanner in dominant hand, scan, drop scanner on cart outside room (that hand is still clean) take off gloves, wash hands, go back outside, get med, go back in and finish admin (with gloves, gown, etc.), document after admin. You can actually face the computer screen so it faces inside the room, if you felt you were making a mistake at the last minute, you can just look at the screen to double check. Even with paper MAR, there should be a place just outside the room for the MAR, or you could bring it in the room when IDing the pt. as long as you don't set it down anywhere, just put it outside when you're done.

I also like the idea of having the duplicate at the bedside; but that would definitely take the whole unit in agreement of undertaking the change (not too hard, but would require continuity).

Just my