JCAHO Requirement

[FineAgain]

The Joint Commission is visiting us this week. Seems they are telling us we now have to provide a pill splitter for every patient. I guess I understand the reasoning behind it but this seems a little excessive. Why not put the effort into education about cleaning it between uses. How does your facility handle this?

[merrywhiterose]

We have 1 pill slicer for about 25 people. We've never had a problem with residue being an issue. I think this is just another example of someone sitting at a desk trying to come up with ideas to complicate a nurse's job.

[Sunflowerinsc, ADN, RN]

We have pill spliter for each pt . It comes with the initial fill of pts meds is kept in the locked med drawer in each pts room. It's a flimsy plastic and the pharmacy buys them in bulk. Pt. can take it with them at discharge. Come to think about it, I'm surprised we don't have to include how to use it when we give discharge instructions , in case someone cuts their finger off!

[sherlynn mckenzie]

We have both splitters and crushers. We were told that JACHO wanted us to crush and administer each medication separately. So we had to get a doctors' order to crush the medications and administer together. I work in Med/Surg and our patients have at least 20 pills x 10 patients on a team, that is just impossible and to pass them in the time we are suppose to.

[FineAgain]

Crush and administer each medication separately? Really? Do you routinely work 24 hour shifts? Because that's how long that would take me with some patients. Honestly!

[MunoRN, RN]

You can buy them online for about $1.25

[Twinmom06, ASN, APN]

Our hospital pharmacy splits any pills as needed and sends them to the floor in a sealed envelope w/specific bar code.

our hospital also does this

[nursingilove]

We have to have them for each patient.

[ClevelandOHRN]

A ridiculous and unnecessary cost on an acute care hospital floor. I can safely administer narcotics and chemotherapy, but I can't be trusted to clean a pill splitter between uses? Stop micromanaging me.

[MrChicagoRN, RN]

I totally agree Jenni811! That's kind of why I brought it up...they always think of something! We have way too many patients to have a pill splitter for every patient -- but not that many meds get split, so it shouldn't really be a problem. Probably will end up coming out of my paycheck somehow :)

TJC does Not require a pill splitter for each patient, you just need one available for each patient that has meds that need splitting.

And as long as you have a policy describing the cleaning procedure, it can be then used for the next patient after discharge and proper cleaning.

or, your facility can have their name put on the splitter, send it home with them, and they will see the facilities name every time they use it! Very inexpensive marketing

[FineAgain]

Yes, one for each patient that needs one. I should have been more clear.

I can safely administer narcotics and chemotherapy, but I can't be trusted to clean a pill splitter between uses?

This!

[monkeybug]

We had one pill splitter for the entire unit, but it was only to be used for one particular medication (cytotec).

[brewski09]

we have a pill splitter/crusher available for each patient. if they don't need it, it doesn't get issued. We also have a silent night pill crusher where you put the pill in a thick plastic envelope and crush it in there if you wish to use it. the envelopes satisfy the individuality requirement because the medicine does not touch the actual crusher.

everyone with cost concerns, just imagine you crush a pill for one patient and then use the same pill crusher for the next patient and they have an allergy to the last medicine you crushed. is it still overkill ???