Keep an eye on those Rx pads!

ImAnMa · Nov 13, 2004

My husband is currently investigating a case where a patient stole a Rx pad from her MD clinic and got her narc filled at a local pharmacy.
I've heard of this happening in dentists offices quite often, (one of my nieces worked in a large dentist group)but never in a docs office.
Anyone else?.

One way to control this problem is for all health care facilitys to go to and use electronic medical records!! and to keep the rx portion of the program locked to all users except the MD, PA, ect. then this neat typed rx prints out and the Dr signs it, also ends the problem of bad handwriting errors in rx dispensing at the pharmacy, EMR = safe,secure effecient medical treatment. IMHO

Daryn · Nov 13, 2004

At my facility we lock the Rx pads in the nurse's med cart. We count them each shift like we do the narcs. This seems to work well.

BittyBabyGrower, MSN, RN · Nov 13, 2004

Ours are all done on the computer also...no paper pads anymore that I know of!

pickledpepperRN · Nov 13, 2004

Seems by next year there will be changes. This is a transition period

http://www.rn.ca.gov/practice/pdf/doj-infobulletin.pdf

Seems the prescribers should be responsible for their pads. Nurses need the time for nursing care.

leslie :-D · Nov 13, 2004

how do they know the md's authorization/dea # that has to be filled in on the script?

URO-RN · Nov 13, 2004

Perhaps that DEA # is printed on the script or pharmacists are not checking? Who knows.

whiteclogs · Jul 30, 2007

After a break in to our office and then getting an EMR system later (MediNotes) we no longer have rx pads - we have a locking Star printer to keep the active roll in and the others are very securely locked up.

Trauma Columnist · Jul 30, 2007

I write scripts frequently. After I give my DEA number once to the big chain pharmacies (CVS, Walgreen, KMart, Walmart) then I'm in the computer and they don't need a DEA number then. I actually keep my script pads in my lab coat at all times, never ever leave them around.

suzy253, RN · Jul 30, 2007

A few weeks ago, a doc had left an Rx pad just sitting outside the nurses station in an area where there is a counter, phones, and a couple of computers. I picked it up and gave it to the charge nurse to keep it under lock & key where it belongs. The docs write out scripts when discharging patients and are notorious for leaving them hanging around.

GeminiTwinRN, BSN · Jul 31, 2007

I have a question along the line of prescriptions.

I'm sure you all are familiar with discharges that go on in hospital settings. Having recently moved to dayshift where there are LOTS more discharges than there were on NOC shift, I am doing more and more discharges. As RNs, we are responsible for going over all the usual discharge sheets, instructions, whatif/worstcase phone #'s, all that. Beyond that, we also hand the patient the prescriptions that the docs have written for them to be filled at their pharmacy (or ours).

My question is, how come the nurses who taught me the procedure for doing these discharges say it's a nono to make copies of the prescriptions? Lots of the scripts are for narcs, but when I made a copy of one of them during my first discharge before I knew we weren't supposed to, the photo copy came out with VOID written several times on it.

When I asked why we weren't keeping copies of the scripts given to the patients, I was told that it was because of security issues. Like someone using a copy to fill a script. How could that be if it says VOID all over it? Weird!

I was (still am) of the opinion that making copies of all the scripts given to the patients and putting them in the chart (after all, it's going to be broken down and sent to MR soon enough) would be a good way for the hospital to have proof that the script was actually given to the client, or at least show that it was written. ??

I realize the discharge papers have all the scripts written on them, but that's really no guarantee that they HAVE been written. With the sheer volume of scripts some of these folks get, I could see how easily a doc could omit one of them from the list and never write it out.

Does this make sense?

heron, ASN, RN · Jul 31, 2007

A little vent here ... and no disrespect intended to any poster living or dead!! ... sometimes it seems to me that mothers and nurses are held responsible for everything that happens to anybody, anywhere, ever! I understand and comply with all the rules and regs regarding inventory control over narcotics ... but there has to be a limit. My hospice at one time expected us to count and sign out prescription forms on my unit. Not a one of us complied and that nonsense soon stopped. We use reasonable precautions ... prescription pads are locked in the med room but are the responsibility of the prescriber every where else. So far, in 30+ years of nursing, I have not been involved in any major problems resulting from stolen prescription forms ... G-d willing, I won't be in the future.

FranEMTnurse, CNA, LPN, EMT-I · Aug 1, 2007

One way to control this problem is for all health care facilitys to go to and use electronic medical records!! and to keep the rx portion of the program locked to all users except the MD, PA, ect. then this neat typed rx prints out and the Dr signs it, also ends the problem of bad handwriting errors in rx dispensing at the pharmacy, EMR = safe,secure effecient medical treatment. IMHO

I have another idea that would solve the problem. Get some plain patches with oh maybe petroleum jelly, etc, and place them in view. I'll bet it wouldn't be long before word got around among the drug users that they're no good, and they would stop it.