Published Mar 15, 2017
littleINlpn
33 Posts
I am updating my medication cabinet and the admin has asked about a key less cabinet, it allows for 2 passwords to be used for it. Have any of you used one? Pros? Cons?
kidzcare
3,393 Posts
I think that this allows too much access. A passcode can be more easily shared than a key that you keep with you at all time.
In hospitals, nurses use a passcode to access meds but they have to count controlled substances each and every time.
ohiobobcat
887 Posts
I use a keyless entry cabinet. The only people who have access to the code are the people who would have a key anyways- one secretary who is trained to give meds in my absence, and the junior high nurse. It is the cabinet that was here when I started, and I have not had any issues with it. I don't count meds every time I open it. That would be ridiculous because I open the cabinet at least 30 times a day.
That's why I wouldn't want one. It's not reasonable to do that. In a hospital Pyxis, a nurse has to count how many Norco or oxy are in a compartment before being able to take one. But to do that in the school would not be feasible.
I would worry that the code would be given out to someone who needed to sub or written down somewhere that someone could locate and access the cabinet.
ETA- I have been in a situation where meds came up missing in the school. It's easier to figure out who had access to the keys in the last few days than to figure out who may have been told a code at any time.
I forgot to mention (I was more focused on the counting!!!)- the code for the cabinet stays in my room. It is in a very specific location and is not supposed leave my room. One secretary and one junior high nurse know how to access the code. Subs are also directed how to access the code.
Like I said, I inherited the cabinet when I took this job. I feel like this system is working well so far.
Limiting access to the code is important. I count controlled meds when I receive them. Most of my daily meds are controlled substances. They go in my locked cabinet which is accessed by me multiple times a day. I track administration and initial counts of those meds in SNAP. I don't count meds every night.
What do others do? And sorry to hijack your cabinet thread, lkirk!!!
NanaPoo
762 Posts
I have keys.
When I first came, my keys were kept in the clinic mailbox which is in the locked administrative offices. BUT, I am not clear on who all has access to that office in the evenings and on weekends. During my 2nd year I had someone replace 3 Focalin tablets with Pepcid over the weekend. Ack! They left a bottle of generic Focalin untouched.
The principal at the time and I decided then I would always carry the keys with me. If I happen to wake up sick I still have my daughter who goes to school here and she brings them in to the front desk. That's a rare day, though. Obviously, no instances of replaced or lost meds since then.
I don't think I'd be comfortable with the passcode idea.
NurseBeans, BSN, RN, EMT-B
307 Posts
I agree, the passcode feels uncomfortable. I have keys that hang around my neck, the only other key to the med cart is kept in the secretary's desk. But I also store the cart in a locked closet, then lock my office door. I have all three keys, the secretary keeps only two of them. I almost never have a sub but when I do, I come in and unlock the doors and make sure the sub has the med cart key that gets left with the secretary, then I lock up at the end of the day. Needless to say it's really not worth being out sick as I have to stop by twice anyway!
Thanks for the feedback! The cabinet we have right now is a black and decker and the lock part is starting to loosen up. What cabinets do you all have? We have a tight budget and the key less cabinet we were looking at is about $220. I also think that limiting the access code for the keyless one would be ideal. No worries ohiobobcat!
OldDude
1 Article; 4,787 Posts
I don't like keyless anything.
JenTheSchoolRN, BSN, RN
3,035 Posts
I have a key to a locked filing cabinet. I am the only person with the key, but there is an extra hidden away that only my principals and admin boss have access to. I leave this key for a sub and/or one of the above people accesses my extra key for the sub.
I don't count meds every day either (just when I get them and track in my EMR; I reconcile each Friday when I refill each student's weekly daily med pill box); the cabinet is left unlocked when I am at my desk (I also keep all my OTCs in there as well as my more expensive equipment like my pulse ox and otoscope) or I'd be unlocking it all day. I do lock at night/when I leave my office to teach, etc. My office itself locks automatically when I shut the door and very few people can access it.
Flare, ASN, BSN
4,431 Posts
we got hit during a qsac inspection for not having a double locking cabinet. So that's what I have now. It's got keys that i keep on me all day them secure in my office at the end of the day. I have 2 spare sets well hidden incase i leave with the keys and am not in or forget them on top of the washer (which may have happened once:whistling:)
AdobeRN
1,294 Posts
I have a locked (key) cabinet for my controlled meds. I don't lock up the PRN's, inhalers or EpiPens - they are in a cabinet. I have a key, secretary has a key and I have a spare key hidden in the office. I only count controlled meds when parents hand me the bottle - I count them with and in front of the parent. Our computer system has a "medication Inventory tab" I then log it in the system.