Leave me alone when I'm passing meds!!!!!

Specialties Geriatric

Published

How would you answer this question?

When nurses are interrupted during medication administration, errors can occur in practice. What percentage of the time do nurses make mistakes when interrupted during medication administration?

a. 22%

b. 31%

c. 74%

d. 100%

The correct answer is "c" 74%.

In a study by Westbrook, et al. (2010), the authors found that interruptions occurred in about 53% of medication administration events resulting in at least one procedural error in 74% of patients, and one clinical error in 25% of administrations. Although many errors were considered to be minor, 2.7% were considered to be major errors resulting in complications or mortality.

The take home point here is that nurses are interrupted frequently during medication administration and that mistakes happen frequently, some leading to catastrophic results. Seek a quiet environment when you give medications and give your peers a break, by leaving them alone during their medication administration.

From:

Westbrook, et al. (2010). Association of interruptions with an increased risk and severity of medication administration errors. Arch Intern Med, 26(170); 683.

Specializes in Med Surg, Tele, Geriatrics, home infusion.

My problem time is last rounds on 11-7 in LTC facilities when I'm doing my morning med pass. I need it done by 6a in order to finish my charting and get out on time. I have roughly 30 people getting synthroids/ pain meds and prilosecs plus 6 fsbs 2 w/ coverage plus sometime 1 or 2 IVs esp flu season. My solid aides take those who ambulate to the b.r. or put people on bedpans in addition to just changing the incontinent ones. But I have a few who don't and they kill me. They don't answer bells because they're "doing rounds" and immediately after they disappear into their get ups rooms. When I ask them to toilet those people I get accused of being lazy. But as much as I don't mind helping- I am trapped in an awful med pass that toileting 3 or 4 people especially fall risks that I have to stay with will make my med pass take till 6:45...at which point I have 2 7-3 nurses breathing down my neck waiting to count and get report. LTC can be hard, and I see it only getting harder. They will keep hitting us with huge resident loads that we can only survive if we work together as a team. Especially 11-7 there's only a few of us so we sink or swim together.

This is a serious issue that really should be the focus instead of worrying about wiping down the glucometers.

I get more interruptions during a medpass from CNA's than I do from family members and they should know not to interrupt the nurse during the medpass. "So and so wants pain medicine" "So and so needs xanax" "So and so wants her pills".

Unless its a critical issue, save it. I am aware of the patients who need pain medicine and know when their next dose is going to be. Everyone will get their pills.

As a CNA I've never been told what you just said, and I guess I've never thought too much about it. Suppose I should have :( I've talked to my charge nurses about whatever and they've never told me this, but honestly I'm glad to read this and I'd no problem with it. I think we as CNAs should be made more aware of this.

Were I used to work in LTC as a CNA I only saw the nurse during medpass or if they were charting. I never could find a good time to ask them for something.

That's a good point. I guess it should be better communicated when the right time is.

My CNAs rarely interrupt me. It's the ringing phone, family members, or department heads saying "do you know you have a call light?" that stops my med pass. I want to say "I know I have a dang call light but I also have narcs sitting on my cart so it is gonna have to wait; I also have CNAs that WILL get it as soon as they finish with their current resident." My med passes take me forever, largely due to stupid interruptions.

uuggg that darn call light crap

Do we work together?! I think I've just found the CNA who is forever interrupting my med pass for the most trivial of things. :uhoh3: Because you might forget to tell the nurse, you feel the need to interrupt the med pass. And doing just than can contribute to a med error that just might kill someone. I suggest you work on some memory techniques.

Screw the med pass...?? Seriously? Unless the patient's life is on the line right at that moment, it can WAIT. Just keep a notebook or some sort of paper in your pocket, write it down and leave it for the nurse on the med cart. That way, YOU won't forget and the nurse is notified and problem of your poor memory..solved.

Come back and post when YOU are the nurse being interrupted for everything under the sun by a CNA with an attitude like yours. I'd be willing to be you'll be changing your tune real quick.

I agree with you 100%. If it's important enough you'll remember, if you have to write it down then write it down. And chances are if it's so and so wants her pain pill, she'll be back on the light soon anyways.

ROFLM(sick)AO!! *cough cough*

... gah... can I shove this on my management people who just recently gathered us licensed nurses and chastised us for focusing only on medpass, that we should pay more attention to our surroundings and answer call lights, etc. "Customer service, guys. Remember, customer service." is what our admin said.

Normally I am sympathetic to our admin, DON, everyone... they're all nice people. But now I'm sick, miserable, and not looking forward to dragging my heavy self for another shift of all that BS.

I as a CNA have always thought way to much is put on the Nurses. Some CNAs complain they don't help us enough or whatever but you all have your jobs to do too. And I know most of the time when a CNA is interrupted by a charge nurse to do something, it's because management or some one else is on them about it.

Well I worked hard for my license as well I might have worked as long as nurses have but it means something to me too. And not reporting something in a timely manner could cost me my license and chance in ever farthering my nursing career. And I have been in too many situation where I have "waited'' on the nurse to finish her MED pass and by been to situation had gotten worse....and who do they blame....CNA!!! or the nurse will lie and claim I had not told her anything. I guess better my license then hers. But you have to realize that the CNAs have a responibility to alert the nurse at any status changes, minor and extreme. May when I become a nurse I will see things differently. But I will certainly keep mind of this the next time I need to tell my nurse something.

I've been blamed for stuff too, I know what your saying, but I think it's just a judgement call of what can wait and what cant. I know what you mean though, there's been times I've been told to wait until they're not busy then later "you should have told your charge nurse"

I think the idea to write it down and put it on her med cart is a good idea so when she gets a min. she can look and you know you've covered yourself. Of course this has to be an agreement of both parties.

Specializes in Med Surg, Tele, Geriatrics, home infusion.

personally I think the idea of writing down requests is a very good one. I both welcome and need feedback on my residents from my cnas. IE if someone's skin is not looking good and you have them in the bathroom that's when I want to see it...not have it mentioned to me in that last few mins of my shift when I'm trying to finish up. CNAs who take that extra few mins to be observant are priceless- wish I could put them all in for raises!

Specializes in LTC.
personally I think the idea of writing down requests is a very good one. I both welcome and need feedback on my residents from my cnas. IE if someone's skin is not looking good and you have them in the bathroom that's when I want to see it...not have it mentioned to me in that last few mins of my shift when I'm trying to finish up. CNAs who take that extra few mins to be observant are priceless- wish I could put them all in for raises!

Right ... thats different. There are things I'd want to be interrupted for.. like that.. and if someones vitals are bad or is vomiting. But things like "mary wants her pills". and "so and so needs a pain pill" ..

Specializes in Geriatics.
Do we work together?! I think I've just found the CNA who is forever interrupting my med pass for the most trivial of things. :uhoh3: Because you might forget to tell the nurse, you feel the need to interrupt the med pass. And doing just than can contribute to a med error that just might kill someone. I suggest you work on some memory techniques.

Screw the med pass...?? Seriously? Unless the patient's life is on the line right at that moment, it can WAIT. Just keep a notebook or some sort of paper in your pocket, write it down and leave it for the nurse on the med cart. That way, YOU won't forget and the nurse is notified and problem of your poor memory..solved.

Come back and post when YOU are the nurse being interrupted for everything under the sun by a CNA with an attitude like yours. I'd be willing to be you'll be changing your tune real quick.

It seems to me that the nurse is the one that needs to work on memory skills.

Specializes in LTC.
It seems to me that the nurse is the one that needs to work on memory skills.

Maybe the CNA needs to realize that the nurse is putting chemicals(medicine) in patients bodies and can make a fatal error if interrupted.

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