Locking up IV solutions

[Bwick]

With the medication safety mandates, how are you handling IV solutions? Do all of them need to be locked up? Do just those solutions with meds like potassium in them? How are you handling this mandate?

Thanks

Sue

[McGyverRN]

My facility's policy is that all IV solutions must be locked up. I'm not sure if this a legal requirment or a JCAHO mandate.

[rjflyn, ASN, RN]

One word Pxyis.

Of course at times that leads to 4 words Pain in the A--

Rj

[manna, BSN, RN]

I'm still a student, but at the facility where we do most of our clinicals (and I worked as an extern last summer), the IVF are most often kept in the med room, along with the tubing, cathlons, needles, etc.

[runneRN]

Only the IV's with meds get locked up in our PYXIS...what is the rationale for locking up plain IV's

[Geeg]

The admin wants everything locked up, so that they can charge for it, item by item. It is all about the $$$$$$, safety is just the excuse.

[suzanne4, RN]

IVs should be in a locked med room, or just a locked room. Pyxis system is fine, if you have it, but it doesn't require that much of a lock.

[Bwick]

thanks for your responses.

Our IV solutions are from Baxter and it says on the bag "for Rx only" on all bags, even the plain ones. Our pharmacy department is interpretting that to mean that we include them in the lock up.

It's not just about the money. We had a JCAHO review last Sept and they were very picky about med storage. They made comments about even securing our crash carts or putting them in plain site because "someone" could role the cart down the hall and into the stairwell to raid it. They are taking medication security very seriously.

I don't know about your facility but ours has a LOT of fixed payers, so it doesn't matter if you charge it to the patient - for the most part, you will not get it back.

[DusktilDawn]

thanks for your responses.

Our IV solutions are from Baxter and it says on the bag "for Rx only" on all bags, even the plain ones. Our pharmacy department is interpretting that to mean that we include them in the lock up.

It's not just about the money. We had a JCAHO review last Sept and they were very picky about med storage. They made comments about even securing our crash carts or putting them in plain site because "someone" could role the cart down the hall and into the stairwell to raid it. They are taking medication security very seriously.

I don't know about your facility but ours has a LOT of fixed payers, so it doesn't matter if you charge it to the patient - for the most part, you will not get it back.

JCAHO is even picky about the pre-filled saline syringes not being left on the counter. IV bags and prefilled syringes are considered medications by them. Where I work, IV solutions are kept in the stock room which is locked.

[snowfreeze, BSN, RN]

Everything we use for patients including the linen is in a locked room. We have keypad access. Regular scheduled meds are in a med cart, narcotics and controlled meds are accessed through a double lock system with a room with a pixis type access. The "kitchen" which is a closet with ice machine, cups, coffee pot and refrig with applesauce, pudding and gingerale is not locked yet.

[NRSKarenRN, BSN, RN]

One local hospital got sued when microwave oven "fell over" off counter and broke her foot so kitchen now code locked. Had tackle box ontop of code cart in nurses station broken into by someone to steel drugs....took the bicarb syringe and IV bags---back in 1978. Shocked the hell out of this then novice nurse. Participated in codes cause RN incorrectly admixed potassium solution --company changed concentration (in fine print) same color label so not noticed.

These are all reasons safety measures are ratching downward: to prevent death and injury.