Med Cart Organization

[RNMoxie]

Pre-survey and following state check is fast approaching. I have a nagging question about med carts in LTC facilities, specifically Florida. Is there an existing policy for how medications need to be organized in the cart? Should it be by room/bed number or name? I seen facilities that have a combination of the two as well, I.e. narc box by name and other non controlled drugs by room/bed. But there doesn’t seem to be a lot of uniformity in facilities so I’m wondering if this is due to the lack or noncompliance of policy or up to the facility or etc. Can anyone provide an answer to this or a link to a policy? I’ve scoured the internet and can’t find anything.

[amoLucia]

Retiree here, so don't know if things have changed too much. The only requirement we used to have was keeping the med carts organized - liquids separate from med cards; eye drops separate, inhalers separate, topical patches separate, etc.

I remember the respiratory neb stuff taking up so much room on the carts. Likewise, IV equip, like flushes were just too much.

Some places' carts would carry the canned supplements.

Treatment oints were NOT on med carts. That was for the tx cart to hold.

Problem was that carts were just getting bigger and bigger and bigger. And that meant getting heavier & heavier & heavier to push. (I always wondered if OSHA ever evaluated nurses' pushing those BIG BEHEMOTHS.)

And then you'd get the nurse who'd put NON-med stuff like GT/IV tubings and resp masks, O2 cannulas, neb masks, etc. NO!!

As for the cart itself, locked narcotic/controlled drugs were always alphabetized. General meds were by room /bed sequence. I couldn't imagine any other way to organize it.

The only regulation I remember was that narcs had to be double-locked so that included the refrigerated ones.

You know who might help you, try your Consultant Pharmacist. They were usually super-helpful. At many places, our consultants would do mock survey med pass observations. You could also try your State Board of Pharmacy for any information.