med error questions and more

momtojosh · Apr 22, 2009

i have had one med error since starting my job in july.......was suppose to give 3 and only gave one cap of a med....i felt awful,the RN was nice about it...she says we all done it,we are only human........you can bet i have slowed down and read EVERYTHING now......i work in a house with 12 medically frail mentally retarded individulas....all in wheelchairs and very very frail....all gtubes and trachs....from 7-9 the med person is doing 7,8 and 9:00 meds..to get ready for day habilitation to come in for 9-3......it is somewhat nuts at times...i know that is no excuse,but i think that is what happened....i was new and trying to get my meds passed before day hab came......

when we are out of a med,we sign and cirlce our intls......then star the back of the mar and state why it wasnt given......just yesterday i was out of a liquid med,couldnt give it....

i know hoiw yoiu feel......i felt bad too.....

Lexxie, LPN · Apr 22, 2009

If a med isn't available, you should initial that block and circle it. Then you can write on the back of the MAR "med not available. Pharmacy notified. Will be delivered in AM" or something similar.

calgirl123 · Apr 22, 2009

Thanks, I will do that from now on. I may lose my job over this, but what Im really upset about is how I could overlook something like this. Thanks again, your input is so appreciated:clown:

sasha2lady · Apr 23, 2009

what i do is initial and circle it and then write on the back of the mar why it wasnt given......our new thing now is that we have a new sheet for refills and so this takes more time thats necessary and after we jump thru hoops to try and get a med in thats due at 8pm at 3pm.....we usually fail ...and anyways....now we have to fill out med errors on every single one...however.....not all nurses are doing this...they will borrow and sign that they gave it which makes the other pt come up short in the end....or they just sign that they gave it and didnt.....luckily...on our med error reports we dont have to put the pts name or our name on it.....i filled out 4 in 2 days just for me not having meds to give and you better believe i checked off all the parts on that thing that dealt with the pharmacy *pharmacy did not deliver * med not available ......yes yes and yes. i just hate that it made me look so bad but the way i see it is ....if you dont have it you cant give it..better to be honest about it than lie and it catch up to you later somehow......our pharmacy is terrible! plus...they are 3 hrs away from our facility which doesnt help us at all!

AshiPanda · Apr 24, 2009

At my job, we sign the med, then circle our signature if there was any reason that the med was not given. Then on the back of the MAR page we write a description of why it is circled. It's ok if you don't have the med to give, but you need to cover your butt

Then you'd want to make sure it's on order through the pharmacy! =)

systoly · Apr 24, 2009

I would try to avoid circling a med and writing, "not available", whenever possible. A lot of times Docs will agree to write an order "...start (or give) when available". If you must circle a med, there should be supporting documentation in the chart. Simply writing, "med not available", doesn't show what you've actually done to try and get the med or why it is not available.

calgirl123 · Apr 25, 2009

THAT IS A GOOD POINT, ACTUALLY AT MY FACILITY WERE NOT EVEN ALLOWED TO CIRCLE AND WRITE MED NOT AVAILABLE, SO ESSENTIALLY THERE ASKING US TO SIGN FOR A MED THAT IS NOT THERE. yA CANT WIN. tHANKS SO MUCH FOR YOUR REPLY

CALGIRL123:banghead:

Starr1966 · Apr 25, 2009

Where I work if a med isn't available, I initial and circle it. Then we are to write above on the PRN med sheet why it wasn't given. I think writing it on the MAR makes more sense, then the reason will be on the same sheet, whereas on the PRN sheet that can be on the medex for a long time until its full. Same as if a resident refuses their meds, initial and circle then chart refused above.

I have a question, if a resident refuses their med, are you to call their doc and report they refused it? I haven't done this at the LTCF I work in, but when I worked at a hospital we had a pt that didn't get a med and were to report it the doc, I didn't know that and I don't know if the CN knew it or not, but we were in some hot water about that one.

calgirl123 · Apr 25, 2009

At my facility your suppose to circle the med and write on the back med refused offered x3 without effect if the res refuses 3 times in a row the dr is suppose to be called. If the med is just not available for whatever reason were not suppose to write it on the mar,which is stupid because according to the state your not suppose to sign if it wasnt given.

Lorrie34 · Mar 28, 2010

It's a no-win situtation here. If you don't have it, the facility wants you to sign it and circle it and fill out on the back of the MAR why it wasn't given. You can't just leave it blank.

But they tell me if it is a vital med (antibiotic or BP etc) we need to make every attempt to find it in the building and get it to the patient or state could say "It was in the building, why didn't the resident get it?" but at the same time, if I "borrow" it from another resident's meds because it isn't in the e-box, it's misappropriation which is a violation of the other resident's rights.

It's a gray area and I hope that someday we find a resolution to this age-old dilema. Doing the best for each resident is always the priority. I may raise a red flag for the facility by documenting "med not available" but at least I'm not violating any other residents' rights and risking my license....I think.

Bobylon · Mar 28, 2010

Am feeling "lucky," here .... we have med admin on laptops atop our med carts. If a med isn't available, we can send a message to pharmacy, who are usually quite prompt in tubing it to us. I always check my entire night's meds to pass and check what's in the cart..... if I need something, pharmacy gets notified immediately and it's rare that anything is administered late....... I couldn't deal with even more paperwork..... am dreading the day the system goes down and we have to go to paper charting/MAR:eek: