Medication diacrepency

[SicuRN101]

I had a medication discrepancy the other day for a benzo. The count was off in the omnicell. I'm not sure if I resolved it. It might look like I took one more than I actually did. I've been a nurse 1.5 years and have had maybe 2-3 discrepancy's like the count was off but I'm concerned this will flag me. Is this common should I be very worried? We also sometimes too will grab like a fenranyl gtt during a busy assignment for another nurse and someone else will scan it but is not the nurse that pulled it. I'm just being worried I will be flagged.

[JBMmom, MSN, NP]

No real way to know what your specific facility will do. You may have some re-education assigned, or it could be more serious, especially depending on what your past discrepancies have been related to. I completely understand getting busy, but make sure you take the time to be sure your narcotic draws are correct, it's probably one of the easiest ways to get yourself in unnecessary trouble. Good luck.

[KelRN215, BSN, RN]

Even if you get flagged, if you haven't been taking illicit/unprescribed drugs, who cares?

And if you're the one that found the discrepancy, wouldn't it look like the mistake was with the person in front of you? Did you have a second nurse verify the discrepancy? When I worked in the hospital, we always had 2 nurses count every controlled substance every time. And if the pyxis said there were 20 lorazepam tablets and we counted 18 but the person before had verified 21 and said they were removing 1, it would look more like that person took too many out.

If your facility doesn't have 2 nurses count every time, I can see how it could be suspicious for either one of you (she verified 21 and took 3 or there really were 20 and you said the count was 18 and took 2 extra for yourself) and the facility could potentially ask both of you or everyone working that shift to submit for a UDS. But, again, if you know you're clean, it's not a big deal.

I am not aware of there ever having been a situation, in the nearly 5 years that I worked in the hospital, where anyone was asked to submit to a drug test because of a discrepancy in the Pyxis count.

[PeakRN]

How would you have caused a discrepancy but then have resolved it by yourself? Does your hospital not require a 2nd RN/LIP/Pharmacist to reconcile discrepancies?

If one of my nurses makes a discrepancy we expect them to tell the charge nurse immediately. The more times someone has been in that drawer since the discrepancy the harder it is for me to figure out the cause, and if there is something missing it becomes very difficult to figure out who actually did what.

I have some nurses who have seem unable to accurately count the number of vials in a container (I think that there is some universal law that elementary math becomes exponentially more difficult when logged into a pyxis/omnicell), we don't hold their number of resolved discrepancies against them.

I would highly recommend against pulling narcotics for other nurses unless there is an emergency, and you either should be scanning it yourself or documenting a narcotic sign out.