Medication incident reports

[Ginger80]

I work night shift at a LTC facility, and I sometimes find hs meds left at a resident's bedside. These are residents who do not have an order that states meds can be left at their bedside (people with dementia).

My question is, would you fill out medication incident reports? Some other nurses have told me not to if there are no narcotics involved, and to just throw away the meds. I have been filling out these reports, but now I'm wondering if I'm getting people into trouble.

Any advice?

[CoffeeRTC, BSN, RN]

Technically, yes. It is a med error if they didn't get the meds. Have you tried speaking with the nurse leaving the meds?

[carolmaccas66, BSN, RN]

Wow, this is so illegal! On the pysch unit I work at, meds are left next to the bedside all the time! I've informed the NMs but haven't seen anything change. I always explain to patients they either take their meds now, or don't get them at all, it is especially dangerous leaving meds with psych patients, but no-one seems to care.

Also in our country you are technically required to watch people take their meds, and ensure they aren't keeping them in their mouth, etc.

You are doing the right thing, keeping the patients from being endangered.

Do u know who is doing it and have u informed the NMs/NUMs?

[etaoinshrdluRN]

My policy is to talk to the tech or nurse and remind them to check orders and observe pill taking. Only once did a tech get defensive and accuse me of targeting her (her usual rationalization of criticism). I pointed out that I was just commenting, but that the next time would be written up as a med error. Technically, I should have done med errors on every instance of those bedside or supper table pill cups, but I do believe in a human approach and progressive discipline, and feel justified in a tactful verbal reminder.

[LouisVRN, RN]

Absolutely! Especially if the medication is documented as given. If the medication is not documented at all, I would probably tell the person (if I could identify who was doing it) that this was a very unsafe practice and try to determine their rationale. Was the patient refusing at that time and they wanted to come back to try later but forgot or never made it back or what?

IMO if this happens more than the once in a blue moon occasion the person needs to get in trouble. No telling who takes the pill if it comes up missing, a staff member or family member and what negative effects they could have.

[nursing6207]

Off the subject. I have had demented and oriented pts take about half the cup of meds and hand it back to me and tell me they can't take anymore right now. At that point I have absolutely no idea what they have taken or not. If I had of known they were going to only take half I would of given them to them one at a time, most impt ones first. So then u have to go back to the omnicell and identify all the pills, as if we have all the time in the world to do this. How annoying. It is also very annoying when u take a pt there pill, open them, then they decide to tell u they are going to finish breakfast then take there meds. Then u have to explain to them that u can't leave them there and sometimes u get the pts that would just rather u throw them out bc they are just not going to take them right now. The lovely obstacles we face every day. YAY :)