I work in LTC. Our meds come weekly from pharmacy in a strip pack (little plastic baggy with all 0800 meds in one bag and then all 1200 in another etc).
So for eg. 0800 bag would have Digoxin, calcium, metoprolol
1200 bag would have calcium
1600 bag would have coumadin, alprazolam
these are just a made up example.
My question is what system do you use in LTC?
ALSO, when our strip packs come in, they make 2 RN's check them. So we go through the MAR and compare the MAR to the actual strip pack to verify that the strip packs are correct, we do this for each resident before we put the strip packs in the med cart. Of course meds are checked by the person giving them at the time-obviously.
This is the only LTC facility I worked in that does that. I think it's unnecessary.
Our facility has a pharmcy rep come in on the first of the month with all of the meds in large cardboard filing-type boxes. The rep checks against the MARs to make sure all the meds are there, and then the boxes get locked up in the med room...
Until the third of the month, when each charge nurse changes out all the cycle cards for whatever med pass they are responsible for. (For example, I do all the 9AM and 2PM cards because I work 7-3. That way, the nurse who is responsible for those meds puts them away, in room order. PRNs/Narcs (even routine ones) are ordered/come in as we run out, and we receive 3 deliveries a day.
It's not a perfect system, but it sounds a bit easier than some others have it!
When you all are talking about the pharmacy "changing out the cards" or delivering a big box of meds, I am not sure what you mean. Does the pharmacy deliver a month's worth of meds for everyone in one big delivery?
At my LTC, there is no routine monthly or weekly delivery. Every med in the cart needs to be individually re-ordered by a nurse when it is running low. When the bubble card only has a week's worth a pills left, we need to order it--it would not automatically be delivered.
It sounds like other places with their automatic delivery would be so much more efficient than the disorganized way it is done in my facility (and every other facility in this area...)
When you all are talking about the pharmacy "changing out the cards" or delivering a big box of meds, I am not sure what you mean. Does the pharmacy deliver a month's worth of meds for everyone in one big delivery?
At my LTC, there is no routine monthly or weekly delivery. Every med in the cart needs to be individually re-ordered by a nurse when it is running low. When the bubble card only has a week's worth a pills left, we need to order it--it would not automatically be delivered.
It sounds like other places with their automatic delivery would be so much more efficient than the disorganized way it is done in my facility (and every other facility in this area...)
Yes, we receive a month's worth of meds at a time, except for Medicare meds, which come in 14 day supplies and have to be reordered as needed. At any given time, only about 10% of my patients are on th 14 day cards. I cannot imagine having to reorder as needed for everyone...to much room for error, since there seems to be weeks where the pharmacy is SO SLOW in delivering!
The meds in baggies is what they do in acute care around here. My facility (and I'm pretty sure all the others in this area) use the blister packs with 30 day (or 7 for Medicare) supplies. Each card has a sticker that is removed and placed on a form to be faxed to the pharmacy for re-order. We have pharmacy come in several days a week to deliver, but a nurse checks the meds in and whatever nurse is responsible for the cart puts the meds in their shift's drawer by resident name.
StarNurse2006
72 Posts
Our facility has a pharmcy rep come in on the first of the month with all of the meds in large cardboard filing-type boxes. The rep checks against the MARs to make sure all the meds are there, and then the boxes get locked up in the med room...
Until the third of the month, when each charge nurse changes out all the cycle cards for whatever med pass they are responsible for. (For example, I do all the 9AM and 2PM cards because I work 7-3. That way, the nurse who is responsible for those meds puts them away, in room order. PRNs/Narcs (even routine ones) are ordered/come in as we run out, and we receive 3 deliveries a day.
It's not a perfect system, but it sounds a bit easier than some others have it!