Medication Unavailable

[txdon]

Recently our corporate pharmacist did an audit and identified several times nurse's circling their initials on the MAR and writing on the back," Medication unavailble". Can someone tell me what nurse's show write on the MAR when a medication is unavailable? I have instructed my nurses to call the Dr and request to hold medication until it becomes available. Is it okay for the nurses to write on the back of the MAR,"Hold medication per Dr. order." or should they write something else?

[CapeCodMermaid, RN]

We were just told by our consultant that hold orders are no longer good especially those which say 'hold for 2 weeks and then call MD'. But for holding one dose of a med, I'd still write 'hold x 1 dose then resume'. The bigger question is why isn't the med available? Do you have a first dose kit (E-Kit) with the most commonly used meds in it? Is the pharmacy slow with delivery? Are the nurses not reordering?

[debRN0417]

I agree with CCM. Why is the medication unavailable? You can write anything you want but a pattern of unavailable medications should be a red flag that either the pharmacy is not getting the medications to you, or the nursing staff are not ordering properly.

[morte, LPN, LVN]

it makes it appear that nothing is being done....you at least need to add that the doctor/pharmacy were notified.

[txdon]

I think a large part of the medication not being available is due to nurses not reordering the medication in a timely manner. Usually this occurs towards the latter part of the weekend, leaving the weekend staff scrambling. Any suggestions on how to improve this system?

[CapeCodMermaid, RN]

Do you have a weekly drug order day? If not, you should have one day a week where the majority of the meds are reordered. Usually it's done on 11-7. Make sure the nurses know it's their responsibility