Narcotic Count Sheet

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Hi, Luna here. I'm hoping to get some understanding of how the narcotic count sheet is to be signed. At my place of work ( a home care position) we have to sign a narcotic sheet for each controlled substance we give to our client. Of the 3 controlled substances, one in particular seems to always be off and it's starting to weird me out because some smells fishy.

So, my question is, should the quantity you sign off on the narc sheet match what remains or what's in the bottle before you remove the pill?

The other two med qty match what remains, while the one med matches what's in the bottle before removal

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Probably just an admin error that has been carried forward without anybody turning their brain on to find the discrepancy like you just did. I would check with the supervisor to find out how she wants you to note the change on the sheet and get it corrected so the amount is then correct. Also file away in the back of your mind that your colleagues lack in attention to detail.

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Probably just an admin error that has been carried forward without anybody turning their brain on to find the discrepancy like you just did. I would check with the supervisor to find out how she wants you to note the change on the sheet and get it corrected so the amount is then correct. Also file away in the back of your mind that your colleagues lack in attention to detail.

Thanks! It just bothers me because I'm new to this position. The person who works prior to my shift always seems to forget to sign or gives an extra dose without signing, throwing the count. I noticed it happened to an even newer employee as well ( we work the least). Then there's arrows and madness on the page where prior person corrects. So I find myself confused.

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The arrows and madness is more disturbing than the original error. Can not tell you how often I have seen arrows and madness. People will obliterate, scratch out, actually rip a hole in the paper scratching over the previous entries, time and time again, and the supervisors won't address the problem. Just make sure you cover yourself with correct procedure because one of these days somebody may be finding themselves answering for a mess and you want to make certain it is not you. I would even go so far as to write a communication note to the supervisor regarding the arrows and madness so it is clear that you are not the one making a mess of the form. Cover yourself.

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You must sign out the med every time you give it. The count of the actual number of pills in the bottle must match what is written on the narc count sheet. The offgoing nurse cannot leave until the problem is resolved.

Never sign the count sheet or accept the patient if there is an incorrect count. Notify your supervisor by phone at once whenever the count is wrong.

The supervisor needs to straighten out the mess you describe at once.

Stuff like this can get you accused of wrongdoing. Or get you fired. Or reported to BON and police.

A wrong count and / or a wrong count sheet these days is completely not acceptable.

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Specializes in LTC, Rehab.

Sign out what remains. In our facility, we have to sign it in a book, showing how many there were, how many you gave, by what method, how many remaining, and then your signature/title.

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Specializes in PICU, Pediatrics, Trauma.
Hi, Luna here. I'm hoping to get some understanding of how the narcotic count sheet is to be signed. At my place of work ( a home care position) we have to sign a narcotic sheet for each controlled substance we give to our client. Of the 3 controlled substances, one in particular seems to always be off and it's starting to weird me out because some smells fishy.

So, my question is, should the quantity you sign off on the narc sheet match what remains or what's in the bottle before you remove the pill?

The other two med qty match what remains, while the one med matches what's in the bottle before removal

If this is a tablet form and the count is off, you should report it to your supervisor, or whomever your company states you should report this to. ALWAYS document what you find. Never document what you expect to find. If it seems "fishy" to you, then you are required by your BRN to report this. You can end up being considered as involved in this and suspected along with anyone else. DO NOT discuss this with co-workers. DO NOT discuss with the family. Let your supervisor investigate it. And write your own, private notes about this, in detail with the dates you noticed this and what you found and what you did. At some point when/if investigated, you may need the notes to recall details accurately. It also shows your company that you are ethical.

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Specializes in PICU, Pediatrics, Trauma.
If this is a tablet form and the count is off, you should report it to your supervisor, or whomever your company states you should report this to. ALWAYS document what you find. Never document what you expect to find. If it seems "fishy" to you, then you are required by your BRN to report this. You can end up being considered as involved in this and suspected along with anyone else. DO NOT discuss this with co-workers. DO NOT discuss with the family. Let your supervisor investigate it. And write your own, private notes about this, in detail with the dates you noticed this and what you found and what you did. At some point when/if investigated, you may need the notes to recall details accurately. It also shows your company that you are ethical.

One more thing I meant to say...just for info to think about...sometimes with liquid meds in a multi dose vial, over time, small amounts add up with non exact doses being withdrawn consistently. But numbers of tablets are numbers of tablets.

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