Narcotic storage

[toronto rn]

Just wondering how other units sign out and store multi-dose narcotic syringes. for example mixed morphine 2mg/ml 10 mls or other narcotic. Can a filled syringe be kept at the bed side?, what safety practises are used? What practise is used for storage if syringes are left at the bedside? or must all doses be individually signed out of narcotics storage. I would appreciate any responses

[zambezi, BSN, RN]

I try to take out as little as possible. So If my patient is orders 4mg/ and for some reason I am giving 2mg, I will pull out the 2mg cartridge. Our dosages come in 2,4,10, and 15. If I do pull out more if I think that I will need it, I keep it in my pocket unitl I use it. I try to waste as soon as possible if I think that I am not going to use it again so I don't forget at the end of my shift. At my hospital random monthly checks are done on narcotic wastages so if you pull out 4 and only 2 is documented chances are you will get a memo on that (if it is a frequent issue for you, you will get audited more frequently and get more than a memo.) Of course, when we waste, someone has to witness and co-sign in the omnicell.

Just recently, my hospital readded 10mg cartridges back to our omnicell because it was easier to pull out exact ammounts and we found that having the variety in dosages available has really cut down on the ammount that we have had to waste.