Need help defining research "key words" please!

[Student Mom to Three]

Hello-

I am a senior nursing student (in more ways than one!) and am doing some online research for a paper I need to write. Basically, I need to locate some research (actual experiment or meta-analysis) that has been done regarding appropriate management of multi-use narcotic tubexes. I'm referring primarily to those medications that are given as part of an operative procedure or in recovery.....the ones that are fentanyl, or hydromorphone or similar q 3-5 minutes. I need to find some research that indicates the safest way to maintain the actual narcotic between doses. Many anesthesia providers keep the partially filled syringes in their pockets....but what are nurses in recovery supposed to do with them? I can't imagine they keep them in their pocket. Do they keep them at bedside? Are they locked up? I know what should happen with them (ideally they would be locked), but I would like to find research backing that up.

Am I making sense?

I have gone to CINAHL and google and am having no luck finding any research. I have been looking along the lines of preventing diversion, managing narcotics in recovery/OR/PACU, etc and am getting nowhere. The only research article I found was done by pharmacy and is about safety measures taken with the ADMs.

Any ideas? I'm not looking for someone to do the work for me, just to share some ideas of key words that could point me in the right direction.

Thanks!!

[rn/writer, RN]

Normally we move student threads to the Nursing Student forums. This request, however, is not likely to be something other students, or even other med/surg nurses who read the student forums, would know much about.

If any of you experienced OR/PACU nurses subscribe to professional journals that have addressed the questions the OP is asking, or if you are aware of any research on the subject, maybe you can share your knowledge. Even if you don't have information about actual research, you could tell her how things are handled at your facility and if the rationales behind your current P&P are evidence based.

Thanks for your assistance.

[Rose_Queen, BSN, MSN, RN]

Before we had a pyxis in each OR, the CRNA or anesthesiologist would have to remove a kit from the central pyxis that had everything they should need for the case in it. They were locked before being removed from the pyxis, and the provider had to put a new lock on before returning it. Pharmacy would reconcile the meds returned vs. meds documented on the anesthesia record. I assume they do the same with the pyxis, it would just be a faster process.