Neonatal Admission Meds and bedside barcode scanning...How do you all do it?

vanilla bean · May 13, 2015

We have a standard order set for baby's admission to the hospital which includes the meds. We pull from Pyxis, scan, and administer. I have no idea what happens behind the scenes w/pharmacy, but have never had any type of delay.

prmenrs, RN · May 14, 2015

Every, single time you run out of your time frame, file a "variance/quality/incident report--whatever you call it. Include all possible sequelae to the baby, licensure issues, standard of care in the community. Keep hitting them w/paperwork until they figure out what's wrong.

Sometime in the near future, you will need stat drugs for a new admission who is a millimeter from coding, and you won't be able to get them. IT, pharmacy needs to get the message that this is not acceptable!

We had a stamp for the order sheet that said "anticipated admission" that we could get stuff with. The hard part was getting X-ray, labs etc ordered w/o a Medical Record # . Nightmare.

Good luck!

Elvish, BSN, DNP, RN, NP · May 15, 2015

We recently transitioned to all computer charting and order entry with Epic, so assuming we get our ordersets initiated in a timely way it's never a problem for us. Admitting baby via Epic is easy-peasy, so all we really have to do then is initiate order sets.

Prior to that we had to manually scan orders down to pharmacy. And before that could be done, we had to manually admit everyone to the computer. Then patient registration had to admit them, and then pharmacy had to verify the orders....so it often took a while. However, I don't know what your facility time frame is, but ours is two hours. Very rarely - if ever that I can remember - did we have a baby born in-house that didn't get their meds on time. The field-delivery kids are a different story, but that's not really what we're talking about here. It's just critical to get the kids admitted and their orders scanned ASAP, then we have no problems in my neck of the woods.

NicuGal, MSN, RN · May 15, 2015

Our order sets go right to pharmacy, but they made all admit meds such as eye gtts, vitamin K, surfactant and starter TPN override meds so we can get them if pharmacy is backed up.

karnicurnc, MSN, APRN, CNS · May 18, 2015

I agree, standard ordersets and submitting incident reports will help. Be thorough, objective, and polite.

canned_bread · May 23, 2015

Every, single time you run out of your time frame, file a "variance/quality/incident report--whatever you call it. Include all possible sequelae to the baby, licensure issues, standard of care in the community. Keep hitting them w/paperwork until they figure out what's wrong.

THIS. I COMPLETELY AGREE.

To often the processes of hospitals are changed and it's damaging. Only with that risk paperwork does something get done. It annoys them, but it's pure legal evidence that the practice isn't working, and why. It's tedious for us, so it often doesn't happen. But it should.

We had a ridiculous major change in our hospital approximately a year ago, and this meant less time for patients, more chance of critical incidents. I started entering the "risks" and "near-misses" in religiously until a change was made. And I encouraged others to do the same. Eventually a meeting was called, and an echo throughout the room from the nurses was that they were scared for the patients, and the patients were noticing the inattention that was occurring.

NicuGal, MSN, RN · May 23, 2015

How long is it taking them to get the mess to you? We have a 30 minute turn around on Amp and Gent but gtts are always a priority. But we are fortunate to have a peds pharmacy on our floor, they are there until 11pm and then orders go downstairs to the main inpt pharmacy.

If if you have an order set, it does make things easier.