Patient wristband scanning question

[njinformaticsrn]

Hi all- looking for feedback. Can you think of any scenarios in which it would be acceptable to NOT scan a patient's wristband in the contect of medication administration? For example, a flush is ordered q8h (these appear on our eMAR as a med) but IV fluids are running; therefore, there is no reason to administer the flush. Rather than bring the COW into the room and potentially disturb the patient, you would intentionally not scan the patient and then mark the flush as not given, providing the not given reason. Code situations could be a valid exception too. Thanks for your input.

[rninformatics, DNP, RN]

In this scenario rather than attempting to justifying NOT scanning, perhaps the flush should be D/C'd or placed on hold until the IV fluids are D/C'd. The caveat being that there is only one site needing to be flushed/with an active IV fluids infusing currently..... of course

"Not distrubing the patient" is secondary to preventing medication errors and utilizing the technological tool appropriately to do so.

Hi all- looking for feedback. Can you think of any scenarios in which it would be acceptable to NOT scan a patient's wristband in the contect of medication administration? For example, a flush is ordered q8h (these appear on our eMAR as a med) but IV fluids are running; therefore, there is no reason to administer the flush. Rather than bring the COW into the room and potentially disturb the patient, you would intentionally not scan the patient and then mark the flush as not given, providing the not given reason. Code situations could be a valid exception too. Thanks for your input.

[njinformaticsrn]

Thanks, rninformatics- yes, I'm looking into another way of addressing the flush rather than having it profiled as a med. Totally agree about the patient safety issue. We are currently trying to whittle away at our wristband scanning exception report which currently has several hundred items on it each day. The real problem is that there are no repercussions when someone does not scan the patient. How are such exceptions monitored at your institution?

[turnforthenurse, MSN, NP]

Code situations, a combative patient that may need a stat dose of Haldol or something, or if a patient is seizing. We are implementing ID band scanning for medications at my facility on 8 Nov. There will be weekly audits generated per RN and monthly generated for each nursing unit. If there is ever time a where we do not scan the wristband, we are supposed to make a comment as to why we didn't. Our new scanning method also requires us to scan one-dose medication vials (such as pain meds, Ativan, hydralazine, etc) - which will be hard for us because we're so used to throwing the vial away the moment it is drawn up into a syringe in the med room. The nurse teaching the course we had to take said we could also put in a comment, "vial accidentally discarded in med room" - but this shouldn't be a regular thing.

[stephenfnielsen]

Only emergencies... Even in codes, if you have the right people in the room- the meds get scanned, no joke. I always just say NEVER admin with out scanning, that way you never need to be wishy-washy making decisions. Your scenario with the flushes- I would just wait until the next time you plan on going in the room and scanning at that time. Unless you have a dying patient and a malfunctioning scanner/barcode- just scan it!

[njinformaticsrn]

thank you all for the feedback- i appreciate the input