JCAHO and bedside medications...

Specialties Ob/Gyn

Published

We recently received notification from our manager that all bedside meds needed to be kept locked up. This includes the Tucks pads, Dermoplast, lanolin ointment and All Purpose Nipple Ointment. So now our new mom's have to call us for every trip to the bathroom and anytime they need to apply ointment. It seems very taxing on nursing staffs time. Anyone else facing these issues and how do you cope? I can understand the Tucks and Dermaplast, but the ointments on a postpartum floor really seems to be pushing it.

ETA: Darn...I do know its JCAHO...transposed the letters...sorry!!

I wouldn't have even made it out of the hospital still beastfeeding.

Hahaha... sorry, but the typo on breastfeeding cracked me up because that is soooo how I would describe my first few days of breastfeeding both of my kids.. BEASTfeeding LMAO :yeah::bugeyes:

Hahaha... sorry, but the typo on breastfeeding cracked me up because that is soooo how I would describe my first few days of breastfeeding both of my kids.. BEASTfeeding LMAO :yeah::bugeyes:

LoL..I didn't realize I typoed that..lol But it is rather appropriate for me too!

I have once had a med left at bedside. Duing one of my surgereis I got a cornial abrasion, and was placed on erythromicin ointment, and the nurse left that at bedside, and told my mom (with out exactly telling her directly) that she could apply it as needed for comfort...this is when I was 12

Specializes in L&D.

We still leave them at the bedside, but I have heard suggestions from other places that had to change. Locked drawer in the room, yes, you have to come in and unlock it for her, but at least it's in the room, you don't have to go to the med room to get it and return it. Every nurse has a key or the lock has a numbered keypad.

One place redefined Tucks, Dermoplast, and Lansinoh as "treatments" rather than as medications and the nurse I heard that from said that it was accepted by JACHO. I really like this idea. Our patients are adults and may have children at home already, so we should (I know, that's a dangerous word) be able to trust them with simple, over the counter "treatments". The most important thing is to be sure that everything is clearly labeled and the patient has been given and understands the instructions for use.

When I give a patient a breast pump, I also give her a plastic medicine cup with dish detergent in it so she can wash the parts. I make sure that it is clearly labeled as dish detergent and remind her to keep it away from her other kids when they visit as we sometimes have the very brightly colored soap (whatever was on sale when someone bought it the last time) that is attractive to kids.

We also do the dish detergent in a clean urine specimen cup. We have pre-printed labels that we affix to it. You are right about that being interesting to children, which is something I never thought of. I will now make sure to make special mention to the parents to keep it away from other children that may visit. Thanks for that tidbit.

The idea of calling the Tucks, lanolin and Dermoplast "treatments" versus "medications" intrigues me. I might have to do some research into that. Our department is doing a lot of refiguring due to the economy and a decrease in our census, so we are often short nurses. While I work nights and don't mind having to run to a patient room to retrieve these items, I know our Dayshift and PM shift nurses are really running ragged some days and my concern would be a patient who would rather "go without" than bother a nurse. I also see our "ratings" dropping if a nurse isn't able to get to the room in time to retrieve the items needed.

These are really great replies and I really appreciate your help.

Thanks!

Wow..In LTC it would need to be that way. Even tx would need to be locked. Heaven forbid you leave vasaline or zinc ox at bedside, but that is a different type of patient.

If this was the case when I was in the hosp for babies....I prob would have not

gotten the tucks, etc for hrs.(getting pain meds was hard enough) I am never one to use the call bell either.

Specializes in Community, OB, Nursery.

I thought patient autonomy was a big JCAHO thing? This is just stupid - if my pt wants dermoplast spray & tucks pads @ her bedside for her sore hiney, then she gets it. JCAHO be damned. I'm in a particularly foul mood today and it seems to me (in my foul mood) that this rule was one made up by someone who's never had a baby.

Elvish - I'm with you. I just came off shift and had a mommy with sore nips. I told her to keep the lanolin. No way was I going to restrict her using it while I tended to my other 6 patients. Against JCAHO's rules, yes. Best for my patient...you bet. I'll be my patient's advocate everytime.:D

Hmmmmmmmmmm Pt advocacy vs JCAHO interesting concept.

I know...

One would think the two would go hand in hand...

In the begining I believe that was the foundation but now I am not sure . Sometimes in an effort to build a good foundation it gets lost in the overkill. If it isn't broken don't fix it type of thing. Sometimes things can be fixed to the point of no repair due to over thinking. What is standard today is gone 10 yrs from now. They call it progress but....is it really?

TuTonka - I had to give you a Kudos for your post. I couldn't have said it better myself. I'm glad JCAHO exists and I'm glad they try to keep things in check...but sometimes it is so apparent (as another poster said) that they are really outside the bedside care realm and don't always have a clue what is going on there in the trenches.

I hope I make sense...I should be sleeping! LOL.

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