Omnicare Pharmacy-discuss

[ktwlpn]

In my experience we have a big problem getting meds delivered in a timely fashion.You all know that if we don't have a med available (even if it is something as simple as a multivit) the DOH wants us to document and make every reasonable effort to obtain the med. We have to inform the doc if a med is missed,fill out a pharmacy occurrence report yada yada yada....And we are prohibited from "borrowing" a med from another resident. What happens to us frequently is we'll fax labels well before the cut off time for same day delivery but then 2 days later get a written notice that the fax was illegible...HELLO? 2 days later? You are now probably out of some meds.Shouldn't someone be picking up the phone each and every time a fax is received that transmitted poorly and notify the sender? Then there are the times we get a notice stating "our records show this order was d/c'd on this date " and we look in the chart and no order was written on or around the date they cite. ow does that happen? Or-we don't receive a med that we have called them several times for-then we end up with NINE BOXES of the med....Then other times we can not get a refill because "our records show this med was ordered too soon" How does THAT happen? I remeber working in a facilty years ago in which pharmacy staff came in on a monthly basis and switched out the med carts-we were not responsible for routinely ordering refills.That system worked out well-I don't remeber ever having these problems.Omnicare is almost self serve-we have to peel and stick re-order labels on a sheet to fax...On top of our mega med pass....whoopee...

[StNeotser, ASN, RN]

Oh I have so much to say about these guys!

We use them.

1. If someone is ordered a prn narcotic, something like 1 vicodin q6hrs, we seem to get four cards of thirty pills - then they only use about half a card of the vicodin and we can't send the vicodin back. All my patients are medicare, so is there any wonder medicare costs the taxpayer so much?

2. I ran into the same problem of having about ten meds for different patients missing last weekend. I must have spent an hour all told out of my shift chasing up the pharmacy and running to different floors to see if I could "borrow" the med I was out of - none of them were narcotics. This is a frequent occurence. As all my patients are medicare we only get weekly supplies of meds - if one med is not ordered on the exact right day before 4pm then we can be out of it for a day.

3. The weekend before during my noon med pass a pharmacist waltzes in and says "I need your med books" I say "Who are you?" He says "ugh, I'm ________, the pharmacist at omnicare" I say "Well, I'm in the middle of the med pass, you'll have to wait" When finished with the med pass I say to him "You can wait 15 minutes or so so I can check I signed every med out or you can have the books now"

He takes the books. About two hours later, he's gone and I have the charge nurse running upstairs saying this pharmacist reported me for having med holes. The next week I get a message from the DON saying she heard I had "quite a few med holes"

[CoffeeRTC, BSN, RN]

Meds from home need to be checked by pharmacy first and need to come in the same bottle ordered. At least this used to be policy. Rarely do we have residents able to bring them in or family do do this normally they are d/c'd from the hospital without warning.

Heck..I'm happy to get a code status, family contacts and a bit heads up from SW before an admit comes in. (yeah...we have problems with comunication)

[achot chavi]

meds from home need to be checked by pharmacy first and need to come in the same bottle ordered. at least this used to be policy. rarely do we have residents able to bring them in or family do do this normally they are d/c'd from the hospital without warning.

heck..i'm happy to get a code status, family contacts and a bit heads up from sw before an admit comes in. (yeah...we have problems with comunication)

you're a hundred percent right, and we have a good relationship with our pharmacist so she signs off on it- what else can we do when the discharge is friday afternoon!!meds must be in the original untampered packaging with clear exp. date and lot #.

some families don't bring some of the drugs so we have the doctor order it for sunday, if its imperative that they receive the medication and it cant be borrowed, our pharmacist will bring it special, mind you- she will kvetch about it for about 6 months, make sure we know how what a martyr she is ( had to walk in the snow 6 miles uphill both ways when she had 104 fever, sick hubby and grandson and her only pair of shoes have holes on the bottom-lol). so we try not to ask any favors but sometimes- well - what can you do?

question, what do you do with a dropped pill- that hits the ground= do you pick it up wipe it off and use it, or throw it out?

[CoffeeRTC, BSN, RN]

Thrown away...but given the fact that it could be the last one and all the other pharmacy issues...thought about twice, LOL.

We have delivery drivers. Pharmacist comes once a month to check the charts.

[StNeotser, ASN, RN]

I always throw away dropped pills. If it's a narcotic I get someone else to cosign.

[CapeCodMermaid, RN]

We would NEVER accept meds from a patient's home. Who knows what's really in those bottles? We have a local pharmacy and if we're really in a jam, we send one of the staff to walk over there and pick up a few days worth of meds. Never had anything like this at any other facility.

[achot chavi]

In Israel the pills dont come in bottles, so it would be virtually impossible to tamper with- Our local pharmacy is closed on friday aft till sun morn, even hospital pharmacies are closed.

Thanks for the feedback on the dropped pills. I have caught staff and gotten complaints about this from families. I have to make more of an issue on this and write an inhouse policy not to use dropped pills\ Thanks

[debRN0417]

question, what do you do with a dropped pill- that hits the ground= do you pick it up wipe it off and use it, or throw it out?

have you ever heard of "kissing it to god"???? ha ha!

[CapeCodMermaid, RN]

How about the 3 second rule?

[achot chavi]

Our pharmacy has ascertained that all dropped pills be returned and they will give replacements- 3 seconds or not.

[debRN0417]

You know, back in the olden days, way back...hehe... we did not have the luxury of getting medications delivered every day, or calling for a back-up. I did a lot of praying and careful preparation...needless to say there was always one who managed to drop every pill...oh god...what a nightmare. I unfortunately have "kissed" a time or two back in the day. I hate to admit it, but it is true, especially narcotics, god forbid you dropped one of those......Yeah, I knew what I was doing, I didn't do it if it rolled under the bed or anything. but if it fell on the sheet or table top, or somewhere half clean. Was it right? Of course not.

[CapeCodMermaid, RN]

If I dropped a pill on the floor, I'd ask myself what would the resident do if they were in their own home. Our floors are at least as clean as that. They would pick it up and use it, I'm sure. So if I dropped a tylenol I wouldn't use it...but a zocor? which costs a couple of dollars for each pill?? Probably.