Passing meds already "prepared "??

[cdeyoung]

I am a new LPN and am starting my first job next week at an associated living facility. I noticed in the interview, that their Med carts have the meds set out in cups for each patient in advance. (Each pt has their own drawer, I think) So you would be passing pills not in their containers or blister pack that someone else has prepared. I don't know about this, it doesn't seem like a good idea to me. Is this common practice in ltc? I can't find info re : this on the web from my state standards of practice. If I want to prep my own meds how do I go about doing this without making things hard for myself with my coworkers or losing my job? What should I do? Any help would be really appreciated! Thank you

[HouTx, BSN, MSN, EdD]

I can assure you that this is NOT an acceptable standard of practice in any acute care situation - don't have much experience in other environments. Here's the real test... if you gave a 'wrong med' to a patient, and were trying to explain the situation to their lawyer, what would you say to defend your actions????? I doubt whether "I assumed it was correct" would be the right answer. Are you sure that the nurse who is administering the meds was not the one who actually prepared the med cups? Still not a good practice (multiple pts at once), but more understandable. Otherwise, who would have prepared them?

Sounds like you have already started getting your ducks in a row by looking at your state practice regulations... if you didn't find anything, you may need to call them. Most of the time, their rules & regs are more general in nature & need to be interpreted to make sure you understand how they apply in a specific situation.

Then - read the organization's policy & procedure for medication administration. I doubt whether it supports the practice you described because if so, it probably wouldn't be acceptable to any licensing agency.

[turnforthenurse, MSN, NP]

I do not work in LTC but I can say I hope this isn't a common practice anywhere. I don't care if it is done to "save time" - it is BAD practice and can result in errors and potential harm to a patient. If the meds are already set out and a coworker asks me to give them to a patient, I will only do so if the med is still in the original blister pack or med vial or whatever. That way you know what is being given. It's very hard to look at a pill and be able to tell what it is let alone the dosage strength, and what if a patient refuses a med? You wouldn't know which is which.

[RNsophia]

Administer only the meds that you prepare. I used to work in a SNF and we had little labeled cups, but we prepped those cups ourselves and signed with our OWN signature in the MARS for each med--not to mention the narcs! Protect your license. You worked darn hard for it.

[jagged777]

good info

[born2circulateRN]

Personally, I would definitely not feel comfortable administering medications this way. You have no idea what medication you're administering or the dosage - if you don't know the name of the medication, how can you be sure if it's even to the correct patient? How can you perform the 6 rights? If you ask me, that is a disaster awaiting to happen. As the previous posters stated, very bad and unsafe practice. You do not want to administer what you don't prepare, especially if your signature is following it - because then, fingers are going to be pointed at you if something goes bad. Patient safety is always the priority.

[Meriwhen, ASN, BSN, MSN, RN]

Never a good idea because even the best nurse or pharmacist can make a mistake and pull the wrong medication for you. And should something happen, guess whose rear will be on the line? YOURS because you were the one who actually administered the medication. You are the patient's last line of defense against harm from a med error.

Now if the meds were prepared but still sealed in their unit-dose packs, that's another story because then you can still verify the medication and ensure you are giving the correct one.