Pill falls on pt gown...is it safe to give?

[sle1191]

I am a student nurse in the second med-surg clinical of my BSN (two more quarters!) The other day I had an agitated pt who put his med in his hand and missed as he flung it into his mouth. The tablet just landed on his gown near his collarbone. Both the pt and reached for the tablet and I picked the tablet up with my clean glove and better positioning to make sure it didn't slip and fall on the floor. My pt took the med after it touched his gown. My instructor reprimanded me upon leaving the room, she said that I had made a med error and that the drug was contaminated. I understand this completely and took it seriously. When I told my fellow nursing students about it they all said that they would have given it, as long as the pt was not neutropenic and the pill did not land on the floor. What would another RN do about a tablet landing on a gown?

[Boog'sCRRN246, RN]

I too would give the med. If this is considered a med error, then I'm in trouble! This happens to me almost every time I work. A patient will want his/her pills put in the hand, rather than a med cup and lo and behold, one pill always manages to fall out. It's ridiculously wasteful (not to mention a pain in the *** to have to re-pull the med - even more so if it's a narcotic) to throw away a pill just because it fell on the patient's gown. Of course, if the gown were visibly soiled, etc, I would reconsider.

[TheCommuter, BSN, RN]

Many of my patients actually prefer to place their pills on their gowns, on their blankets or sheets, in their hands, or even on top of their overbed table, especially if they are to receive a bunch of pills. My elderly patients do this for easier sorting because many of them cannot swallow more than a couple of pills at a time.

The real world of nursing operates differently than the textbook version. None of my current or previous workplaces would have bothered to write me up for a med error because the pill landed on the patient's gown.

[mindlor]

Calling that a med error is silly.

Right med: check

Right Dose: check

Right Time: check

Right Route: check

Right Client: check

Right documentation: check

So technicall it cannot be considered a med error. However each agency has their own take on infection control. Check the policy of the agency, ie run it by the infection control team......

I cant imagine many situation where giving the med would be contraindicated....this is what all that bubbly churning stomach acid is for

[psu_213, BSN, RN]

OK, first...definitely not a med error, so let's get that silliness out of the way.

The when you are in school correct answer is to get another pill and give it. In real life, I dare to say the vast majority of nurses would give the pill. In a situation where all meds come from the pharmacy, it might be 2 hours before another dose comes up. Not as big of a deal if you get the med from a Pyxis, but still, most would give it.

[nelcoy4]

I've never heard of this. I would have to do incident reports everyday because a lot of my patients dump their meds in their hands. Then I'm searching everywhere for a pill. I give it to them just as long as it doesn't fall on the floor.

Off topic- I don't feel like starting a new thread, but the real question is- How many nurses get a new pill if it falls on the floor?

[Boog'sCRRN246, RN]

I've never heard of this. I would have to do incident reports everyday because a lot of my patients dump their meds in their hands. Then I'm searching everywhere for a pill. I give it to them just as long as it doesn't fall on the floor.

Off topic- I don't feel like starting a new thread, but the real question is- How many nurses get a new pill if it falls on the floor?

If it falls on the floor, I most definitely get a new pill. Even if the patient insists on taking the pill that fell on the floor. You just don't know what nastiness is on the floor even if it just landed there for a second. :barf01:

[JDZ344]

Off topic- I don't feel like starting a new thread, but the real question is- How many nurses get a new pill if it falls on the floor?

I'm not a nurse, but I hope ALL of them! Please don't disillusion me....

[MomRN0913]

This is ridiculous. I have given many a med that has fallen on their gown. You can't keep a med sterile. Heck, it isn't sterile in the first place.

You know how much money hospitals would lose if the nurses got a new med for each one that fell on a gown?!

Not to mention the delay in administration of that medicate if a new one needed to be brought up from pharmacy each time, especially if not all meds are kept in a pyxis like where I worked?

Unrealistic.

[turnforthenurse, MSN, NP]

Calling that a med error is ridiculous, imo. I have given pills all of the time that have fallen on a patient's gown or on their blanket/sheet. Now if the pill falls on the floor, I grab a new one. Who knows what is on that floor! :barf01:

[SHGR, MSN, RN, CNS]

Had that happen a few times. I found that older patients (and most patients in the hospital are older) preferred to take the pill in that scenario, if it fell onto the gown or sheets. Many would have taken it even if it had fallen on the floor (insert cute comment about how 3-second rule does NOT apply in hospital setting).

I offered the choice of taking it (if they hadn't already just picked it up and taken it) taking it, or waiting for pharmacy to bring a new one. I mean that respects the patient's background and preference- which your instructor should respect, since it is definitely not an error or dangerous to the patient unless they have some kind of immunocompromise.

[MN-Nurse, ASN, RN]

I'd call 5 second rule. Unless my clinical instructor was around to see it then I would waste any med that might be able to be deemed not pristine and get a new one from the pyxis.