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Discussion

Pill line

Just starting back in corrections after quite a few years away and am a little blown away by pill line. This 'prepouring' of numerous inmates' (up to 150) meds, seems like a total recipe for multiple medication errors. Add to this, MARs that are super difficult to decipher, handwritten orders, and no scanning. Wondering if anyone can provide some tips for making this challenge a little easier?

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It definitely takes some work to make it all come together. Pill pass at my facility includes more than 400 inmates at a time. Staff has to be diligent at transcribing any medication changes to the envelopes, and making changes to the meds inside them. Our initial MARs are pre-printed, but changes after the first of the month are hand written in. Previously, all of our MARs were hand written, like yours.

The alternative is that pill call is delayed for 2-3 hours while everything is filled every morning or evening. The system that we use has the blessing of the state board of nursing, because of the volume that we dispense.

We used to make our own envelopes for each pill pass. There were envelopes that any nurse could use, but we only trusted our own. But then, we were pre-pouring for ourselves, not for other nurses.

  • Experts
On 12/6/2018 at 3:46 PM, Orca said:

It definitely takes some work to make it all come together. Pill pass at my facility includes more than 400 inmates at a time. Staff has to be diligent at transcribing any medication changes to the envelopes, and making changes to the meds inside them. Our initial MARs are pre-printed, but changes after the first of the month are hand written in. Previously, all of our MARs were hand written, like yours.

The alternative is that pill call is delayed for 2-3 hours while everything is filled every morning or evening. The system that we use has the blessing of the state board of nursing, because of the volume that we dispense.

Are you saying that one nurse pours and another administers? How sure are you that your bosses aren't just saying the BON thinks this is acceptable?

If so, seems like the work hours should be changed so that the same nurse pours and gives the meds.

I would not want to give meds that someone else had poured. This was taught to me as a seriously wrong thing to do. Is it not taught that way in school any more?

On ‎3‎/‎18‎/‎2019 at 7:58 PM, Kooky Korky said:

How sure are you that your bosses aren't just saying the BON thinks this is acceptable?

I am an upper level administrator, and I received notification directly from the BON. This is a situation that we had been working directly with them on for about a year.

Granted, this isn't ideal, but most nurses aren't passing meds to over 400 people in one shift. As a practical matter, it simply doesn't work to pour immediately before passing. Our BON recognized that, and they made allowances for it.

Changing work hours isn't an option due to the operating schedule of the institution. That, and we would never find anyone who would work here if our day shift began at 2 or 3 AM.

Medline does get quicker when you get used to it. But you really have to think of hints to help you be more efficient. i,e, I would mark the bubble paks a.m. and p.m. especially if someone was taking the same med twice but different dosage. I would rubber band multiple paks together to make sifting easier. I would highlight the name of the med, and time to be given. Anything you can think of to make the process smoother. Also, the inmates know what they're supposed to be getting, and sooner or later you will make a mistake. If I hand the inmate their pills and I see them look and then there's "a funny look" I will grab the pills back and say "something wrong?" (I grab them back because half the time the inmates will take the pill, THEN complain you gave them something wrong.) Sometimes they think you made a mistake because the brand changed and so the pills look different. If I know this occurred I will tell them ahead of time so they don't freak out.

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