Pre-pouring meds

suebird3 · Mar 23, 2005

I know that we are going to get our butts kicked, but been there, done that! I was one of 2 nurses on 3-11, and we both had 60 patients. (Heck, on 11-7, I was the only nurse for all 120 people! ) These people had sooooo many meds, pre-pouring was a must. There is NO WAY I can pass all those pills in 2 hours. It meant 2 minutes per patient. And if I worked the "heavier" side,I had to put off my 5 pm bolus feeding until AFTER I got done with meds. What can I say?

Still Riding · Mar 23, 2005

I'm only a student. But i was wondering for some of the LTC facilities would the use of blister packs work. i know htat there are some meds that change but for the pts that get lots of meds that never chang?

PHTLS · Mar 23, 2005

Look, you're not in a acute setting( residents tend to be more stable), so it's cool. Just as long as you don't make major medicine errors, you're fine.

Now, if the States around...

PHTLS · Mar 23, 2005

I know that we are going to get our butts kicked, but been there, done that! I was one of 2 nurses on 3-11, and we both had 60 patients. (Heck, on 11-7, I was the only nurse for all 120 people! ) These people had sooooo many meds, pre-pouring was a must. There is NO WAY I can pass all those pills in 2 hours. It meant 2 minutes per patient. And if I worked the "heavier" side,I had to put off my 5 pm bolus feeding until AFTER I got done with meds. What can I say?

Damn right. Ever try assembling an AIDS patient's cocktail meds? Takes me like 5 minutes to get all those anti-viral meds ready along with their other meds (pain meds, psyche, vit, stool softners, appetite stimulants, etc).

Blackcat99 · Mar 23, 2005

Sometimes one can pre-pour even if they didn't intend to do it. At LTC I would see the resident and I would start getting their pills ready. By the time I would finish getting all of their pills together I would turn around to give them to the resident and the resident would be no where in sight. :chuckle

flashpoint · Mar 23, 2005

I disagree 100%...worked all three shifts in three different LTC...between 50 and 110 residents each and I NEVER set up my meds in advance...yes, you have to hustle...yes, you have to be on your toes...yes, if something goes wrong or you get interrupted you fall behind, but I never "pre-poured."

Here'e why I never "pre-poured" - When I was a CNA, we had a nurse who "pre-poured" all of her meds the minute she walked in the door...one night she got her meds ready and stepped outside to smoke. She slipped on the ice and broke her hip...the nurse coming in to cover for her had no idea what was in the cups...pharmacy had to come in and sort through everything and everyone go their meds really late.

It doesn't take that much time once you get into a routine...you can still do your three checks, observe the five (or six or seven) rights and get done.

CoffeeRTC, BSN, RN · Mar 23, 2005

Yes and No. I agree with Cotjockey, but things happen like Blackcatt.

I've never gotten more than one or two residents ready at a time..I've seen nurses do this at the start of their shift (11-7)...and wonder what else they do or don't do all shift. On our 11-7 their is only 1 or 2 at 12pm then the next pass is 6 am. Many errors happen doing this.

PHTLS · Mar 23, 2005

I disagree 100%...worked all three shifts in three different LTC...between 50 and 110 residents each and I NEVER set up my meds in advance...yes, you have to hustle...yes, you have to be on your toes...yes, if something goes wrong or you get interrupted you fall behind, but I never "pre-poured."
Here'e why I never "pre-poured" - When I was a CNA, we had a nurse who "pre-poured" all of her meds the minute she walked in the door...one night she got her meds ready and stepped outside to smoke. She slipped on the ice and broke her hip...the nurse coming in to cover for her had no idea what was in the cups...pharmacy had to come in and sort through everything and everyone go their meds really late.
It doesn't take that much time once you get into a routine...you can still do your three checks, observe the five (or six or seven) rights and get done.

Uhh..yeah. I'm sure we're all going to go out and smoke every day, have a fracture, and leave our pills lying around (label that damn cups) without bothering to tell the replacement nurse what's in those pre-poured meds.

Ummm.yeah :rolleyes:

flashpoint · Mar 23, 2005

Either way, most facilities have policies against pre-pouring your meds. I just don't understand why people don't do things the way they are supposed to be done. I certainly wouldn't want a doctor who takes shortcuts...I wouldn't want my nurse to take shortcuts either.

CapeCodMermaid, RN · Mar 24, 2005

I'm only a student. But i was wondering for some of the LTC facilities would the use of blister packs work. i know htat there are some meds that change but for the pts that get lots of meds that never chang?

We HAVE to use blister packs in my facility...doesn't make it any quicker. All the OTC meds are still in bottles. The problem is the patients all take way too many meds...no 92 year old woman needs 26 pills, 2 inhalers, and 3 eye drops!

CHPN1680 · Mar 24, 2005

When I first started in LTC, I worked for a facility that still used the old ticket system for meds. I thought that it worked great! You would pre-pour meds and the tray had holes in it for the med cups with slots behind each cup for the ticket with the pt. name and drug.

I agree, that you leave room for error by prepouring. It is definately a challenge to get those meds out within the prescribed time when you have so many patients. A patient falls, a new admit rolls in, short on CNA's and have to help feed etc..... Our system surely is flawed. I agree with one of the above posters. Get them off so many meds! Really, do you think that at 80 years old, it is time to be starting someone on meds to lower cholesterol! If I took 17 pills in the morning, I wouldn't eat breakfast either!