Pre pulling meds

[Riegelbeagle]

I’m still in orientation and one my preceptors chewed me out because I refuse to pre pull meds. I work with kids. Bedtime is 9 and meds are ordered for 9. To me it seems more pragmatic to change med time to 8 but I was chewed out for that too. As med nurse I can have up to 32 kiddos. To me this seems unrealistic to give meds to that many kids and pre pulling dangerous. Am I just wrong ? I have always been told pre pulling set you up for mistakes.

[TCASII, ADN]

On ‎9‎/‎24‎/‎2019 at 4:18 AM, DAL2010 said:

I've worked as an RN across multiple states and specialties and have always been told: Pre-pulling meds is against JCAHO and against most (if not all) state boards. If anyone is found pre-pulling during audits/visits, discipline will be given to the particular nurses involved and to the facility. I left one facility after only a few months because they told me pre-pulling was the only way they did med pass. It felt wrong to me. They lost accreditation the following year - this was among the reasons why: unsafe medication preparation and administration practices.

Pre-pulling is also found to increase errors. Labeling medicine cups is not allowed (HIPAA). Pulling one patient at a time and then immediately administering to that patient is Best Practice according to pretty much every resource out there.

We just went through JCAHO inspection and they knew we pre-pulled. Nothing was said about it at all. It's psych, so I can't imagine the seriousness of of it. I understand a med-surg, ED or ICU type of environment however.

[penelopelp]

Yea, we pre-pulled at the last place I worked, and The Joint Commission had no problem with it. We have the labeled cups in a container. TJC just wanted to make sure that we throw away the cups each time and not reuse the labeled cups due to infection control. I don’t pre-pull at the current place that I work, but I also have a lot lower patient census.

[Jedrnurse, BSN, RN]

On 9/8/2019 at 8:40 PM, Snatchedwig said:

1hr before and 1hr ahead. Would not allow me to edit. But ya can totally sympathize, orientation sucks.

I'm confused. One hour before/ahead gives you a two-hour window I thought.

On 9/8/2019 at 6:31 PM, Snatchedwig said:

Depending on medication and company policy you may have the option for 1hr a head and 1 hr after to give the medications. Which in turn gives you three hours.

I'm confused- I would think that an hour before/after would give you a two hour window, not a three...