Pulling Meds Early

[mcmike55]

We have always pulled our meds and put them on that procedure's case cart ahead of time, but I'm hearing that this may need to stop.

In the morning, we take our case carts from Sterile Processing into our central hallway, and put them outside the OR that the case will be done.

As the day goes on, the circulator will pull the meds that are needed for that case such as Lidocaine, Pitressin, x-ray dye, etc, and puts them on that particular cart.

The center hall is a restricted area, but anyone allowed into the OR's may walk through there, including pt care techs, and the occasional vendor.

During a medication administration FMEA, I mentioned that, and the administration rolled their eyes.

From what I understand, it's some sort of a Joint Commission issue that will require us to pull the meds as we need them, not ahead of time.

Has anyone heard of this, are we the only one's pulling meds ahead of time?

We are a small rural hospital with only a few OR's, and not just anybody can put on scrubs and walk around our halls. I understand that security is an issue,,,,,but..

Mike

[Rose_Queen, BSN, MSN, RN]

We will sometimes pull them early if there's an extra person (we staff 1 circulator/2 scrubs per OR, so if the surgeon brings a PA, one person is free) but we have to put them either inside the case cart or inside the room. We don't pull for the whole day, although our sister unit (ambulatory surgery) pulls for the whole day and keeps it in the OR.

[SandraCVRN]

If we pull early (I don't) we keep the meds in the room. Meds are supposed to be monitored at all times

[canesdukegirl, BSN, RN]

We have "kits" in tackle boxes for each service according to the par level of medication use. There are no narcs, no Prop, nothing like that, but just Marcaine, epi, bacitracin, stuff like that. We keep them inside the OR at all times. We have not gotten "dinged" for this by JCAHO, so I suppose it is ok. Just be cognizant of what you are pulling and don't leave them in the hallway.

[MamaCheese]

We pull our meds before each case. Our Pyxis is in our core so it just takes an extra minute to get what we need. Our management would go nuts if they saw meds outside of rooms pulled with the cases.

[wartthree]

We use to, then Joint came thru and put a stop to it. All meds are to be supervised as I understand it. So now only our 0730 cases are not pulled because we dont have anyone in central core overnights. But then when she gets there at 0600 she pulls meds for the rest of the day and puts them in the case carts for us. Because she is in CC with the carts I guess they see that as they are being monitored.