Pulling Meds for Multiple Patients

[trustsupplyguy]

In order to save time, I will often pull meds from the Pyxis for more than one patient. For example, I'll get patient #1's meds, put them in a little zip-lock bag, put the Pyxis receipt with the patient's name into the bag and them zip it shut. Then I'll do the same for patient #2. So ultimately I have 2 or 3 ziplock bags containing meds and the related Pyxis receipt.

Several nurses have told me this is "bad" and not to do it. But I don't get what the problem is. When I get to the patient's room, I pull his ziplock and check everything against the MAR before giving the meds. The receipt is in the bag so anyone can see whose meds these are and what meds were taken from the Pyxis.

Will the meds from bag #1 jump into bag #2 by magic and change what's written on the Pyxis receipt? Seriously, am I missing something (I am pretty new)? Is there a Joint Commission ruling on this? I have never had a problem doing this, and it does save time.

[marilurn]

I did this all the time when I work the floor. It is a safe way and it saves lots of time in fact I have been teaching my nursing students to do this.

[nanacarol]

I agree that your practice has serious potential for negative patient outcome. One of Joint Commission's patient safety goals is to eliminate medication errors, your refusal to follow approved standards is not in keeping with safe medication practice. Sure there are many, many work arounds that less than prudent nurses use, but the question is are they well thought out, andn if so, whay hasn't your organization changed policy? The old adage "buyer beware" goes to you and your colleagues, how will you defend you actions in a court? Things to consider in your defense: 1. did you follow policy, 2. were your actions those excersized by a majority of nurses with your level of training, experience and education, and, 3. what are best practice suggestions for this practice? Nanacarol:nono:

[nanacarol]

Hi, good to hear from someone outside of America. We are not allowed to use medication purchased in the name of one patient for another. Some nurses may not abide by the rule but it is not sanctioned.

We are speaking of a medication dispensing machine, where the medications are set up by patient, dose, time of administration. The concept was set up, I believe, to help decrease med errors contain medication costs, and prevent diversion of medications. Carolynn:welcome:

[nanacarol]

Marilurn, I find it distressing that nursing students are being taught to use work arounds in medication administration. Nursing students have little or no critical thinking skills and as novices should be encouraged to follow policy and procedures to the letter and work within the system until they have a routine down and have had an opportunity to evaluate the pros and cons of the processes, then work within the organization for change. This would be the new nurse I would hire, not one who comes with the impression that jeopardizing the licensing and certification of the organization is okay.

Just my thoughts. Nanacarol

[marilurn]

I guess I should explain this alittle better. The hospital I work for has a Pyxis this stores the meds and you pull each patients med from this machine. This is when I place the meds in plastic bags for each patient they are then placed in a MAC machine when you go into the patient room using the MAC you must scan the patient armband ask the patient their name and birth date then you must scan each package of pills or Iv bottles before giving the patients their meds. Our hospital has passed all joint commission inspections.

Marilurn

[anonymurse]

I guess I should explain this alittle better. The hospital I work for has a Pyxis this stores the meds and you pull each patients med from this machine. This is when I place the meds in plastic bags for each patient they are then placed in a MAC machine when you go into the patient room using the MAC you must scan the patient armband ask the patient their name and birth date then you must scan each package of pills or Iv bottles before giving the patients their meds. Our hospital has passed all joint commission inspections.

Marilurn

Right, I think some participants in this thread are imagining Pyxis wrongly. Pyxis gives out ONE pt's meds at a time. I log in, give Pyxis my fingerprint, then pick a patient. I pull all that pt's meds and seal them with the printed receipt. Then I pick another, and so on.

[ksbdmb]

In my hospital, we are taught as practice to keep patient labeled ziplock bags and to get all your meds at the same time from the pixus... This is the way we are taught!!!

We take our MAR's to the bedside and open our meds there as well... If you are reading off your MAR , checking the name band, and checking the meds in your hand before opening them, then your patient should ALWAYS get the right drug.