Ques. about presetting up of meds

[mondk]

Hey all. I'm an RN who works the night shift at a 60 bed LTC facility. Of course, I'm the only nurse there during those hours and have a 22 bed RCF to oversee as well. I don't have many 0600 meds, but that seems to be the worst time for my shift. Can't we legally preset meds as long as we have cards with the med names on them and dosages and resident's names??? Just wanted to know, mondk

[grandmanurse1]

Definitely illegal to prepour meds in Florida. Big cites, fines, etc. Increases the risk for med errors. It seems you have two problems that could be solved fairly easily....you need to have a locked drawer on your med cart so you can store your narcotics there....and you need to keep your meds to a minimum on 11-7. In Florida, it is also a cite if we move meds to 6 a.m. for staff convenience....it must have a legitimate reason...abt therapy q 8 hours or on an empty stomach, etc. All others go to 9 a.m., etc.

[P_RN, ADN, RN]

I'm in SC and I have not heard that setting meds prior to the med pass is illegal

We used the Pyxis Dispenser. Night shift would pull day shift's 9am meds, and day shift would pull night shift's 9pm meds. The meds were put in a zip lok bag with the patients name on a sticker. That bag went into the patient's drawer in the med cart.

The med nurse still had to do the 5 Rights, but it certainly helped. Meds were not signed out on the MAR until after they were given. DHEC, JCAHO and OSHA had no problems with this. Now this was a hospital and not an ECF/LTC.

I haven't seen one of those cup and tray deals since the 70's though

[CurlySue]

Originally posted by catlady

I can't imagine signing off MARs before giving a med. What if you're not the one who ends up giving the meds? I know nurses who go through the med book at the beginning of the night and sign off all their meds. I'd hate to be that nurse if she or he has to go home sick, or the resident gets sent out in the middle of the night. Same thing with nurses in the hospital who sign off assessment flow sheets at the beginning of the shift. Then the patient codes and dies at 2 am, but the flow sheet says they were fine at 6 am....

I had one night working with another nurse when there was an emergency at 5 am and he had to deal with the resident. I offered to do his meds for him, and found that he not only had signed off all his MARs, but all the pills were in the drawers, not only poured, but already crushed.

I found this hard to believe, but in the facility I am currently working in the "official" proceedure for a med pass is "pour", "document" then "pass". I was actually reprimanded for pouring, passing then documenting!

I work in the skilled/short term unit of our facility with a very rapid turnover rate. In essence I have a different set of patients from week to week which makes it difficult to know their preferences. There are occasions when I will ask the patient if they are ready to take their pills... then go and set them up only to return to their room and have them occupied or unable to take them at that time. I usually save the meds instead of wasting them. (imagine chucking a couple of sandimmune because the patient was sitting on the toilet, or working with a therapist...not practical at all....)

~*~*~CurlySue~*~*~