question...to go meds

[sharksgal]

We're anticipating Joint commission....while preparing our NM stated that we have been giving "to-go" meds incorrectly. We have been told that nurses cannot hand over the to-go meds to the patients as this is dispensing and only MD's and RPh can do this. Working 7p-7a in a rural community with no open pharmacies after 9pm...we give a lot of these. Does anyone have experience with this? Looking for other p/p on to go meds....thanks!

[TRAMA1RN]

I work in a rural ER and we too give to go meds, our solution has been to have medication labels preprinted with our most common to go meds with a place for directions. We may dispense butonly with co-signature from MD. I personally think this is stupid if I can give you medication in the ER why can I not send you home with a dose to go?

[bill4745, RN]

In our ER, no one can send meds with a patient. That is "dispensing" and only be done by a pharmacist.

[traumaRUs, MSN, APRN]

Yep Bill - that's the way it is in IL also.

[Medic/Nurse, BSN, RN]

No problems with that in my current position. Thankfully.

I have worked places that "dispense" and it was a PITA.

Basically, the pharmacy packages a set list (commonly written) of "meds to go. 4 pack or 6 pack"

The MD writes an order for a "to go pack".

This pack is retrieved from the pyxis under the patients name. (No more depleting the on hand quantity!) We take it to the MD for signature/instruction and verification before we d/c the patient.

Pack is labeled.

Name ______________________

Date________________________

Medication Name and strength

Quantity - 6 (Six)

Take ____ tablet/capsule (etc) by _____

every ____ hrs/days.

Authority _____________________ (MD name/signature)

Also, all precautions are labeled and a medication information sheet (prepared by pharmacy) is distributed with the 'to go pack". This is noted in the discharge instructions as dispensed with information sheet and notes if additional Rx is given along with other d/c info.

I think this system worked fairly well.

Good Luck.

Practice SAFE!

[rjflyn, ASN, RN]

Thank goodness for 24hr walgreens and cvs.

rj

[ERRNTraveler, RN]

It depends on the state you work in- some states allow ER's to do this, others don't. If your state allows it, the drug must be labeled with the drug, dose, sig, prescribing doctor's name, patients name, quantity, etc.... And the physician must write an order for the to-go med on the patient's chart. Some states require the pharmacy to dispense the to-go med, in which case, an order is sent to pharmacy, and pharmacy sends the completed prescription back to the ER.

[ZippyGBR, BSN, RN]

rightpondian viewpoint

tto meds are a pain in the backside

limited range of prepacks frompharmacy pre labelled with fill in the blanks labels must be prescribed by a prescriber or someone who can sign for TTO under the Nurse practitioner Patient group Directives ( not all rightpondian NPs are independent prescribers)

becasue the packs are prepacked and already labelled - some require dose instructions ( e.g. some ofthe antibiotics are take 1 or take 2 ...) others just require the patient name ( UK dispensing labels don't require the prescriber's name on them)