"Right" way to pulls meds from cards?

[Pat_Pat RN]

Is there a right or wrong way?

Tell me how you do it.

[Pat_Pat RN]

No one at my facility keeps cards alphabetically.

I will pull the entire card to pop. Sometimes, I bring all of my cards, but usually one at a time. When I put them back, it is in the order that I popped them, with the most recent at the front. That way, if I get interrupted, it gives me a third (or fourth) check on where I left off on my pass.

I've worked at 3 different places. The one that kept the drugs in alphabetical order always had faster med passes.

[heron, ASN, RN]

Explain how taping an accidently popped pill back where it goes has anything to do with stealing drugs.

Our board of pharmacy considers it evidence of tampering, like a broken seal on OTC meds. Since that board controls our license to handle narcotics, I'm inclined to take them seriously.

[Mn nurse 22]

Explain how taping an accidently popped pill back where it goes has anything to do with stealing drugs.

There have been cases where nurses have taped calcium tablets into Lortab packs or other medications that look like the narcotic. I would never give a med that was taped back in and will always waste it with another nurse.

[morte, LPN, LVN]

my understanding (capecod needs to chime in here) is that you select ea card in order from the MAR that you will need, then pop each. returning the cards en masse to the cart. I try to select those that will be next, and put them in the front.

[Junebug903, LPN]

Yes, taping is not ok. The difficulty with the "bingo" cards is that a lot of patients in LTC/SNFs take way too many meds and the cart becomes too full...and due to that, meds get popped out by the pressure of the other cards. Bingo cards are easy, but not financially then best. A lot of meds end up getting wasted. As well as, nurses not popping the packs and refilling them correctly.

[Junebug903, LPN]

The places I worked, we usually had the meds in room/patient/resident order and having them in order the same as the order on the MAR.

[LTCNS, LPN]

In Indiana, "taping" a narc is considered tampering with a med by the ISDH. This is something that the state surveyors checked for during our last survey.

It's the same here. If a narcotic is popped out by mistake, it has to be wasted with another nurse counter signing as a witness.

[SWM2009]

Alphabetical order? I wish. I consider it a plus when I actually find all the meds I need for the resident. What order they are in is usually the least of my worries since many of my co-workers seem to have an aversion to reordering meds or calling the doctor/pharmacy to resolve issues with meds.

[caliotter3]

I've worked at 3 different places. The one that kept the drugs in alphabetical order always had faster med passes.

I worked on night shift and when I had a chance, took the time to put the cards in alphabetical order. Other shifts really wouldn't have the time or make the time to do such an activity and I found doing things like this, when I had the time, made for a more productive shift for me. It beat sleeping on duty like the other nurse did. I also took the time to clean the carts, clean the med room, and do all the other little tasks that made the job easier for everyone, not just me.

[Pat_Pat RN]

The places I worked, we usually had the meds in room/patient/resident order and having them in order the same as the order on the MAR.

This is what I want. Everyone else thinks it is no big deal to have to hunt through every card to find the ones you need.

[ClearBlueOctoberSky]

The problem is getting them to stay that way.

[NurseQT]

Everywhere that I worked the cards were separated by med times and resident (A.M. Meds and Noon Meds in one drawer, P.M. Meds and HS Meds and NOC Meds in another drawer, PRNS in another) All A.M. Meds are organized in order by rooms with a divider between each resident's meds. The cards are always organized to follow the MAR... So when I go to do the A.M. Med pass, I pull open the drawer, locate the resident's Meds who I'll be administering and pull out all the cards because those will be only the a.m. Meds. The cards are in the same order as the Meds are in MAR. Than when I'm done the cards go back in their slot backwards (which tells me that the person has been done), some places flip all the cards back after each shift other places leave them flipped and then the next day they are turned around the other way after the Meds are given..

Does that make sense?