Scanning meds before giving them( like the BID or ACCU checks)

[Lorie P.]

ok here goes, just finished our quarterly ed classes at work and this is the new medication administration system that is going into affect soon.

our pharmacy is switching over to a scanning system that is suppose to work like this:

all meds come in a single package that has a bar code on it. take the med/meds to the pt's room, scan the med package, scan the pt's id band and then the scanner will tell you if you can give the med of if it is too soon, too late or can't give at all.

does anyone else know of this system or knows of anyone using? it seems like a head ache waiting to happen. i mean if a pt has 10 + meds each one has to scanned and what if you get off schedule due to going to a code, pt off floor etc??

any ideas on what this might do to floor nurses??

thanks

nurse hobbit

[bargainhound, RN]

I hate the system, but there are those that do like it.

[rntg]

First let me say I am not particularly fond of the method, but I can see its good points.

We have been using the system or one like it for a little over a year. We were already used to the prepackaged single meds or unit dose system. this was an added step. Now we have to take a laptop on a cart into every room for every med. Most of our rooms are semi private so you need to go past the first bed, all their equiptment, visitors, chairs, etc to get to the second bed, and no more rushing in to a room to give pain meds on the way to the next room, so in this way it is alot more time consuming. There are good things it alerts you to, like the wrong dosage or allergies a paitent has entered or drug interactions, or the wrong med on the wrong patient.

The scanner itself will alert you if the time is too soon or too late, but you can still give it, it is an override type action. Like it will say "the time has past for this med, do you still want to give it", and then you go on to the regular screen. On ours you can also give meds that are not yet entered by pharmacy, but have to be careful to change the dose screen to "once" because the default for the med scanned, like say Percocet the default will come up as q4hrs and then stay in the sytem even after the pharmacist enters it. It takes awhile to get used to and its hard to explain until you have used it. On ours you can still document the old way, say in a code situation. We have been using computerized med charting for awhile, so if all of this is new, it definitely will be alot different for you...good luck.

The other down side, if you are used to doing assessments, passing morning meds, getting people up, all in the same visit to the room like I am...it is going to take you alot longer to get around to everyone, so you may have to alter your morning plans a little until you get into the swing of it. It really does take more time...especially when you have all your meds out and scanned and then your patient decides he is nauseated and/or needs pain med, then you have to truck down to the pyxix, come back and start the whole process over again.

As a side note, when we first started using this method, we also noticed our legs were hurting alot more at the end of the shift, it was because what we used to spend sitting in front of a computer charting our meds, we now spent standing in front of a laptop in a patient's room...also, our halls look terrible because we have 10 computer carts up against the wall amongst all the rest of the stuff that regularly collects on a medsurg floor.

[Lorie P.]

thanks for the input, don't know how long it will be before we go to this systme. also we still do old fashion charting, paper & pen.

guess i will be one of the lucky ones, i work 11-7 so most times i really don't have that many meds to give, mainly prn's for pain, n/v etc.

[frenchfroggyAPRN, MSN, LPN, RN, APRN]

We use it too, it has its good points and its bad points. We have had it for a year and have became used to them now, if we don't have one we don't feel right. It has dramatically decreased our med errors, and patient satisfaction with their meds. Our patients have became so used to the scanners, that when you walk into the room with a Computer on Wheels (COW) they automatically hold up their arm for us to scan them.

If you are in a code situation you don't have to worry about scanning everything, you write down everything like we used to and go back later and scan the meds, put the correct time in, and it has a place for everything ( temp, b/p, pulse, pain rating etc.). COW's went down Tuesday, it was a pain having to write out our meds for the next shift, luckily they came back up later that night. We do have a printout of the meds for each person for each 12 hour shift, so you do have your print out to see what you need to give that shift., Our COW's are not in the hallway, the hospital took out a closet and built a COW Corall for the COW's and the dynamaps, the halls look much better, not as cluttered.

[rntg]

Even if we had a closet for our dynamaps and computers, we wouldn't be able to use it, as these things our on busy medsurg floor are constantly in use. There would be no convenient place to put them. Wish we could do that.

[RNKITTY04]

We use this system also. Like others have said, some bad some good. What used to take me 20 minutes now takes me approx 1hour20 min.