Had my first dealings with the ridiculous 12 mcg Fentanyl patch this weekend as I had a patient on 37 mcg total. First, I had to go pick it up as it was of course not stocked in our Pyxis. I open both packages. When I open the 12 mcg one, it appears to be empty. Hmmm, strange. Maybe I got an empty package by mistake. Oh no, there it is, the size of a small clear Pez candy. I take that one and the 25 out of their packages(first mistake) and put them on top of the tegederm dressing l'll use over them. I take the old patches off and place them aside as they'll need to be wasted. Then I get the 25 and the tegederm but the 12 is nowhere to be found. Oh god. Images of my nursing career flashing before my eyes, I search frantically on the floor and surrounding area to no avail. Well, it was a good run. 7 years. Before they thought I diverted a 12 mcg patch. I turn on bright lights and finally see it, taunting, malicious, and barely visible. I hold it in my hand the entire time until I place it.
They really need to improve the packaging/coloring on that thing. Maybe a fluorescent pink stripe or something.
Yeah I placed a tegederm over the new patches but put a large opaque label on the side of the dressing with date, time, dosage, drug, and initials. And our med administration system requires we enter the place we put the patch(es.) The safety issue is a good point though.
Glad my tale could serve as a warning:) oh and the covering on the one I placed was clear too. The whole minuscule unit was as good as invisible. Like I said, I thought the package was empty at first.
Yeah I placed a tegederm over the new patches but put a large opaque label on the side of the dressing with date time, dosage, drug, and initials. And our med administration system requires we enter the place we put the patch(es.) The safety issue is a good point though. Glad my tale could serve as a warning:) oh and the covering on the one I placed was clear too. The whole minuscule unit was as good as invisible. Like I said, I thought the package was empty at first.[/quote']
Another facility I worked at required we placed a tegaderm over the clear patch and a bright orange dot sticker in the corner with time date and initials. We also had to physically check the patch placement at shift change with the next nurse to ensure the patch was in place and sign off on it in the computer.
I never open the new ones until the old ones are off and disposed of. On our MARS we have to make a note of where we put the patches so you can find them.
I have also played the "find the patch" game. Panic inducing to say the least.
We USED to place Tegaderms over all clear patches, but a couple of residents were breaking out from the adhesive, so there went that safety net. I hate not having them covered! It's like an extra safety net of knowing they're going to stay where you put them!
I'm a new lpn and have only worked with patches in the school clinical setting, we were taught to pre open the package to date and initial the patches, before entering the pt room. I can imagine the patches you were talking about were way too tiny to write anything on . I will be cautious when opening patches now, thanks for sharing.
sistrmoon, BSN, RN
842 Posts
Yeah I placed a tegederm over the new patches but put a large opaque label on the side of the dressing with date, time, dosage, drug, and initials. And our med administration system requires we enter the place we put the patch(es.) The safety issue is a good point though.
Glad my tale could serve as a warning:) oh and the covering on the one I placed was clear too. The whole minuscule unit was as good as invisible. Like I said, I thought the package was empty at first.