Published Sep 6, 2013
I'm noticing a disturbing trend of fentanyl Patches being stolen. While most facilities do a fairly good job of accounting for controlled substances, I can't help but realize that the only opioid we cannot keep locked under control at all times is fentanyl. Once applied to a resident, we have lost all controls that we have for other controlled substances that are locked up until immediate use. So I'd like to remind all nurses out there that we need to do our best to be accountable, and when a patch turns up missing - make sure you take it seriously and report it accordingly.
Eric Christianson, Pharm.D.
We have another thread on the forum right now about the patches and the difficulty we have in keeping them adhered to our residents,especially the low dose patch.It's very small. I hope the manufacturer picks up on this and re-designs it. They could certainly make a large border around it. I have never seen any of the bigger patches go missing at my facility,it's always the tiny bastards-you can barely see them on the person and if they get balled up into the linens they are gone.Now we have to visualize the patch in situ at shift change.The residents love to be awakened for that.
I know on my unit, we have to document fentynal patches are in place each shift including location.
Esme12, ASN, BSN, RN
This is a problem but I an not so sure they are always being stolen....they are very difficult if not impossible to keep on the patient https://allnurses.com/geriatric-nurses-ltc/fentanyl-patches-845877.html
I once had a mother pitch a huge tantrum because I needed to visualize the fentanyl patch on her child. The patch was on her buttock. The mother thought it was inane and scandalous that I insisted on looking at it. Needless to say, she fired me. And needless to say, I was very happy about it.
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In the ltc I worked for, this was a big problem, patches coming up "missing". Hey it can happen occasionally but consistently is not cool. Initially we drugged tested everyone on the unit,a few ppl can't up dirty but lucky for them they had scripts that covered them. We began using opsite or tegaderm to cover the patches then had to visualize them during report off and document. Eventually we weeded out the culprit and they were fired.
Oh and the police were contacted and I believe chargers filed on the person
LadyFree28, BSN, LPN, RN
I don't know about missing the tiny ones...it seems for me hard for the to take off of a person... FWIW, When needed, I do place a regs deem over it, just depends on the patient.
OTOH, at least they caught the person stealing fentanyl patches in your facility doppleganger2.
txredheadnurse, BSN, RN
New regs require documentation of the wastage of the removed patches in addition to signing them out when applying them. The idea behind this is to discourage the diversion of said patches. Several facilities I am in for audits also require each shift to document presence and site of narcotic patches; same rationale as the qshift verification check.
I haven't heard about the new regs. We just throw the old patch away in the red sharps box. We are suppose to check every shift to see if the pain patch is still on the patient.
SuesquatchRN, BSN, RN
Y'know, we have such a nannyish government that we spend hours every shift in LTC just counting drugs. For goodness' sake, if someone is in pain, psychic or physical, let 'em have 'em.
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