Writing times on bubble packed med cards?

[4x4country]

Question ---- can you write on a card of medication? At my old job, we had bubble packed meds in a LTC. Each shift had their own way to ID each med cards they were to give on that shift. First shift had their own personal number system on the left hand of the card. Second card simply wrote- 4pm or 8pm in permenant marker on the right hand of the card. Third shift takes a yellow highlighter striaght line across the top of the med card.

It made it very quick to pull the med card out and triple check it to the MAR, especially if you had a pt on 20-30 meds. However some say the down fall was that people dont check it against the MAR and dont notice changes. I always double check, personally.

However it is a state violation to write on the cards?

We had this system of writing on card for yrs. State never taged us on it, 4 yrs perfect survey. So why did we get away with it?

[MUUGUZI]

I don't believe there is any regulation for writing on the pak.

As long as you don't write on the actual pharmacy label, potentially obscuring any of the information on it, you should be ok.

I also worked in an LTC and we marked all over the bubble paks EXCEPT for on the pharmacy label.

If any information on the label was incorrect, we had to call the pharmacy and start a war the pharmacists!

[SuesquatchRN, BSN, RN]

We always marked the shift in different colored ink. Not a deficiency.

We also initialed next to each pill that was popped. Made tracking med errors easy.

[sclpn]

we have a few halls that mark the bubble pack with the admin. times but all nurses don't follow suit so if you are switched to a different hall the packs may not be marked. pharmacy told us to be careful and not cover the expiration date or label

[NurseExec]

We don't write on the cards--what if you have to change times? The card ends us getting completely trashed, and the incidence for errors goes up. We mark the times on the MARs/TARs with highlighter--blue for days, green for evenings, and pink for nights. If the times change, the entry must be d/c'd out, and re-written with the appropriate times.

[CoffeeRTC, BSN, RN]

Why can't you get a card for each shift or med times. Like if it was a tid...we would have 3 cards sent out. Puch out the date that you are to give the med. Easy unless you have people that don't punch on the date that it should be give. That is the only time we write on the cards.

[caliotter3]

We always marked the shift in different colored ink. Not a deficiency.

We also initialed next to each pill that was popped. Made tracking med errors easy.

We also did the same thing at my facilities. It cut down on errors, but there were still some occasionally. Definitely easier to track the errors. Never heard anything about this not being ok.

[Murse901, MSN, RN]

As others have stated, it is okay to write on the card as long as you don't write on the pharm label.

[NurseExec]

Why can't you get a card for each shift or med times. Like if it was a tid...we would have 3 cards sent out. Puch out the date that you are to give the med. Easy unless you have people that don't punch on the date that it should be give. That is the only time we write on the cards.

Nice idea, but 30 people with at least 5 meds given at least 3 times a day--dear lord, you wouldn't be able to fit all the cards in the cart, LOL!

[CapeCodMermaid, RN]

My pharmacy consultant tells us it is against the regs to write anything on the cards. I think you're looking for trouble. The med nurse should look at EVERY block on the MAR to determine which meds need to be given. Color coding??? Never heard of it and wouldn't allow it in my building.

[pielęgniarka, RN]

Every LTC facility I've worked at has done some type of color coding on the MAR-- a little line with highlighters (over the time only 0730, 1600, 2000). May be a local thing... Day shift's times are plain, eves are pink and nocs have light green. While scrolling thru allll the med orders it makes it easier to spot your shift's meds.

You're supposed to compare the pharm labels with the MAR at all times. Never just go by the pharm label.

So nurses here are saying that they initial every spot on all the bubblepacks in addition to the MAR? Sounds timeconsuming. We only initial the bubblepacks+MAR for narcs and abx and even that's not mandatory. All other meds, its signed out on the MAR only. (well, of course narcs are signed out in the narc book too.)

My pharmacy consultant tells us it is against the regs to write anything on the cards. I think you're looking for trouble. The med nurse should look at EVERY block on the MAR to determine which meds need to be given. Color coding??? Never heard of it and wouldn't allow it in my building.

[SuesquatchRN, BSN, RN]

So nurses here are saying that they initial every spot on all the bubblepacks in addition to the MAR? Sounds timeconsuming. We only initial the bubblepacks+MAR for narcs and abx and even that's not mandatory. All other meds, its signed out on the MAR only. (well, of course narcs are signed out in the narc book too.)

One place did that so they could track med errors. It was a PITA royale.