#medpass

[oregonlatte]

25 pills! #polypharmacy #medpass #medicationinteraction #neuro https://www.instagram.com/p/B3GRQDYgFRw/?igshid=vnqv7ggyw202

[zenide]

#derp #murse #rn #medpass

[scrxpharmacy]

Ongoing concern about insulin pen reuse in hospitals & long-term care facilities

More than 700 patients at a New York (NY) hospital may have been exposed inadvertently to human immunodeficiency virus (HIV), hepatitis B, or hepatitis C because of the reuse of insulin pens on multiple patients after changing the disposable needle (www.ismp.org/sc?id=144).

  All it takes is one or two individuals who are not aware that it is unsafe to place a new disposable needle on a pen used for one patient and use it to deliver a dose of insulin to another patient. For example, a new graduate nurse or a temporary nurse may not have received proper training regarding the use of insulin pens, and thus a knowledge deficit may exist. Completely controlling for this is difficult, perhaps even impossible, given that unsafe pen use has persisted despite educational efforts and monitoring.

[scrxpharmacy]

SCRx Med Pass Checklist

4-8 oz. of water of fruit juice with bulk laxatives

Administer bronchodilator 1st : steroid last

C-II are under double lock

Control count record is signed before C-II is given

Drug label, MAR, Physicians order are identical

Ensure Med is crushable

Enteral tube Meds. Are not cocktailed

Enteral tubes are checked for placement

Enteral tubes are flushed before & after meds

Eye ointments separated by 10 mins. Eye closed 1-2 mins after. Use separate tissue for each eye

Food and fluid items are covered and dated

Food given with meds is within diet restrictions

1hr before or 2hrs after meals for empty stomach

Give AC, PC and time specific meds on time

Hands are washed between direct resident contact

HOB-enteral tube pt. when giving meds

Injection and patch sites are documented on MAR

Insulin vial dated when opened

K+ supplements & NSAIDS

MAR protected when unattended

Med cart and med room keys are retained by nurse at all times

Med carts are always visible to nurse or locked

Med carts are clean, stocked and clear of trash

Medication is expelled directly to soufflé cup

Medication pass starts and ends on time (+ or – hr)

Medications are not pre-poured or pre-charted

Medications withheld or refused are documented per policy

Missing medications are handled properly

Multiple drops to same eye, wait 3-5 mins, eye closed for 3 mins. Or gentle pressure to tear duct 1 min after

Nurse can explain med use and side effects

Nurse is with resident until meds are swallowed

Pill crusher is clean

PRN’s chart-reason and effectiveness of med

Residents are identified (picture, armband, name)

Residents properly positioned-administration ease

Rights and privacy are maintained

Rinse mouth after use of steroid inhaler

Separate multiple puffs by 1 minute

Shake inhaler prior to each puff

Suspensions are shaken well, over pours are discarded

Use syringe for measurement-not souffle cup

Wash hands before and after eye drops

Waterless hand cleansers used in 15 seconds wet rub

[scrxpharmacy]

How to Use Ear Drops Properly

(Having someone else give you the ear drops may make this procedure easier.)

1Wash your hands thoroughly with soap and water.2Gently clean your ear with a damp facecloth and then dry your ear.3 Warm the drops to near body temperature by holding the container in the palm of your hand for a few minutes.4 If the drops are a cloudy suspension, shake the bottle well for 10 seconds.5 Check the dropper tip to make sure that it is not chipped or cracked.6 Draw the medication into the dropper, or hold the dropper-top bottle with the dropper tip down.

7Tilt the affected ear up or lie on your side. Pull the ear backward and upward (or if giving  to a child younger than 3 years of age, pull backward and downward) to open  the ear canal.

8 Place the correct number of drops in your ear. Gently press on the small skin flap over the ear to help the drops to run into the ear canal

9 Keep your ear tilted up for a few minutes or insert a soft cotton plug in your ear, whichever method has been recommended by your pharmacist or doctor.10    Replace and tighten the cap or dropper right away.11    Wash your hands to remove any medication.

Remember

Follow directions carefully

Do not miss doses

Store medications out of reach of children

[scrxpharmacy]

How to Use Rectal Suppositories Properly

1Wash your hands thoroughly with soap and water.2 If the suppository is soft, hold it under cool water or place it in a refrigerator for a few minutes to harden it before removing the wrapper.3Remove the wrapper, if present.4 If you were told to use half of the suppository, cut it lengthwise with a clean, single-edge razor blade.5 Put on a finger cot or disposable glove, if desired (available at a pharmacy).6 Lubricate the suppository tip with a water-soluble lubricant such as K-Y Jelly, not petroleum jelly (Vaseline). If you do not have this lubricant, moisten your rectal area with cool tap water.

7 Lie on your side with your lower leg straightened out and your upper leg bent forward toward your stomach.

8 Lift upper buttock to expose the rectal area.9 Insert the suppository, pointed end first, with your finger until it passes the muscular sphincter of the rectum, about 1/2 to 1 inch in infants and 1 inch in adults. (If not inserted past this sphincter, the suppository may pop out.)10    Hold buttocks together for a few seconds.

11    Remain lying down for about 5 minutes to avoid having the suppository come out.

12    Discard used materials and wash your hands    thoroughly.

Remember

Follow directions carefully

Do not miss doses

Store suppositories in a cool place and avoid melting; refrigerate them if so labeled

Store medications out of reach of children

[scrxpharmacy]

How to Use Eye Ointments and Gels Properly

(Using a mirror or having someone else give you the eyedrops may make this procedure easier.)

1Wash your hands thoroughly with soap and water.2 Avoid touching the tip of the tube against your eye or anything else - the medication and its container must be kept clean.3 Holding the tube between your thumb and forefinger, place it as near to your eyelid as possible without touching it.4 Brace the remaining fingers of that hand against your face.5 Tilt your head forward slightly.6 While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.

7 Squeeze ribbon of ointment or gel into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.

8 Blink your eye gently; then close your eye for 1 to 2 minutes.

9With a tissue, wipe any excess ointment or gel from the eyelids and lashes. With another clean tissue, wipe the tip of the tube clean.10    Replace and tighten the cap right away.11    Wash your hands to remove any medication.

Remember

Follow directions carefully

Do not miss doses

Your eyesight may be cloudy after using the ointment or gel

Store medications out of reach of children

[scrxpharmacy]

How to Use Metered-Dose Inhalers

1Wash your hands thoroughly with soap and warm water.2 Remove the cap and hold the inhaler upright.3Shake the inhaler.4Breathe out slowly through your mouth.5 Hold your inhaler as shown in the picture or as recommended by your doctor.6 While you are breathing in, press down on your inhaler one time to release the medication.7 Continue to breathe in slowly and as deeply as you can.8Hold your breath for 10 seconds, if you can, to allow the medication to reach deeply into  your lungs.9Repeat steps 3 to 8 until you have inhaled the number of puffs that your doctor prescribed. Ask your doctor or pharmacist if you need to wait between puffs of your medication.10    Rinse your mouth thoroughly with water.11    Spit out the water. Do not swallow.