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PO MED PASS DEMO

PO MED PASS DEMO. SUPPLIES NEEDED. EACH SPN IS TO TAKE THE FOLLOWING SUPPLIES 1. 4 MEDICINE CUPS 2. 4 ENVELOPES 3. 2 UDW 4. 5 POST-IT NOTES 5. MARS and PAPER PILLS FOR ERIN SMITH (already have MAR) STEVEN TYLER

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PO MED PASS DEMO

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  1. PO MED PASS DEMO

  2. SUPPLIES NEEDED • EACH SPN IS TO TAKE THE FOLLOWING SUPPLIES • 1. 4 MEDICINE CUPS • 2. 4 ENVELOPES • 3. 2 UDW • 4. 5 POST-IT NOTES • 5. MARS and PAPER PILLS FOR • ERIN SMITH (already have MAR) • STEVEN TYLER • JENNIFER ANISTON • BRAD PITT • 7. HAVE READY: RED AND BLACK PEN, HIGHLIGHTER, SCISSORS, PAPER, IPOD, PREP PAPERS, SHARPIE

  3. OBJECTIVES • 1. CORRECTLY FILL OUT UNIT DOSE WORKSHEET (UDW) • 2. CALCULATE DOSAGES WITH 100% ACCURACY • 3. ADMINISTER DRUG CORRECTLY ACCORDING TO ORDER AND FORM OF DRUG 100% OF TIME • 4. CORRECTLY ID CLIENT 100% OF TIME • 5. CORRECTLY RECORD MEDS GIVEN OR NOT GIVEN ACCORDING TO POLICY

  4. 6 PT RITES • PATIENT • DRUG • TIME • ROUTE • DOCUMENTATION • DOSE • 100% OF THE TIME!!!!!

  5. 6 RIGHTS OF MED ADMINISTRATION • 1. RIGHT PATIENT • a. Check the original order • b. Check the MAR • c. Check client name band- 2 identifiers • NAME and MEDICAL RECORD #/ • or BIRTHDATE • d. Ask client name, DOB, and allergies • e. Red flags- same names

  6. 6 RIGHTS OF MED ADMINISTRATION • 2. RIGHT DRUG • a. Check the original order • b. Check the MAR • c. Check the package or container • d. Inform the client of med name and reason • for giving • e. Red flags- same color, close names

  7. 6 RIGHTS OF MED ADMINISTRATION • 3. RIGHT ROUTE • a. Check the original order • b. Check the MAR • c. Does this match client and condition? • d. Watch abbreviations • e. Red flags

  8. 6 RIGHTS OF MED ADMINISTRATION • 4. RIGHT TIME • a. Check original orders • b. Check the MAR • c. Does time match use of drug • d. Any conflicts/counteractions with • other drugs • e. Watch abbreviations for times • f. Red flags

  9. 6 RIGHTS OF MED ADMINISTRATION • 5. RIGHT DOSE • a. Check original order • b. Check MAR • c. Is dose within recommended guidelines • d. Pay attention to numbers • e. Correct calculations • f. Red flags

  10. 6 RIGHTS OF MED ADMINISTRATION • 6. RIGHT DOCUMENTATION • a. Correct MAR • b. Correct signature • c. Correct space on MAR • d. Correct date and time

  11. ABBREVIATIONS • WATCH WHICH ABBREVIATONS ARE USED. • REVIEW INFORMATION SHEET GIVEN.

  12. PREPARATION: GETTING STARTED • 1. MUST ARRIVE ON TIME- BE EARLY ON MED PASS DAYS • 2. OBTAIN UDW • a. OBTAIN CLIENTS TO PASS MEDS ON. • 3. FILL OUT UDW- will go over in detail • 4. CHECK MEDS ON MAR TO COMPLETE UDW • 5. OBTAIN REPORT ON CLIENTS • 6. NOTE ANY “NPO” – for any reason • 7. MAKE SURE CART ADEQUATELY STOCKED:

  13. PREPARATION: GETTING STARTED 8. WILL DO DRUG CALCULATIONS ON BACK OF UDW • 9. UDW IS NOT PART OF CHART

  14. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS

  15. UNIT DOSE WORKSHEET • 1. Time across top • 2. Rooms down side • 3. Use client initials with room numbers • 4. Fill in each room in your mod, may have admission later • 5. 3 columns at bottom: FSBS, PRN MEDS, MEDS HELD • 6. IV’s or RN meds on column to right • 7. Nurse name and date on top of UDW

  16. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS

  17. UDW • 8. Check meds on MAR in order they are written. DO NOT attempt to find all 0800, then 0900, etc. • 9. Make a tally mark on UDW in time space that med is due • 10. If due at half hour time, can make a diagonal space in time slot. • 11. Mark IV meds on worksheet in RN slot in correct client space.

  18. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS

  19. UDW 12. Be careful of qod orders, even /odd day orders • 13. Be aware of stop/start dates, one time orders, and expiration dates • 14. Check client’s allergies and be sure patient is not getting a med they are allergic to. Put sticky note on UDW for allergies for a red flag for nurse. This is the only information to look up about the med while filling out UDW. • 15. Do not look up all information about med while filling out UDW. • 16. Put FSBS in column at bottom of unit dose worksheet with time and room # and under appropriate time to be done at top.

  20. MED PREPARATION • 1. WASH HANDS • 2. PREPARE MEDS WITH AS LITTLE DISTRACTION AS POSSIBLE • 3. PREPARE MEDS FOR ONLY ONE CLIENT AT A TIME • 4.PREPARE ONLY ONE MED AT A TIME – DOING • ALL 3 CHECKS ON THAT MED BEFORE • MOVING ON TO NEXT MED • 5. DO NOT PRE-SIGN MEDS

  21. MED PREP (CONTD) • 7. GIVE ONLY WHAT YOU HAVE PREPPED • 8. IF PILLS FALL ON FLOOR, DISCARD IN SHARPS • 9. REPORT ANY ERRORS • 10. KNOW INFO ABOUT MEDS • 11. DO NOT LEAVE CART UNLOCKED • 12. DO NOT LEAVE MEDS OUT ON CART • 13. DO NOT LEAVE MARS OPEN

  22. MED PREP (COND) • 14. GIVE MEDS IN CORRECT ORDER • a. Pills and tabs • b. liquids • c. syrups • d. inhalers • e. eye/nose drops • f. sublingual • g. topicals • h. injections

  23. MED PREP (CONTD) • 15. ASSIST PT IN TAKING MEDS • 16. STAY IN ROOM UNTIL PT. TAKES MEDS • 17. DISPOSE OF CUPS PROPERLY

  24. PREPARING MEDICATIONS • DECIDE WHICH PT. TO PREP MEDS FOR FIRST • PRIORITIZE • THINK • WHO SHOULD MEDS BE PASSED FIRST ON?

  25. REPORT 0700 JEN ANISTON ADMITTED YESTERDAY FOR CHF. HISTORY OF DIABETES AND HYPERTENSION. T: 99.0, P: 62 IRREG, R: 24, BP: 140/88. BILAT RALES IN BASES, +1 PITTING EDEMA BLLE. BRAD PITT ADMITTED 2 DAYS AGO WITH CELLULITIS OF LLE. HISTORY OF HYPERTENSION. T:98.9, P: 88 REG, R: 20, BP: 158/88.

  26. WHO TO PASS MEDS ON FIRST? • JEN ANISTON: Has 0730 med due. • PREP J. ANISTON’S MEDS FIRST. • CAN GO SPEAK WITH J. ANISTON FIRST if you do not know the following information: • ASK ABOUT ALLERGIES- TYPE OF REACTION. CODEINE: CAUSES EMESIS. MAKE SURE HAVE STICKY NOTE ON UDW ABOUT ALLERGIES. • HOW TAKE HER MEDS? • INFORM PT WILL PREP MEDS AND RETURN. • RETURN TO CART TO PREP JEN’S MEDS.

  27. JEN ANISTON MEDS • 1ST CHECK • 1. READ PT. NAME, DOB, MED RECORD #, ALLERGIES AND DATE ON MAR • 2. DRUG NEEDED IS: CARAFATE 1 GRAM( READ FROM MAR) • 3. FIND CARAFATE 1 GRAM (FROM DRAWER) • 4. DUE P.O., A.C., DUE THIS AM ON NOV. 28TH AND HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO. • 5. IF CAN NOT FIND CARAFATE IN DRAWER, LOOK UP CARAFATE TO FIND GENERIC NAME • 6. END OF 1ST CHECK.

  28. JEN ANISTON MEDS • 2ND CHECK:SET UP A B C CUPS (Can be set up prior to starting) • 1. NEED: CARAFATE 1 GM (READ FROM MAR) • 2. HAVE: CARAFATE 1 GM (READ FROM PACKAGE) • 3. DUE: PO, A.C., THIS AM FOR NOV 28TH, HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO (READ FROM MAR). CHECK EXPIRATION DATE ON MED • 4. WHAT IS CARAFATE? FOR GASTRIC ULCERS. APPROPRIATE DOSE? YES • 5. WHAT CUP TO GO IN? C • 6. ANY CALCULATION, CUT, CRUSH? NO • 7. ANY ASSESSMENT? NO • 8. SIGN TIME TO MAR. • 9. END OF 2ND CHECK.

  29. JEN ANISTON MEDS • 3RD CHECK • 1. NEED CARAFATE 1 GM (FROM MAR) • 2. HAVE CARAFATE 1 GM (FROM PACKAGE) • 3. DUE PO, AC, THIS AM, ON NOV 28TH, NOT BEEN GIVEN YET, NOT ALLERGIC TO. NOT EXPIRED • 4. END OF 3RD CHECK

  30. JEN ANISTON MEDS • LOOK AT UDW. NEED 0730 MED, HAVE 0730 MED. • WILL PREP 0800 MEDS ALSO AT THIS TIME. • 1. NEXT MED: 1ST CHECK: • 2. NEED: LANOXIN 0.125 MG (READ FROM MAR) • 3. HAVE: LANOXIN 0.125 MG TABLET (READ PACKAGE) • 4. DUE: AM AT 0800, PO, NOT BEEN GIVEN YET,FOR NOV 28TH, ALLERGY TO CODEINE. NOT EXPIRED • 5. AN EVERY OTHER DAY MED. MAKE SURE NOT GIVEN YESTERDAY. LOOK AT OLD MAR. • 6. END OF FIRST CHECK

  31. J.A. MEDS • 2ND CHECK • 1. NEED: LANOXIN 0.125 MG • 2. HAVE: LANOXIN 0.125 MG • 3. DUE: 0800 AM, PO, NOT BEEN GIVEN YET, NOT GIVEN YESTERDAY OR TODAY, NOT ALLERGIC TO. NOT EXPIRED • 4. WHAT IS LANOXIN? ANTIARRHYTHMIC, INCREASES C.O., SLOWS HR • 5. ANY ASSESSMENT? APICAL 1 MIN. HOLD <60. • 6. ANY CALCULATION? CUT, CRUSH, POUR? • 7. WHAT CUP? A (APICAL) • 8. PUT IN A CUP • 9. SIGN TIME OF 0800 ON MAR • 10. END OF 2ND CHECK

  32. J.A. MEDS • 3RD CHECK • 1. NEED: LANOXIN 0.125 MG • 2. HAVE: LANOXIN 0.125 MG • 3. DUE: PO, 0800, NOV 28TH, NOT BEEN GIVEN TODAY OR YESTERDAY, NOT ALLERGIC TO. NOT EXPIRED • 4. IN A CUP • 5. END OF 3RD CHECK

  33. J.A. MEDS • NEXT MED DUE: 1ST CHECK • 1. NEED: LASIX 20 MG (READ FROM MAR) • 2. HAVE: LASIX 10 MG TAB ( READ FROM MED PACKAGE) • 3. DUE: PO, 0800, NOT BEEN GIVEN YET, ON NOV 28TH, NOT ALLERGIC TO. NOT EXPIRED • 4. END OF 1ST CHECK

  34. J.A. MEDS • 2ND CHECK • 1. NEED: LASIX 20 MG • 2. HAVE: LASIX 10 MG TAB • 3. DUE: PO, 0800, NOT BEEN GIVEN YET ON NOV 28TH, NOT ALLERGIC TO. NOT EXPIRED • 4. WHAT IS LASIX? DIURETIC • 5. ANY ASSESSMENT? BLOOD PRESSURE. HOLD <100/50 • 6. ANY CALCULATION? YES. DO MATH ON BACK OF UDW. NEED 2 10 MG TABS. • 7. OBTAIN ANOTHER 10 MG TAB AND DO 1ST AND 2ND CHECK ON THAT TAB. CHECK EXPIRATION DATE ON NEW TAB • 8. WHAT CUP? B CUP • 9. TIME MAR FOR 0800 ON 28TH. • 10. END OF 2ND CHECK

  35. J.A. MEDS • 3RD CHECK • 1. NEED: LASIX 20 MG • 2. HAVE: LASIX 10 MG- 2 TABS (LOOK AT BOTH TABS) • 3. DUE: PO, 0800, TODAY NOV 28TH, NOT BEEN GIVEN YET, NOT ALLERGIC TO, NOT EXPIRED • 4. ALREADY IN B CUP. BOTH TABS • 5. END OF 3RD CHECK.

  36. PREPARING MEDS (CONTD) • - Do all 3 checks on each med before preparing another med. • - Check meds with UDW to make sure equal meds are prepared.

  37. J.A. MEDS • CHECK MEDS HAVE WITH UDW. • NEED 3 MEDS. • HAVE: CARAFATE, LANOXIN, AND LASIX 2 TABS. • CORRECT? • READY TO GIVE MEDS!!!!!

  38. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS

  39. ADMINISTERING MEDS • 1. GATHER EQUIPMENT • A. MARS • B. MEDS IN CUPS • C. CUP, WATER, (FOOD, SPOON) • D. STETH, SPHYGMO • 2. WASH HANDS

  40. ADMINISTERING MEDS • 3. ID PATIENT • A. USE 2 MEANS TO IDENTIFY CLIENT: NAME • AND DOB • B. PLACE MAR NEXT TO ID BRACELET AND • MATCH NAME, DOB, AND MEDICAL • RECORD # • C. ASK PT ALLERGIES AND REACTION • D. ASK PT HOW FEELING

  41. ADMINISTERING MEDS • 4. DO ASSESSMENT AS NEEDED • A. APICAL: 84 • B. BLOOD PRESSURE: 142/92 • 5. ASK YOURSELF IS IT OK TO GIVE MEDS? • A. MAY GIVE ALL MEDS

  42. ADMINISTERING MEDS • 6. 4TH CHECK • A. NEED: LANOXIN 0.125MG • HAVE: LANOXIN 0.125MG • DUE: PO, 0800, TODAY, NOT GIVEN YET, • APICAL 84, NOT EXPIRED, NOT • ALLERGIC • B. NEED: LASIX 20MG • HAVE: LASIX 20 MG (IN 2 TABS) • DUE: PO, 0800, TODAY, NOT GIVEN YET, • BP 142/92, NOT EXPIRED, NOT ALLERGIC

  43. ADMINISTERING MEDS • C. NEED: CARAFATE 1 GM • HAVE: CARAFATE 1 GM • DUE: PO, 0730, TODAY, NOT • GIVEN YET, NOT EXPIRED, NOT • ALLERGIC • END OF 4TH CHECK • OPEN PACKAGES AND GIVE MEDS

  44. ADMINISTERING MEDS • 7. GIVE PT MEDS. OK TO TAKE ALL AT SAME TIME IF ABLE. WAIT WITH PT TIL SWALLOWS PILLS. MAY HAVE TO CHECK IN MOUTH TO MAKE SURE ALL HAVE BEEN SWALLOWED. • 8. FINAL 5 • 9. WASH HANDS

  45. DOCUMENTATION • 1. SIGN OFF WITH INITIALS ON MAR IN CORRECT TIME AND DATE SLOT • 2. USE 2 OR 3 INITIALS • 3. SIGN BOTTOM OF MAR. (OK IF DONE EARLIER) • 4. CROSS OF MEDS GIVEN ON UDW. • 5. WRITE AP AND BP ON MAR AND UDW NEXT TO TIME GIVEN.

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