As Daniel suggests, our system is set up with a limited number of drugs (per
our HA med policy) that REQUIRE another nurse to input BOTH their mnemonic
and password before filing. Our drugs are Heparin, PCA-controlled opiates,
chemo, heparin and insulin (IV drips only), paralytic agents, and pediatric
meds for patients under 45 kg. Our Peds dept is NOT yet on BMV, but when
they are we will use this same process. This has been a policy here for a
long time, and was a part of the initial BMV training, so staff have been
accepting. Another thing we did with our system here to enforce proper use
of the safety system was change the barcode on the wristband so the ones on
the label won't read for meds or POC glucose meters. 

-----Original Message-----
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of
Sharon LaDuke
Sent: Friday, May 11, 2007 7:26 AM
To: Davis Daniel - Southern Hills; Witt, Sharon L.;
[EMAIL PROTECTED]; [email protected]
Subject: RE: [MEDITECH-L] Med documentation of High Alert Meds...

Daniel's comments about bedside medication prep and verification resonate
with me. I worked at a facility that had had eMAR/BMV for 3 years. Nurses
did things like open all the meds and remove them from their packaging
somewhere other than the patient bedside, and scan patient labels instead of
the wristband. They were completely circumventing the purpose of BMV. They
did it because they perceived that it saved time, and most of them really
had not thought through the threat, not only to patients, but to their own
licenses. The facility recently put a big emphasis on retraining the nursing
staff to use the system properly. With all nursing directors, Pharmacists
and even Administrators involved, and weekly medication safety meetings to
discuss scan rates and plan followup with noncompliant nurses, things turned
around in a hurry. I believe the cycle of nurses training new nurses to do
things incorrectly has been broken at that hospital. Sharon


-----Original Message-----
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of
Davis Daniel - Southern Hills
Sent: Thursday, May 03, 2007 1:04 PM
To: Witt, Sharon L.; [EMAIL PROTECTED]; [email protected]
Subject: RE: [MEDITECH-L] Med documentation of High Alert Meds...

I believe you can limit the number of high risk meds that you require the
signature on and make this work.  I don't believe it is best to design the
process to allow/encourage poor behavior.  If you are using BMV then you
should be preparing the meds at the bedside.  So, if that is happening how
can an RN/LPN verify that med except at the bedside.

 

The whole purpose of BMV and eMAR is patient safety.  If you circumvent that
what do you have?

 

Daniel Davis

________________________________

From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of
Witt, Sharon L.
Sent: Tuesday, May 01, 2007 5:14 PM
To: [EMAIL PROTECTED]; [email protected]
Subject: RE: [MEDITECH-L] Med documentation of High Alert Meds...

 

Please post.

 

We are currently using Emar and just document that it was verified by an
RN/LPN - Y/N.  We changed this when going to BMV because of the difficultly
of needing someone at the bedside otherwise.

 

I am currently involved in another project looking at this very topic and it
would be great to know what others are doing.

 

Sharon

 

________________________________

From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of
[EMAIL PROTECTED]
Sent: Monday, April 30, 2007 6:24 PM
To: [email protected]
Subject: [MEDITECH-L] Med documentation of High Alert Meds...

Either on paper or electronically, do you require a "co-sign" on High Alert
Meds?

If so:

1.      Briefly, which meds are considered HA at your site 
2.      If electronically, do you require a PIN or just the User ID 

If not, does your site have nursing use a non-documented visual verification
of any meds (insulin, peds doses, etc.)?

 

Thanks to all - Kevin.

 

 

 

Kevin McConnell, PharmD.

Clinical Consultant

(713)480-6810

[EMAIL PROTECTED]

www.RPhInformatics.com <http://www.RPhInformatics.com> 

 

<http://www.RPhInformatics.com>  

 


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