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1 PO MED PASS DEMO. SUPPLIES NEEDED 2 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.

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Presentation on theme: "1 PO MED PASS DEMO. SUPPLIES NEEDED 2 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."— Presentation transcript:

1 1 PO MED PASS DEMO

2 SUPPLIES NEEDED 2 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 3 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 4 PATIENT DRUG TIME ROUTE DOCUMENTATION DOSE 100% OF THE TIME!!!!!

5 6 RIGHTS OF MED ADMINISTRATION 5 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 6 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 7 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 8 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 9 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 RIGHT DOCUMENTATION a. Correct MAR b. Correct signature c. Correct space on MAR d. Correct date and time

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

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

14 14 HOURS ROOMS IV’S/NURSE NOTES UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

15 UNIT DOSE WORKSHEET 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 16 HOURS ROOMS A 400B JA 401A 401B 403A 403B BP 404A IV’S/NURSE NOTES UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

17 UDW 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 18 HOURS ROOMS A 400B J.A. ll lll 401A 401B 403A 403B B.P. l lll 404A IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

19 UDW 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 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) 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) 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) ASSIST PT IN TAKING MEDS 16. STAY IN ROOM UNTIL PT. TAKES MEDS 17. DISPOSE OF CUPS PROPERLY

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

25 REPORT 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 26

27 WHO TO PASS MEDS ON FIRST? 27 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.

28 JEN ANISTON MEDS 28 1 ST 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. 28 TH 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 1 ST CHECK.

29 JEN ANISTON MEDS 29 2 ND 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 28 TH, 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 2 ND CHECK.

30 30

31 JEN ANISTON MEDS 31 3 RD CHECK 1. NEED CARAFATE 1 GM (FROM MAR) 2. HAVE CARAFATE 1 GM (FROM PACKAGE) 3. DUE PO, AC, THIS AM, ON NOV 28 TH, NOT BEEN GIVEN YET, NOT ALLERGIC TO. NOT EXPIRED 4. END OF 3 RD CHECK

32 JEN ANISTON MEDS 32 LOOK AT UDW. NEED 0730 MED, HAVE 0730 MED. WILL PREP 0800 MEDS ALSO AT THIS TIME. 1. NEXT MED: 1 ST CHECK: 2. NEED: LANOXIN MG (READ FROM MAR) 3. HAVE: LANOXIN MG TABLET (READ PACKAGE) 4. DUE: AM AT 0800, PO, NOT BEEN GIVEN YET,FOR NOV 28 TH, 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

33 J.A. MEDS 33 2 ND CHECK 1. NEED: LANOXIN MG 2. HAVE: LANOXIN 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 < 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 2 ND CHECK

34 34

35 J.A. MEDS 35 3 RD CHECK 1. NEED: LANOXIN MG 2. HAVE: LANOXIN MG 3. DUE: PO, 0800, NOV 28 TH, NOT BEEN GIVEN TODAY OR YESTERDAY, NOT ALLERGIC TO. NOT EXPIRED 4. IN A CUP 5. END OF 3 RD CHECK

36 J.A. MEDS 36 NEXT MED DUE: 1 ST 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 28 TH, NOT ALLERGIC TO. NOT EXPIRED 4. END OF 1 ST CHECK

37 J.A. MEDS 37 2 ND CHECK 1. NEED: LASIX 20 MG 2. HAVE: LASIX 10 MG TAB 3. DUE: PO, 0800, NOT BEEN GIVEN YET ON NOV 28 TH, 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 1 ST AND 2 ND CHECK ON THAT TAB. CHECK EXPIRATION DATE ON NEW TAB 8. WHAT CUP? B CUP 9. TIME MAR FOR 0800 ON 28 TH. 10. END OF 2 ND CHECK

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39 J.A. MEDS 39 3 RD CHECK 1. NEED: LASIX 20 MG 2. HAVE: LASIX 10 MG- 2 TABS (LOOK AT BOTH TABS) 3. DUE: PO, 0800, TODAY NOV 28 TH, NOT BEEN GIVEN YET, NOT ALLERGIC TO, NOT EXPIRED 4. ALREADY IN B CUP. BOTH TABS 5. END OF 3 RD CHECK.

40 PREPARING MEDS (CONTD) 40 - Do all 3 checks on each med before preparing another med. - Check meds with UDW to make sure equal meds are prepared.

41 J.A. MEDS 41 CHECK MEDS HAVE WITH UDW. NEED 3 MEDS. HAVE: CARAFATE, LANOXIN, AND LASIX 2 TABS. CORRECT? READY TO GIVE MEDS!!!!!

42 42 HOURS ROOMS A 400B J.A. ll l1l 401A 401B 403A 403B B.P. l lll 404A IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

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

44 ADMINISTERING MEDS 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

45 ADMINISTERING MEDS 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

46 ADMINISTERING MEDS TH 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

47 ADMINISTERING MEDS 47 C. NEED: CARAFATE 1 GM HAVE: CARAFATE 1 GM DUE: PO, 0730, TODAY, NOT GIVEN YET, NOT EXPIRED, NOT ALLERGIC END OF 4 TH CHECK OPEN PACKAGES AND GIVE MEDS

48 ADMINISTERING MEDS 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

49 DOCUMENTATION 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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51 51 HOURS ROOMS A 400B J.A. 1II AP84 BP142 /94 lll 401A 401B 403A 403B B.P. l lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

52 NEXT PATIENT 52 TO BRAD PITT’S MAR CAN GO SPEAK WITH BRAD PITT ABOUT MEDS ASK HOW TAKES MEDS ASK ABOUT ALLERGIES:NONE INQUIRE ABOUT PAIN. STATES HAVING PAIN IN LLE. 6/10. FOR LAST ½ HOUR. NOTHING HELPING INFORM WILL PREP MEDS AND BE BACK

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54 54 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 lll 401A 401B 403A 403B B.P. l lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

55 BRAD PITT MEDS 55 1 ST CHECK 1. NEED BRAD PITT’S DRAWER 2. HAVE BRAD PITT’S DRAWER, FOR (READ OFF MAR) BRAD PITT, MR #002, ALLERGY NONE, FOR NOVEMBER 28 TH. 3. NEED TO LOOK AT MAR WHILE READING INFORMATION. 4. ONLY HAVE TO ADDRESS NAME AND MEDICAL RECORD NUMBER WHEN OBTAIN MED DRAWER FOR FIRST TIME.

56 BRAD PITT MEDS 56 1 ST CHECK 1. NEED: CARDIZEM 60 MG( READ FROM MAR) 2. HAVE: CARDIZEM 60 MG (FROM DRAWER) 3. DUE: P.O., 0800, DUE THIS AM ON NOV. 28 TH AND HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO. 4. IF CAN NOT FIND CARDIZEM IN DRAWER, LOOK UP OTHER NAME. 5. END OF 1 ST CHECK.

57 BRAD PITT MEDS 57 2 ND CHECK:SET UP A B C CUPS 1. NEED: CARDIZEM 60 MG (READ FROM MAR) 2. HAVE: CARDIZEM 60 MG (READ FROM PACKAGE) 3. DUE: PO, 0800, THIS AM FOR NOV 28 TH, HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO (READ FROM MAR). NOT EXPIRED 4. WHAT IS CARDIZEM? ANTIANGINAL, ANTIARRYTHMIC, ANTIHYPERTENSIVE. APPROPRIATE DOSE? YES 5. WHAT CUP TO GO IN? AB 6. ANY CALCULATION, CUT, CRUSH? NO 7. ANY ASSESSMENT? YES: AP & BP 8. SIGN TIME TO MAR 9. END OF 2 ND CHECK.

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59 BRAD PITT MEDS 59 3 RD CHECK 1. NEED CARDIZEM 60 MG (FROM MAR) 2. HAVE CARDIZEM 60 MG (FROM PACKAGE) 3. DUE PO, 0800, TODAY ON NOV 29 TH, NOT BEEN GIVEN YET, NOT ALLERGIC TO. NOT EXPIRED 4. IN AB CUP 5. END OF 3 RD CHECK

60 B.PITT MEDS 60 NEXT MED DUE: 1 ST CHECK 1. NEED: ZOCOR 10 MG (READ FROM MAR) 2. HAVE: ZOCOR 10 MG TAB ( READ FROM MED PACKAGE) 3. DUE: PO, 0800, NOT BEEN GIVEN YET TODAY OR YESTERDAY, ON NOV 28 TH, NOT ALLERGIC TO. NOT EXPIRED 4. END OF 1 ST CHECK

61 B. PITT MEDS 61 2 ND CHECK 1. NEED: ZOCOR 10 MG 2. HAVE: ZOCOR 10 MG TAB 3. DUE: PO, 0800, NOT BEEN GIVEN YET TODAY OR YESTERDAY,ON NOV 28 TH, NOT ALLERGIC TO. NOT EXPIRED 4. WHAT IS ZOCOR? LIPID LOWERING AGENT 5. ANY ASSESSMENT? NO 6. ANY CALCULATION? NO 7. APPROPRIATE DOSE? YES 8. WHAT CUP? C CUP 9. TIME MAR FOR 0800 ON 29 TH. 10. END OF 2 ND CHECK

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63 B. PITT MEDS 63 3 RD CHECK 1. NEED: ZOCOR 10 MG 2. HAVE: ZOCOR 10 MG 3. DUE: PO, 0800, NOV 28 TH, NOT BEEN GIVEN TODAY OR YESTERDAY, NOT ALLERGIC TO. NOT EXPIRED 4. IN C CUP 5. END OF 3 RD CHECK

64 B. PITT MEDS 64 NEEDED SOMETHING FOR PAIN: PRN MED LOOK AT PRN MAR WHAT ORDERED FOR PAIN? IF UNSURE OF WHAT MEDS ARE ON MAR, LOOK UP. IF NOT ORDERED ANYTHING, CALL DR IF ORDER FOR PAIN MED, PREPARE MED

65 B. PITT PRN MED 65 ORDERED VICODIN ES 1 TAB Q 4 HRS AS NEEDED FOR PAIN. VERY IMPORTANT THAT HAS NOT BEEN MEDICATED IN LAST 4 HOURS. VICODIN ES IS A NARCOTIC. WILL NOT BE IN PT DRAWER. WILL HAVE TO GET FROM SEPARATE LOCKED DRAWER. NARCS ARE COUNTED AT END OF EACH SHIFT. EACH FACILITY IS DIFFERENT WHERE ARE KEPT. MUST STILL DO 3 CHECKS ON MEDS

66 B. PITT PRN MED 66 1 ST CHECK NEED: VICODIN ES 1 TAB HAVE: VICODIN ES 1 TAB DUE: PO, EVERY 4 HOURS PRN, HAS NOT HAD IN LAST 4 HOURS, NOT ALLERGIC, NOT EXPIRED END OF 1 ST CHECK

67 B. PITT PRN MED 67 2 ND CHECK NEED: VICODIN ES 1 TAB HAVE: VICODIN ES 1 TAB DUE: PO, EVERY 4 HOURS PRN PAIN, HAS NOT HAD IN LAST 4 HOURS, NOT ALLERGIC, NOT EXPIRED WHAT IS VICODIN? NARCOTIC PAIN MED ANY CALCULATION? NO, ORDER FOR 1 TAB, HAVE 1 TAB APPROPRIATE DOSE? YES ANY ASSESSMENT? RESPIRATORY RATE WHAT CUP? C TIME MAR FOR 0830 END OF 2 ND CHECK

68 68

69 B. PITT PRN MED 69 3 RD CHECK NEED: VICODIN EX 1 TAB HAVE: VICODIN ES 1 TABS DUE: PO, EVERY 4 HRS PRN, HAS NOT HAD IN LAST 4 HRS, NOT ALLERGIC, NOT EXPIRED IN C CUP END OF 3 RD CHECK

70 B. PITT MEDS 70 CHECK MEDS HAVE WITH UDW. NEED 2 MEDS. HAVE: CARDIZEM AND ZOCOR CORRECT? ALSO HAVE PRN MED- VICODIN 1 TAB. READY TO GIVE MEDS!!!!!

71 71 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 lll 401A 401B 403A 403B B.P. l lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDSMEDS HELD

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

73 ADMINISTERING MEDS ID PATIENT A. USE 2 MEANS TO IDENTIFY CLIENT B. PLACE MAR NEXT TO ID BRACELET AND MATCH. C. ASK PT ALLERGIES AND REACTION D. ASK PT HOW FEELING

74 ADMINISTERING MEDS DO ASSESSMENT AS NEEDED A. RESP RATE: 24 B. APICAL: 68 C. BLOOD PRESSURE: 90/60 5. IS IT OK TO GIVE MEDS? A. MAY GIVE VICODIN ES AND ZOCOR MEDS B. MUST HOLD CARDIZEM

75 ADMINISTERING MEDS TH CHECK A. NEED: CARDIZEM 60 MG HAVE: CARDIZEM 60 MG DUE: PO, 0800, TODAY, NOT GIVEN YET, APICAL 68, BLOOD PRESSURE 90/60, NOT EXPIRED, NOT ALLERGIC MUST HOLD DUE TO BP. MED IN AB CUP HELD B. NEED: ZOCOR 10 MG HAVE: ZOCOR 10 MG DUE: PO, 0800, TODAY, NOT GIVEN YET, NOT EXPIRED, NOT ALLERGIC

76 ADMINISTERING MEDS 76 C. NEED: VICODIN ES 1 TAB HAVE: VICODIN ES 1 TAB DUE: PO, EVERY 4 HRS PRN PAIN, NOT GIVEN IN LAST 4 HOURS, NOT EXPIRED, NOT ALLERGIC TO END OF 4 TH CHECK OPEN MEDS AND GIVE

77 ADMINISTERING MEDS 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

78 DOCUMENTATION SIGN OFF MEDS GIVEN WITH INITIALS ON MAR 2. CIRCLE TIME ON MAR OF MED NOT GIVEN 3. USE 2 OR 3 INITIALS 4. SIGN BOTTOM OF MAR. (OK IF DONE EARLIER) 5. CROSS OFF MEDS GIVEN ON UDW. 6. CIRCLE TALLY MARK ON UDW OF MED NOT GIVEN 7. WRITE AP AND BP ON MAR AND UDW NEXT TO TIME GIVEN. 8. FILL OUT PRN EFFECTIVENESS SHEET 9. WRITE PRN MED GIVEN ON UDW 10. WRITE MED HELD ON UDW

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81 DOCUMENTATION 81 PRN EFFECTIVENESS SHEET 1. DATE 2. TIME 3. PRE-MED CODE: 6 4. INITIALS 5. LOCATION OF DISCOMFORT: LLE 6. MED: Vicodin ES 1 tab 7. TIME REASSESSED: MUST REASSESS IN MIN. 8. POST MED CODE: WHATEVER PAIN LEVEL IS 9. INITIALS

82 82 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 lll 401A 401B 403A 403B B.P. ll AP 68BP9 0 /68 lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 ViicodinPainMEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68

83 WHERE TO NEXT? 83 LOOK AT UDW. WHO TO PASS MEDS ON NOW? - NO MEDS DUE AT 0900 DO REASSESSMENT OF PAIN ON B.PITT BY 0930 AND DOCUMENT 1 MED DUE AT 1000 FOR JEN ANISTON. PREP 1000 JEN ANISTON MED -3 CHECKS OF MED -TO ROOM -4 TH CHECK -DOCUMENTATION

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85 85 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 l BP 130/84 ll 401A 401B 403A 403B B.P. ll AP 68BP9 0 /68 lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 Vicodin PainMEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68

86 WHAT ABOUT BRAD PITT? IVPB MED DUE. REMIND RN TO DO. REASSESS BP AND APICAL. IF ABOVE PARAMETER, GIVE MED. IF STILL BELOW PARAMETER, HOLD. REASSESS BP: 110/74 AP:70 -OK TO GIVE MED.

87 PREP HELD MED 87 BRAD PITT-CARDIZEM DO 1 ST CHECK DO 2 ND CHECK. WHAT CUP? AB AT END OF SECOND CHECK, WRITE NEW TIME ADMINISTERING MED: 1000 DO 3 RD CHECK. TO BEDSIDE. ID PT DO 4 TH CHECK GIVE MED DOCUMENTATION: MAR AND UDW

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89 89 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 l bp 130/84 ll 401A 401B 403A 403B B.P. l l AP 68BP9 0 /68 AP 70 BP 110/74 lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 Vicodin PainMEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68

90 WHAT NOW? : FOR BRAD PITT? CAN GIVE AT 1100 OR WAIT TIL 1130 AND GIVE 1100 AND 1200 MEDS TOGETHER. WILL GIVE TOGETHER AT 1130

91 FOR JEN ANISTON MEDS: -NEED CARAFATE -DO 1 ST CHECK -DO 2 ND CHECK: IN C CUP. TIME 1130 ON MAR. -DO 3 RD CHECK -TO BEDSIDE -ID PT 4 TH CHECK. OPEN MEDS -GIVE PO. -DOCUMENTATION

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93 93 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 l bp 130/84 ll 401A 401B 403A 403B B.P. l l AP 68BP9 0 /68 AP 70 BP 110/74 lll IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 VicodinPainMEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68

94 NOW TO BRAD PITT NOW -HAS FLAGYL AND ALDOMET DUE -PREP EACH MED WITH 3 CHECKS -READY TO GIVE -TO BEDSIDE -ID PT -DO ASSESSMENT: BP 124/74 4 TH CHECK. OPEN MEDS -OK TO GIVE MEDS -DOCUMENTATION

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96 96 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 l bp 130/84 ll 401A 401B 403A 403B B.P. l l AP 68BP9 0 /68 AP 70 BP 110/74 ll bp 124/74 l IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 Vicodin PainMEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68

97 WHAT NOW? 97 WHO TO PASS ON NEXT? AT 1330 BRAD PITT HAS 1, DUE TID JEN ANISTON HAS 1, DUE QD WILL PASS TO BRAD PITT

98 LAST PASS FOR BRAD PITT 98 DUE IBUPROFEN 800 MG AT 1400 DO 1 ST CHECK DO 2 ND CHECK: C CUP, TIME MAR FOR 1400 DO 3 RD CHECK TO BEDSIDE ID PT ANY ASSESSMENT? 4 TH CHECK. OPEN MED GIVE MED. DOCUMENTATION

99 99 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 l bp 130/84 ll 401A 401B 403A 403B B.P. l l AP 68BP9 0 /68 AP 70 BP 110/74 ll bp 124/74 l IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 Vicodin PainMEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68

100 LAST PASS FOR JEN ANISTON 100 DOCTOR JUST ORDERED HER TO BE NPO FOR A CAT SCAN. UNABLE TO ADMINISTER ANY PO MEDS AT THIS TIME TIL FURTHER NOTICE. MUST NOTIFY PT. SINCE IS A BP MED, SHOULD DO BP WHILE IN PT ROOM. MUST DOCUMENT ON MAR AND UDW OF HELD MED MAKE STICKY NOTES AND PLACE ON UDW AND MAR

101 101 HOURS ROOMS A 400B J.A. lII AP84 BP142 /94 l bp 130/84 ll 401A 401B 403A 403B B.P. l l AP 68BP9 0 /68 AP 70 BP 110/74 ll bp 124/74 l IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 UNIT DOSE WORKSHEET FSBS PRN MEDS 403B BP 0830 Vicodin PainMEDS HELD 403B B.P-CARDIZEM 60 MG 0800 BP:90/68 400B JA- PRINIVIL NPO 1400

102 END OF SHIFT 102 RECHECK UDW- ALL MEDS GIVEN OR NOT RECHECK MAR- ALL MEDS GIVEN OR NOT AND SIGNED OFF RESTOCK CART REPORT ANY INFORMATION TO NEXT SHIFT. ESPECIALLY PRN’S, MEDS HELD, ANY VITAL SIGNS, FSBS

103 POURING LIQUID MEDS 103 DO PROPER CHECKS POUR DURING 2 ND CHECK PALM LABEL READ AT EYE LEVEL ON FLAT SURFACE. DO NOT POUR OVER MAR DO NOT POUR EXTRA BACK INTO BOTTLE IF PREPPING MEDS FROM A MED BOTTLE, DISPENSE MED INTO LID OF MED BOTTLE, THEN PUT INTO MEDICINE CUP. DO NOT DUMP INTO HAND OR REACH INTO BOTTLE TO GET OUT MED

104 NEW PATIENTS 104 CAN DO STEVEN TYLER AND ERIN SMITH MARS NOW MAKE UDW FROM THEIR MARS HAVE PAPER PILLS FOR THEM

105 END OF THE DAY 105 EACH INSTRUCTOR TAKE 8-10 STUDENTS AND DO MED PASS ON TYLER AND SMITH. HAVE SIT IN CIRCLE AND GO AROUND AND HAVE EACH STUDENT DO A PIECE OF THE PASS.


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