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 JENNIFER ANISTON BRAD PITT 7. HAVE READY: RED AND BLACK PEN, HIGHLIGHTER, SCISSORS, PAPER, IPOD, PREP PAPERS, SHARPIE

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 WILL GO OVER UDW IN DETAIL 2. A MUST 3. 6 RITES OF ADMINISTRATION 4. 2 IDENTIFIERS 5. DOCUMENT ACCORDING TO FACILITY POLICY

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

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 If no wrist band on, ask staff to identify. May use picture if no wristband on. Must ask them to state name and bd. As inpatient, use name and medical record #. As outpatient, name and birth date. Must also ask allergies. If leave room, must re-id client. must id each time giving a medication.

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 Must look at packages. Do not get complacent with colors/ package looks like. Read labels all 3-4 times. BE sure.

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 If pt npo, can not give po meds. If have suction on, no po meds. Make sure can mix if have to crush. Make sure can crush. Look up. IF unable to swallow pills, can crush or get another form.

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

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 If unsure, call pharmacy Calculations must be 100% accurate Put on back of udw

6 RIGHTS OF MED ADMINISTRATION 6. RIGHT DOCUMENTATION a. Correct MAR b. Correct signature c. Correct space on MAR d. Correct date and time Make sure correct mar. Usually use 2 or 3 initials. Legible

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

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: BE READY TO PASS BY 0700. 2. BRING OWN UDW 3. WILL BE ASSIGNED CLIENTS TO PASS MEDS ON. WHEN A NURSE, WILL HAVE AN ENTIRE MOD/WING YOU ARE RESPONSIBLE FOR 4. WILL USE AS STUDENTS. MOST LONG TERM CARE FACILITIES DO NOT USE- GIVING MEDS TO SAME CLIENTS EVERY DAY. VERY USEFUL IN ACUTE CARE SETTINGS 5. USE STICKY NOTES ON UDW AND MARS TO ALERT FOR NPO. 6. MED CUPS, WATER CUPS, WATER, SPOONS, MEDS, FOOD, GLOVES, HAND SANITIZER, ALCOHOL, CRUSHER, cutter

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

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

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 FILL OUT TIME ACROSS TOP. ROOM NUMBERS DOWN SIDE. PUT NAME ON TOP SO IF LOSE, CAN BE GIVEN BACK TO OWNER

07 08 09 10 11 12 13 14 UNIT DOSE WORKSHEET 400A 400B JA 401A 401B HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B JA 401A 401B 403A 403B BP 404A IV’S/NURSE NOTES PRN MEDS MEDS HELD FSBS

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.

07 08 09 10 11 12 13 14 l l l UNIT DOSE WORKSHEET 400A 400B J.A. 401A HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l l l 401A 401B 403A 403B B.P. 404A IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS MEDS HELD FSBS

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.

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

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

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

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

PREPARING MEDICATIONS DECIDE WHICH PT. TO PREP MEDS FOR FIRST PRIORITIZE THINK WHO SHOULD MEDS BE PASSED FIRST ON? DO JEN ANISTON FIRST DUE TO 0730 FS AND INSULIN

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.

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.

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.

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.

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

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

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

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

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

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

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.

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.

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

07 08 09 10 11 12 13 14 l l l 1 UNIT DOSE WORKSHEET 400A 400B J.A. HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l l l 1 401A 401B 403A 403B B.P. 404A IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS MEDS HELD FSBS

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

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

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

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) BP 142/92, NOT EXPIRED, NOT ALLERGIC

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

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

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.

07 08 09 10 11 12 13 14 1 II AP84 BP142/94 l l l UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. 1 II AP84 BP142/94 l 401A 401B 403A 403B B.P. l l IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS MEDS HELD FSBS

NEXT PATIENT 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

07 08 09 10 11 12 13 14 l II AP84 BP142/94 l l UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 401A 401B 403A 403B B.P. l l IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS MEDS HELD FSBS

BRAD PITT MEDS 1ST 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 28TH. 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.

BRAD PITT MEDS 1ST 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. 28TH AND HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO. 4. IF CAN NOT FIND CARDIZEM IN DRAWER, LOOK UP OTHER NAME. 5. END OF 1ST CHECK.

BRAD PITT MEDS 2ND 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 28TH, 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 2ND CHECK.

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

B.PITT MEDS NEXT MED DUE: 1ST 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 28TH, NOT ALLERGIC TO. NOT EXPIRED 4. END OF 1ST CHECK

B. PITT MEDS 2ND 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 28TH, 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 29TH. 10. END OF 2ND CHECK

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

B. PITT MEDS 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

B. PITT PRN MED 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

B. PITT PRN MED 1ST 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 1ST CHECK

B. PITT PRN MED 2ND 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 2ND CHECK

B. PITT PRN MED 3RD 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 3RD CHECK

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

07 08 09 10 11 12 13 14 l II AP84 BP142/94 l l UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 401A 401B 403A 403B B.P. l l IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS MEDS HELD FSBS

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

ADMINISTERING MEDS 3. 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

ADMINISTERING MEDS 4. 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

ADMINISTERING MEDS 6. 4TH 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

ADMINISTERING MEDS 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 4TH CHECK OPEN MEDS AND GIVE

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

DOCUMENTATION 1. 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

DOCUMENTATION 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 45-60 MIN. 8. POST MED CODE: WHATEVER PAIN LEVEL IS 9. INITIALS

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 401A 401B 403A 403B B.P. ll AP 68BP90/68 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 ViicodinPain MEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68 FSBS

WHERE TO NEXT? 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 -4TH CHECK -DOCUMENTATION

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 l BP 130/84 401A 401B 403A 403B B.P. ll AP 68BP90/68 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68 FSBS 85 85

WHAT ABOUT BRAD PITT? 1000 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.

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

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 l bp 130/84 401A 401B 403A 403B B.P. l l AP 68BP90/68 AP 70 BP 110/74 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68 FSBS

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

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

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 l bp 130/84 401A 401B 403A 403B B.P. l l AP 68BP90/68 AP 70 BP 110/74 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 VicodinPain MEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68 FSBS

NOW TO BRAD PITT 1130 NOW -HAS FLAGYL AND ALDOMET DUE -PREP EACH MED WITH 3 CHECKS -READY TO GIVE -TO BEDSIDE -ID PT -DO ASSESSMENT: BP 124/74 4TH CHECK. OPEN MEDS -OK TO GIVE MEDS -DOCUMENTATION

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 l bp 130/84 401A 401B 403A 403B B.P. l l AP 68BP90/68 AP 70 BP 110/74 l bp 124/74 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68 FSBS

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

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

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 l bp 130/84 401A 401B 403A 403B B.P. l l AP 68BP90/68 AP 70 BP 110/74 l bp 124/74 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD 403 B B.P-CARDIZEM 60 MG 0800 BP:90/68 FSBS

LAST PASS FOR JEN ANISTON 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

UNIT DOSE WORKSHEET HOURS ROOMS 07 08 09 10 11 12 13 14 400A 400B J.A. l II AP84 BP142/94 l bp 130/84 401A 401B 403A 403B B.P. l l AP 68BP90/68 AP 70 BP 110/74 l bp 124/74 IV’S/NURSE NOTES Ancef 1 gm ivpb 1000 USE JEN AND BRAD MARS TO FILL OUT UDW PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD 403B B.P-CARDIZEM 60 MG 0800 BP:90/68 400B JA- PRINIVIL NPO 1400 FSBS

END OF SHIFT 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

POURING LIQUID MEDS DO PROPER CHECKS POUR DURING 2ND 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

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

END OF THE DAY 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.