The "Pouch-Pack" System Flashcards
What does each indivdual pouch-pack have in common to each other
- Administration TIme
- Drug Name
- Residents Name
- Room Number
- Administration Date
- Drug Quantity
- Drug Strength
- Drug Manufacturer
Where are all of the regularly scheduled medications dispensed?
All medications (solid, oral) are dispensedin the Multidose Drug Distribution System
How are the medications sealed? What makes them identitifiable?
What idetifiers do they have that shows you who its for?
The medications are in individually sealed packages that are resident, date, pass-time and medication specific.
How are the packages connected?
The packages are connected together chronologically with a one week supply.
Where is the medication stored?
Each resident’s strip will be stored in a resident-specfic bin in the medication cart.
When is the reordering done?
monthly? everyday? weekly?
The reording is done automatically on a weekly basis for packaged medications.
What medications need to be ordered as needed by the nurse?
Other medications, such as creams, inhalers and PRN mdications must be reordered as needed by the nurse.
Are the pouches resident specific? Are the drugs listed in specfic order?
The pouches ARE resident specific.
Drugs are listed on each pouch in NO particular order.
How many drugs are allowed in the pouch at once?
5 different drugs at one time is allowed in the pouch.
if a resident is
prescribed Acetaminophen (1), Levocarb (2), Risperdal (3) and Altace (4) Pantoprazole,
(5) all 5 drugs will be found in a single pouch. Even if a resident gets 2 pills of Acetaminophen, 2 pills of Levocarb, 2 pills of Risperdal, 2 pills of Altace, and 2 pills of Pantoprazole, all 10 pills will be packaged together
What must you look for on the pacmed before adminsitering medication?
When adminstering medication, always look at the top and bottom pacmed as well as the next pouch.
Just in case the resident is receiving more than 5 different medications at this medication pass.
Contents of the Multi-Dose Pouches
What will you find in the pouches?
- Most solid oral medications
- Non-Cytotoxic, and cytotoxic, hazardous medications (labeled with yellow ‘Cytotoxic Handle Properly’ Label)
- Warfarin (Coumadin) - in strip but in a seperate pouch for easy identification
Contents of the Multi-Dose Pouches
What wont you find in the pouches?
-Drugs that are heat sensitive and cannot be packaged in a multi-dose (strip).
- Drugs that are air sensitive and should not be removed from their original packaging before adminstration.
- Patches (i.e. Nitro-Dur®)
- External products (creams, ointments)
- Eye drops and eye ointments
- PRN or as needed medication
- narcotics
Dropped or Contaminated Pills
What is the process if you drop or contiminated pill?
If a pill is dropped or contaminated, go to the plastic pack at the end of the strip with the same medication and time. Notify the nurse that a pack was used at the end of the strip so that a replacement pack can be ordered.
Dropped or Contaminated Pill
Whats the process if a narcotic pill is dropped or contaminated?
If the pill is a narcotic you will require a nurse/UCP to witness the disposing of the pill. On the narcotic sheet indicate that the drug was “wasted” and both parties are to sign the sheet. Take the next pill from the package and give to the resident.
Medication Errors and Incidents
What are the 5 types of Medication Errors?
- Wrong Drug: Giving wrong medication
- Wrong Dose: Giving wrong amount of medication
- Wrong Route: Giving medication through a different route than whats ordered.
- Omission: Not giving medication thats ordered.
- Unauthorized Drug: Administration of a drug that wasnt ordered to that resident at the time.
What are the 4 Medication incidents?
- Medication given, but not signed for
- Replaceable dropped medication
- Not documenting administeration of medication on eMAR
- Medication spat out by patient, which is replaceable
What are some (9) of the causes of Medication Errors and Incidents?
- A lack of verification of one of the “8 rights”
- Miscommunication among professionals
- A lack of knowledge of information about the drug
- Similar or confusing product names or appearance
- Confusing direction for use
- Poor techniques
- Illegible orders
- Interruptions during adminsitration
- Workload and staffing issues
What do you do when a Medication Error has occurred?
Under NO circumstances should you try to cover up a medication error or incident. The first thing to do is remain calm. Report the error or incident to the nurse at once and he or she will decide on the next steps. The resident may have to be sent to see a physician or hospital.
It is also essential to assess how this error incident could be prevented in the future. If it happens once, it could happen again.
What do you do if you mess up with the medications?
It is important to complete a “medication incident form” outlining all the circumstances so that there can be follow-up and ensure that the health and wellness manager/director of care is informed. If the incident is a pharmacy incident, the form should be forwarded to pharmacy asap.
