[nursinghumor]

Oh Geez, don't get me started on inspections. I've worked agency through dozens of them in facilities I go to.

Floor conditions at that time have no connection or resemblance to reality. They might as well be back in nursing school where "anything is possible" and you "have everything you need."

Andrew Lopez, RN
http://www.4nursing.com

[cassioo]

I don't know if I posted here or where but we did pass that Joint inspection. The did have a few "recommendations" Get privacy curtains with bigger mesh on top for better air circulation.....guess the screens in my windows at home have too small mesh and air can't come in little holes. Lock the anestheia cart that is kept in the sub-sterile area behind the L&D nurses station to the wall...that way nobody can go in there and steal the anestheia cart...I probably wouldn't notice a strange person going into the OR, getting that big craftsman toolbox and pushing it down the L&D hall, down postpartum hall then out the front lobby. Same with the crash cart chain it to the wall...that way when you have a code find the key or remember the combination, unlock it, then unplug it the go to the code...I wouldn't be able to remember the combination or the keys would be with another nurse in another room or locked in the pyxis. You think a "smart" crook that wanted anestheia or crash cart stuff would open it and take out drugs needed....don't know what they'd want with a spinal kit. In all of the records they reviewed they did find 1 trailing zero (on an anesthesia record). They also didn't like the concious sedation policy for some reason. Just basically nit picky stuff

[lam]

I had just started working in in this LTC facility and this pt was there that had been given an antibiotic that he was allergic to and it sent him off to the hospital. when he came back he was there for a couple of weeks and I get a call from his daughter who has him at home with her for a visit and she is giving me all these symptoms so I pulled his chart to see what new meds he was on and sure enough he was given the same antibiotic at the same nursing home I just told her to get him to the hospital fast. Scary isn't it.

[Night Angel]

People need to be more careful with meds. The buck certainly got passed on this one!!

[Shelly Levitt]

HI. There is a Forum for LTC nurses. Might want to post these horror stories there. Good thing the pt. didnt have anaphylactic shock. If I ever had to go to a nursing home just to be on the safe side I wouldnt take any medication.

[lam]

Post is " Med Errors and Reality" and the patient did go into anaphalactic shock the first time. I am a Nurse, I have worked LTC, Acute care, agency (per diem and travel), LTAC. I know some view LTC as a lesser position when in reality it is a more rounded position. Not a lot of technical skills required but, over all nursing assessment and people skills are utilized more.

[kimmiejs]

The system has its pros and cons. The system works well preventing medication errors especially preventing patients from receiving medications they are allergic to. I know at our hospital before you give certain medications it will display critical information (PT/INR, K+, Platelet Count, etc...). I will be one of the first to admit that I from time-to-time have problem scanning the bar code on some medications. One of the biggest drawbacks with the system is the cart used by my hospital. It is big, heavy, difficult to maneuver. The laptop provides no wrist support so carpal tunnel can be a big problem. If they could find a better way to deliver the medications this would be a step in the right direction.

[faviola]

I think those electtronic MARS are great..but dont forget they can make mistakes too..Always keep the 5 rights in mind!

[tazzy_joanne]

Just the other day I had a pharmacist come up to me to point out that another pharmacist had entered the IVPB antibiotic wrong. The nurse doing the 24 hour check did not notice either and unless I was going back a couple of days of orders I would not notice it either...not that I had time to sit and review two days of orders. Our system is using an electronic MAR which can be updated by the pharmacy and the nurses may not see the order because the pharmacist has talked to the doctor it just appears on the computerized MAR (of which most of the RN's print out in the morning) very bad communication and lots of room for error. So nurses are not the only ones to blame.

[kimmiejs]

Originally Posted by lam

I had just started working in in this LTC facility and this pt was there that had been given an antibiotic that he was allergic to and it sent him off to the hospital. when he came back he was there for a couple of weeks and I get a call from his daughter who has him at home with her for a visit and she is giving me all these symptoms so I pulled his chart to see what new meds he was on and sure enough he was given the same antibiotic at the same nursing home I just told her to get him to the hospital fast. Scary isn't it.

One of the good things about electronic EMARS is once the allergy is listed into the hospital computer system it will be there for all hospital admissions. This really is a plus since unconscious patients can not tell you if the medication that you are about to give them will cause an anaphylactic reaction or not.