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JCAHO REQ: Locked meds in ED

Gillian McNaughton thrums at btinternet.com
Wed Apr 19 20:24:39 BST 2006

I assume you had a stand by call but no matter all resus rooms in our A/E
departments have their own drug cupboards which are opened on 'use' of the
room and locked again when patient is transferred out the drug packing is
kept for log at the end in sequence on a table or tray  

-----Original Message-----
From: statman2500 at aol.com [mailto:statman2500 at aol.com] 
Sent: 19 April 2006 03:09
To: trauma-list at trauma.org
Subject: Re: JCAHO REQ: Locked meds in ED

May I suggest that a $80.00 small fridge from Walmart be placed in your
shock room for your paralytics (if you get a seperate container for the
paralytics, you will be able to keep cardizem, life saving tetanus.  Your
engineering dept can equip it with a lock in 10 minutes.  For non- fridge
items, an airway med box (small plastic tool box) with a break-a-way lock
can be kept on a shelf in the room.   
-----Original Message-----
From: paul.middleton <paul.middleton at usa.net>
To: 'Trauma &amp; Critical Care mailing list' <trauma-list at trauma.org>
Sent: Wed, 19 Apr 2006 07:56:04 +1000
Subject: RE: JCAHO REQ: Locked meds in ED

What's an Omnicell?

Dr Paul M Middleton
Emergency Medicine
-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Howard, Dot
Sent: Wednesday, 19 April 2006 3:20 AM
To: trauma-list at trauma.org
Subject: JCAHO REQ: Locked meds in ED

Need help with this one. Having been cited by JCAHO for not having
either all meds locked up in Omnicell or having a pharmacist review each
med before it is given, we are now faced with dilemma trying to meet
JCAHO rules. As we just had a trauma patient who needed a rapid
intubation, we had a delay due to the nurse having to go out of the room
to the Omnicell and pull meds, this also complicated by the fact that
the patient arriving by ambulance is "not in the computer" so a trauma
patient number has to be generated ( taking more time) before the order
can even be entered. Result : delays in care to a patient due to lack of
ready access to Rapid Sequence Meds.

Options that have been considered... 1) small Omnicell in each room but
cost prohibited ( $20,000 per room)or 2) having a fanny pack for nurse
with drugs- pharmacy says that is prohibited by JCAHO, 3) have
pharmacist stationed 24/7 in ED ( cost prohibited) .

Surely others are having this issue as well, where JCAHO 's desire for
safety may be in conflict with an emergency patient's needs.

Your recommendations would be appreciated. Than ks


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