Medication Errors

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I am interested to know if any other nurses out there are experiencing the same problems that I do in my facility.

I am a charge nurse a County Detention Center. I have experienced a wide range of dynamic and challenging nursing related problems while in this facility. But one of the worst is the medication error. When an inmate is arrested he/she MUST be screen by a registered nurse in booking. In about 10 minutes a complete health and physical must be obtained, as well as a mental health screen. When there are hundreds of arrests made in one shift, mistakes are made. First of all getting accurate information from an inmate that is under the influence of controlled substances, they are either not competent enough to discuss their medical history or their memory is impaired. Also, even if an inmate reveals a chronic medical condition they are usually ignorant to the names and uses of any medications they have recently been taking.

With such a rough start to providing someone medical care; often inmates are not started on the correct medications if they are started on them at all. This is a major problem with inmates diagnosed with physical AND mental disorders.

I also believe some of the medication errors that are made are so because all the medications in our facility are labeled by generic name. But, all the medications are ordered by BRAND name. This causes quite a bit of confusion with the med pass nurses. Sometimes they have as many as 200-400 inmates to pass meds to at one time. They are rushed, have little time to cross reference names of the medications, and don’t realize they are making errors.

I have suggested to our corporate office to send medications labeled as they are ordered by their brand name. Also I have stated my belief that using a paper based system to manage the healthcare of approximately 4,000 inmates (that may be housed in jail for a couple of days to a year) is not appropriate. A computer system of ordering medications and using MAR’s that are printed instead of hand written should dramatically reduce the amount of medication errors made.

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