(Previous discussion continued) RE: Daily digest for tbnurses@ntca.simplelists.com - Keehr, Terri (05 Sep 2018 10:43 EDT) RE: Daily digest for tbnurses@ntca.simplelists.com - Belinda Davis (05 Sep 2018 11:57 EDT)
RE: Daily digest for tbnurses@ntca.simplelists.com by Keehr, Terri (05 Sep 2018 10:43 EDT)
Reply to list
Diana,
How do you manage weekends? Do you do Sat and Sun home visits for DOT, or leave the medication bottles with the client?
Terri Keehr, BSN, RN
TB Program Manager
Grand Forks Public Health
151 South 4th Street Suite N301
Grand Forks, ND 58201
701-787-8120
From: TB nurse communication [mailto:nobody@simplelists.com]
Sent: Tuesday, September 04, 2018 7:34 PM
To: tbnurses@ntca.simplelists.com
Subject: Daily digest for tbnurses@ntca.simplelists.com
(Previous discussion continued)
Re: Daily digest for tbnurses@ntca.simplelists.com - Fortune, Diana, DOH (03 Sep 2018 22:14 EDT)
Re: Daily digest for tbnurses@ntca.simplelists.com by Fortune, Diana, DOH (03 Sep 2018 22:14 EDT)
Reply to listHi all,
In New Mexico it is exactly as Ann described. We cannot per state pharmacy rules repackage medications into SAT packets for weekend dosing without a pharmacist or MD physically signing the packets/bottles. That becomes dispensing medications and is not allowed. For DOT workers or others who may be supervising DOT - the patient must open the bottle of medications and give themselves or (child) the medications while the DOT worker observes the dosage. Of course RNs can administer medications just as we would in a hospital environment.
Not being able to send SAT packages for weekend dosing is inconvenient and difficult to manage. Wish there was an easier way to do so!
Diana Fortune
From: TB nurse communication <nobody@simplelists.com>
Sent: Monday, September 3, 2018 6:22 PM
To: tbnurses@ntca.simplelists.com
Subject: Daily digest for tbnurses@ntca.simplelists.com
(Previous discussion continued) Re: Daily digest for tbnurses@ntca.simplelists.com - Scarpita - CDPHE, Ann (03 Sep 2018 11:15 EDT) Re: Daily digest for tbnurses@ntca.simplelists.com by Scarpita - CDPHE, Ann (03 Sep 2018 11:15 EDT)
Reply to listGood Morning, All and Happy Labor Day!
Your question is a good one. Something I believe we have all questioned ourselves at some point. I have looked into this in the two states I have worked and as I understand the laws and our limitations in scopes of practice surrounding dispensing of medications, RNs are not legally able to do legally do this. Only a pharmacist can dispense, including repackage and relabel medications. That said, you can immediately take from a bottle to a package if that is being given to the patient immediately by the RN who is doing the preparing (as you would in a SNF). You cannot put into smaller packages and give to the patient to take at a later date (weekend doses). You cannot prepare packages given by other nurses.
California may have a different law related to dispensing. I think Ann Raftery would know that answer (for California) but am not sure she is in the office this week. I am eager to hear if it does and any policies surrounding the application of RNs doing this in the field. It may be something we could propose expanding in other states.
So, I am sorry, I don't have what you are seeking and I commented but I believe you are bringing up a VERY good question and again, I am eager to hear more weigh in. For anyone sharing policies, procedures or protocols around this, I would like to ask that they touch on how they arrived at those and if their state has laws which allow nurses to dispense (i.e. different dispensing definition).
Hope you all have a superb Labor Day!
Respectfully,
~Ann
Ann Scarpita BSN, MPH
TB Nurse Consultant
Tuberculosis Program
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South, Denver, CO 80246
P 303.692.2656| F 303.759.5538
"Wisdom is knowing the right path. Integrity is taking it." ~M.H. McKee
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
On Fri, Aug 31, 2018 at 6:47 PM, TB nurse communication <nobody@simplelists.com> wrote:
Repacking Medications - Katie Kelsch (31 Aug 2018 11:16 EDT) Repacking Medications by Katie Kelsch (31 Aug 2018 11:16 EDT)
Reply to listHi all,
This is for small/medium size counties, without a chest clinic and without a pharmacy. We are looking for Policies and Procedures around RNs repacking medications in to the DOT Packets. We receive the medications from our patients (filled at commercial pharmacies like CVS or Walgreens). We then create individual DOT packets in small plastic envelopes. Some concerns/questions that have come up are focused around:
· Labeling
· Child Poisoning Prevention Act
· The actual physical repackaging of medication
Thank you all! Have a safe Labor Day weekend.
Katie
Katie Kelsch, BSN, RN, PHN
Senior Public Health Nurse
Yolo County Health and Human Services Agency
Fax: 530-669-1549 (confidential)
Please consider the environment before printing this email.
YOLO COUNTY EMAIL DISCLAIMER:
This email and any attachments thereto may contain private, confidential, and privileged material for the sole use of the intended recipient. Any review, copying, or distribution of this email (or any attachments thereto) by other than the County of Yolo or the intended recipient is strictly prohibited. if you are not the intended recipient, please contact the sender immediately and permanently delete the original and any copies of this email and any attachments.
To reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.orgTo reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.orgTo reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.org
RE: Daily digest for tbnurses@ntca.simplelists.com by Belinda Davis (05 Sep 2018 11:57 EDT)
Reply to list
Hello Everyone!
We had the same issue. We have the meds bubble packed and can request that the pharmacy do weekend packaging for the month. We keep the M-F packet at the clinic and the patient has the weekend packet at home. The pharmacy does all the packaging.
Belinda Davis, RN, BSN
TB Nurse Case Manager
Pima County Health Department
2980 E. Ajo Way
Tucson, AZ 85713
520-724-8461 office
520-981-0631 cell
520-294-1092 fax
From: TB nurse communication <nobody@simplelists.com>
Sent: Tuesday, September 4, 2018 5:34 PM
To: tbnurses@ntca.simplelists.com
Subject: Daily digest for tbnurses@ntca.simplelists.com******* This message and sender come from outside Pima County. If you did not expect this message, proceed with caution. Verify the sender's identity before performing any action, such as clicking on a link or opening an attachment. *******
(Previous discussion continued)
Re: Daily digest for tbnurses@ntca.simplelists.com - Fortune, Diana, DOH (03 Sep 2018 22:14 EDT)
Re: Daily digest for tbnurses@ntca.simplelists.com by Fortune, Diana, DOH (03 Sep 2018 22:14 EDT)
Reply to listHi all,
In New Mexico it is exactly as Ann described. We cannot per state pharmacy rules repackage medications into SAT packets for weekend dosing without a pharmacist or MD physically signing the packets/bottles. That becomes dispensing medications and is not allowed. For DOT workers or others who may be supervising DOT - the patient must open the bottle of medications and give themselves or (child) the medications while the DOT worker observes the dosage. Of course RNs can administer medications just as we would in a hospital environment.
Not being able to send SAT packages for weekend dosing is inconvenient and difficult to manage. Wish there was an easier way to do so!
Diana Fortune
From: TB nurse communication <nobody@simplelists.com>
Sent: Monday, September 3, 2018 6:22 PM
To: tbnurses@ntca.simplelists.com
Subject: Daily digest for tbnurses@ntca.simplelists.com
(Previous discussion continued) Re: Daily digest for tbnurses@ntca.simplelists.com - Scarpita - CDPHE, Ann (03 Sep 2018 11:15 EDT) Re: Daily digest for tbnurses@ntca.simplelists.com by Scarpita - CDPHE, Ann (03 Sep 2018 11:15 EDT)
Reply to listGood Morning, All and Happy Labor Day!
Your question is a good one. Something I believe we have all questioned ourselves at some point. I have looked into this in the two states I have worked and as I understand the laws and our limitations in scopes of practice surrounding dispensing of medications, RNs are not legally able to do legally do this. Only a pharmacist can dispense, including repackage and relabel medications. That said, you can immediately take from a bottle to a package if that is being given to the patient immediately by the RN who is doing the preparing (as you would in a SNF). You cannot put into smaller packages and give to the patient to take at a later date (weekend doses). You cannot prepare packages given by other nurses.
California may have a different law related to dispensing. I think Ann Raftery would know that answer (for California) but am not sure she is in the office this week. I am eager to hear if it does and any policies surrounding the application of RNs doing this in the field. It may be something we could propose expanding in other states.
So, I am sorry, I don't have what you are seeking and I commented but I believe you are bringing up a VERY good question and again, I am eager to hear more weigh in. For anyone sharing policies, procedures or protocols around this, I would like to ask that they touch on how they arrived at those and if their state has laws which allow nurses to dispense (i.e. different dispensing definition).
Hope you all have a superb Labor Day!
Respectfully,
~Ann
Ann Scarpita BSN, MPH
TB Nurse Consultant
Tuberculosis Program
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South, Denver, CO 80246
P 303.692.2656| F 303.759.5538
"Wisdom is knowing the right path. Integrity is taking it." ~M.H. McKee
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
On Fri, Aug 31, 2018 at 6:47 PM, TB nurse communication <nobody@simplelists.com> wrote:
Repacking Medications - Katie Kelsch (31 Aug 2018 11:16 EDT) Repacking Medications by Katie Kelsch (31 Aug 2018 11:16 EDT)
Reply to listHi all,
This is for small/medium size counties, without a chest clinic and without a pharmacy. We are looking for Policies and Procedures around RNs repacking medications in to the DOT Packets. We receive the medications from our patients (filled at commercial pharmacies like CVS or Walgreens). We then create individual DOT packets in small plastic envelopes. Some concerns/questions that have come up are focused around:
· Labeling
· Child Poisoning Prevention Act
· The actual physical repackaging of medication
Thank you all! Have a safe Labor Day weekend.
Katie
Katie Kelsch, BSN, RN, PHN
Senior Public Health Nurse
Yolo County Health and Human Services Agency
Fax: 530-669-1549 (confidential)
Please consider the environment before printing this email.
YOLO COUNTY EMAIL DISCLAIMER:
This email and any attachments thereto may contain private, confidential, and privileged material for the sole use of the intended recipient. Any review, copying, or distribution of this email (or any attachments thereto) by other than the County of Yolo or the intended recipient is strictly prohibited. if you are not the intended recipient, please contact the sender immediately and permanently delete the original and any copies of this email and any attachments.
To reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.orgTo reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.orgTo reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.org
To reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna
Will at lwill@tbcontrollers.org