I have been an LPN for 12 years. Most of my experience has been in a hospital setting and a few years in long-term care. I took a position in the local county jail in my town. At the long-term care facility, we used to write on the drug package label “discontinued” or “refuses” if that was the situation with the medication.
The medication packages are similar to the ones at the jail: a package with a label at the top with the drug information and patient/inmate information on it. Its the same info that is on a label on a prescription you would get from a pharmacy. I was told it was illegal to write anything on the label and that it was a felony. I had never heard this before and I have tried to find out the answer and am having no luck finding out anything.
Dear Nancy replies:
It is probably safe to say that anytime medications are administered, regardless of the setting, basic and universal standards of medication administration should be followed. Blister packs have been around for some time, so their acceptance in administering medications is not at issue. What is at issue is the documentation of the medication in the packs when the medication is discontinued, refused and the like.
A Medication Administration Record and/or the Controlled Substance Administration Record is the proper place to document any conditions concerning the administration of medications, including a medication given, a medication discontinued, a medication refused and so forth. Although time consuming, this requirement is consistent with universal nursing practice when
The MAR should be located in the patient’s record where all who care for the patient can review it as needed. Documenting on the blister pack is unsafe and unreliable since they can be lost, the documentation may not be easily read, the name and dosage of the medication may be obscured and the notations on the pack may be confusing at best. Moreover, how is one to know that who placed any notation about the medication on the blister pack is doing it due to a physician’s or advanced practice nurse’s order? All of these factors places the resident/inmate/patient at risk.
It is always a good idea never to add information to a prescription label. Alterations or additions can open one to charges of tampering with medications, prescribing medications for a patient/resident/inmate without a license, diverting medications by changing or adding to the original prescription, to name a few problems.
You can read more about medication administration with blister packs and other methods of storing medications prior to administering them in texts on nursing practice, law and nursing practice, and medication administration in specific settings (e.g., jails, long-term care facilities). The Internet also has a wealth of information for your review.