Avoiding Mistakes: Best Practices for Nurses Handling Narcotic Drugs
All nurses in all healthcare settings have a very important job: making sure that narcotic medicines are handled safely. Narcotics, sometimes called opioids or controlled substances, are strong drugs that must be used exactly as directed to avoid overuse, diversion, or injury to patients. This article lists a number of best practices that nurses can use to provide the best care possible while also following the rules set by the law and their own institutions.
What you need to know about narcotic drugs and their risks
Morphine, fentanyl, hydromorphone, oxycodone, and methadone are all examples of narcotics. These drugs are very strong pain relievers. They work well for treating both short-term and long-term pain, but they also come with many risks:
Addiction and dependence
Depression of the lungs
Mistakes with medications
Drug diversion
Healthcare workers need to be cautious and pay close attention to these drugs.
Laws and rules that govern businesses
Nurses need to know and obey the rules that govern the use of narcotics, such as:
Rules from the DEA (Drug Enforcement Administration)
Rules from the State Board of Nursing
Policies for handling narcotics at the facility level
If you don’t obey these rules, you could face disciplinary action, lose your license, or even be charged with a crime.
Safe Ways to Get and Store Drugs Safe Ways to Store Them
You must keep narcotics in closed, safe cabinets with double locks and keys or automated drug distribution devices like Pyxis or Omnicell. Only people who are allowed to should be able to use these systems, and they should keep a record of all activities.
Controls for the environment
Make sure that storage areas are:
As the medicine label says, the temperature must be managed.
Not open to unauthorized access
Regularly checked for mistakes in the inventory
Keeping track of your inventory and paperwork correctly
Keeping accurate records
It is vitally important to keep careful records of every dose of a narcotic medicine. There should be documentation that includes:
Name and ID of the patient
Name of the drug, dose, and route
Date and time of administration
Name and qualifications of the nurse in charge
Why it was given
Checking and reconciling the inventory
Daily or shift-based counts of narcotics must be done to find any differences as soon as possible. You should disclose differences right once and write them down according to the rules.
Giving narcotics with care
The Ten Rights of Giving Medicine
Always observe the Ten Rights to avoid mistakes:
The right patient
The right medicine
Correct dosage
The right way
The right time
The right Documentation
The right Assessment
The right to Refuse
The right to evaluation
The right to Evaluation
Before giving out any medications, check the orders and patient ID with two different identities.
Check High-Risk Medications Twice
It is best to have a second nurse double-check the dose when giving strong narcotics like fentanyl or hydromorphone.
Stopping diversion and misuse
Seeing Signs of Diversion
Watch out for warning signs like these:
A lot of drug waste
Differences in the paperwork
Avoiding witnesses while in charge
Too much time spent around drug cabinets
Throwing Away Trash with a Witness
Don’t throw away unused drugs by yourself. Always have a nursing witness sign off on the garbage, and utilize approved waste disposal procedures that make it impossible to get back the medicine.
Training in Education and Skills
Nurses should have regular training on how to safely handle narcotics, such as:
Competency tests every year
Scenarios for preventing mistakes based on simulation
Workshops on how to spot people who are looking for drugs
Ongoing education helps people remember best practices and make sure they follow new rules.
Dealing with mistakes with narcotics
Even with precautions, mistakes can still happen. When they do:
Tell the charge nurse or supervisor about the occurrence right away.
Write down the mistake in a clear and accurate way.
Take part in finding the fundamental cause
Learn from the event so it doesn’t happen again.
Reporting things on time is important for keeping patients safe and the nursing profession honest.
Safety of Narcotics Through Technology and Automation
Automated systems have made drug safety much better by
Cutting down on mistakes made by hand
Keeping track of activities in real time
Marking behavior that seems strange
Improving the tracking of inventories
Every nurse should use this kind of technology in their work.
Teaching and speaking up for patients
Patients who are given opioids typically need help understanding:
How to use it right
Possible adverse effects
Risks of abuse
How to store and throw away leftover medicine
Nurses should push for safe home practices and teach their patients how to use drug deactivation systems or take-back programs.
Working together and talking to each other as a team
Good communication between nurses, doctors, and pharmacists makes sure that:
Giving narcotics on time
Making unclear directives clear
Keeping an eye on patients for bad impacts
Solving problems across disciplines
Use the SBAR (Situation, Background, Assessment, Recommendation) communication framework to quickly and professionally raise concerns.
In conclusion, a promise to safety and honesty
Nurses are the first line of defense for patient safety, especially when it comes to giving out narcotic medicines. We not only prevent making mistakes, but we also protect the integrity of our profession and the faith the public has in us by following stringent rules, keeping a close eye on things, and encouraging education and accountability
FAQ
What are narcotic narcotics, and why are they so dangerous?
Opioids, commonly called narcotics, are strong painkillers. Because they can lead to addiction, overdose, misuse, and legal problems, they are thought to be high-risk.
What do nurses do wrong most often when they are in charge of narcotics?
Some common mistakes are giving the wrong dose, not correctly recording the administration, not properly storing the drug, not checking for witnesses during waste, and allowing illegal access or diversion.
What is the best way to store opioids at a hospital?
Only authorized staff should be able to get to narcotics, which should be kept in a secured, safe cabinet or automated dispensing unit (like Pyxis or Omnicell).
What paperwork do you need to give out narcotic drugs?
Nurses must write down the name of the drug, the dose, the route, the time, the patient’s information, and their own name and signature, as well as any waste and a witness if necessary.
What are the “ten rights” of giving narcotics?
The ten rights are the right patient, the right medicine, the right dose, the right route, the right timing, the right documentation, the right evaluation, the right to refuse, the right to education, and the right assessment. Following these rules closely can help stop mistakes with medications.
If a nurse makes a mistake with a narcotic, what should they do?
The nurse must tell a supervisor about the occurrence right away, write it down correctly, and take part in any follow-up reviews or investigations.
What can nurses do to stop the diversion of narcotics?
By keeping strict records, storing things safely, counting things, never working alone with garbage, and being mindful of red signs like changed records or repeated requests for drugs.
What does a second witness do while handling drugs?
To make sure that narcotic drugs are not stolen and that the law is followed, a second nurse must see and sign off on any trash or disposal.
How often should you count narcotics?
Counts should be done at the end of each shift, during handovers, and when units are opened to check the inventory.
What kind of training do nurses need to give them on how to deal with narcotic drugs?
Nurses should get regular training on how to keep patients safe with medications, follow the law, avoid mistakes, see signs of abuse, and keep good records.