December 16, 2009 | | Comments 1
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Thoughts about securing medications delivered via a tube system

A plant ops director asked me recently about medications delivered by a tube system and handled in the following scenarios:

  • Allowed to remain sitting in a tube station in the nursing area
  • Placed in an open basket behind the nursing station
  • Put in the possession of the unit team leader

There is no clear method for managing medications delivered to patient units via the tube system. The overarching national regulatory standards in this regard do not provide much in the way of specificity, so ultimately (as it does with so many things) it defaults to the organization to determine what is “safe”, “secure”, “appropriately secure,” etc.

This discussion really should start with pharmacy managers because they’re the ones who’d have to respond to any state or federal questions if something bad happens.

Of the scenarios mentioned above, the one that feels most secure (and I’m assuming that the unit team leader is appropriately licensed/credentialed to be holding medications) is when the unit team leader maintains possession of the medications.

The other two scenarios (in the tube station and in the open basket) would be a little too exposed for my comfort. Now, if the tube station is secured somehow and only appropriate individuals have access, that would be a little better (though, as we know, sometimes numerical codes become disseminated to the general populations).

Likewise, maybe there is a way to secure the basket. I know a nurse station is in theory always occupied, but I am no fan of hanging my hat on the absolutes of “always” or “never” — those are just red flags to wave at a Joint Commission surveyor.

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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  1. Regarding the security of medications being deliveerd to tube stations in open Nursing Stations. Nursing stations may be secure as far as HIPPA goes but I do not think they are generally secure as far as temporary storage or placement of medications. There is a variety of traffic in this area that is not licensed. This could be messengers, escorts, housekeepers and others who would not normally be allowed into a secured medication area. In a busy unit or a unit that only has two staff at 1:00 AM, accessibiity to medications at the tube station could pose some risks.

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