As we prepared for our initial accreditation survey from the Texas Department of Health last year, we knew that surveyors would ask about how we document, secure and account for narcotics. We developed a narcotics form that follows the patient through pre-op, intraop and post-op, and that's linked to our drug inventory.

During pre-op, when the anesthetist is issued the narcotics he's requested, we hand him the form with a patient label on it. During surgery, he marks the drugs and amounts he's used, getting a signature for any disposed-of portions, and returns the unused drugs to us. The form follows the patient to recovery and discharge, recording what he's given for pain, then it goes to the nurses who check the narcotics inventory at day's end. We can compare the narcotics forms against our perpetual inventory sheets to match up what was taken and what's been used; if there's any discrepancy, we can ask about it.

Our form is simple, easy to read and complete, with color-coding to distinguish between different doses of the same medication. Our anesthesiologists and CRNAs have been compliant.

Kris Fisher, RN, CNOR, BSN
Nurse Administrator
Turtle Creek Surgery Center
Tyler, Texas
writeMail("kris@tcsctyler.com")