Archive September 2018 XIX, No. 9

Ideas That Work: Do You Count Your Propofol?

PLAYING PATIENT
Greenwood (S.C.) Endoscopy Center
MORNING, NOON + NIGHT The Greenwood (S.C.) Endoscopy Center treats propofol as a controlled substance, says Director of Nursing Laura Young, RN, seen here at right counting numbered boxes of propofol in the medication room with Jessica Goodman, RN.

Is it enough to store your propofol in a locked cabinet inside a locked medication room? Technically, yes. Propofol isn’t considered a controlled substance, but the Drug Enforcement Administration may soon designate it as a “scheduled” drug. We treat propofol as we do such sedatives as Demerol, Versed and fentanyl, counting it 3 times daily. We formally record the count in the morning and at day’s end, and also perform an informal count at noon.

Only 2 nurses have access to the medication room: me and our infection control nurse. We both count Propofol when we come in the morning, recording the count on a handwritten sheet that we store in a tabbed binder (each drug we count has its own tabbed section). One of us does an informal mid-day count at around noon that we doesn’t get record and together we do another formal count at day’s end.

A couple tips to make counting easier:

  • Number each box. When we get an order of Propofol in, we number every box with a Sharpie. We keep a log that matches each numbered box with a lot number, an order number and how many vials are in the box.
  • Hold each CRNA accountable. Each CRNA keeps his own Propofol-use log in his procedure room and turns in his unused meds to me at day’s end. The log notes the procedure, drug lot number, dosage, waste and the name of the anesthesia provider who witnessed the waste. This motivates our CRNAs to ensure their room counts are accurate at noon and at day’s end.
  • Laura Young, RN
    Greenwood (S.C.) Endoscopy Center
    lauraaliceyoung@gmail.com

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