Long-Term Care Survey Alert

Published on Tue Nov 04, 2003 PDF

Question: We've read media accounts of nurses and other health care staff stealing fentanyl patches from patients or taking discarded patches to get the remaining drug out of them. Should our facility implement a policy for discarding these pain patches to prevent potential abuse by staff or other problems?

- Minnesota subscriber
 
Answer: Staff in nursing homes or inpatient settings used to flush fentanyl patches, but now there are concerns about the drugs getting into the waste water system. So the recommendation is for staff to fold the patch with the adhesive sides together and drop them into a designated secured biological waste container that cannot be re-entered. Also, even with recommended length of use, the patches will still contain some active drug. Even so, you cannot document the "wasted" drug [as you can with a narcotic where only a certain amount is used to treat the patient's pain]. The facility should thus have a policy requiring two nurses to observe the appropriate disposal of the patch and to document it - just as nurses do when wasting part of a dose of a narcotic in a syringe.
 

- Expert advice provided by Rhonda Nichols, a clinical nurse specialist and pain management expert in Los Angeles.