Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)

Labeling (Medications, Solutions, Containers)

Guidelines:

• At time of draw, always
  • Date, concentration, drug
  • Pre-made stickers best but beware
  • Color coded
• Multi-dose label opened date
  • Not for more than one case
• Cannot be left around OR
• Label on field! When placed
  • Container, syringe, etc
  • Yes also NS and SW
• Record amount from field as used
  • Anticipate need for turnover

Considerations:

• Pre-filled doses best
• Verify meds on field with board, time out, RN to place on field with tech
• Yes, label propofol we know its white too bad
• If mixed up on field, discard, restart
• Omnipaque vs Visipaque
  • Visipaque isosmotic to blood
  • Omnipaque not for blood

Nurse’s role:

• Often pull meds from pharmacy/pyxis
  • Not always, MD to bring from clinic OK with RN verification
• Document administration
• Verify labeling, dosage, etc
• Police the OR

Pitfalls:

• Not labeling concentration
• Non-standard color code
• Emergent staff relief, nothing written
  • How many syringes did you start with?
• SW and NS mixup
  • Crani!
• Unique mixes (not 50/50)
• Local toxicity with mix

Examples:

• Local and vasopressin labeled on field, drawn into syringe. Later notice syringe not labeled (discard syringes, restart from
  known accurate label or from beginning)

Linchpins (Key Points):

• No medication error is made knowingly, and the OR removes most safety rails to med administration