What do you do when you drop pills on the floor?

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ethyl said:
Do you follow the 5 second rule?

:oops:
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Indeed! 10 seconds sometimes if there's a customer in view. 30 seconds if it's a C-II.
 
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twester said:
Indeed! 10 seconds sometimes if there's a customer in view. 30 seconds if it's a C-II.
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This is exactly my protocol! You can even extend that 30 seconds if the C-II rolls behind the fridge and it takes you a while to fetch it.
 
If a customer is in view then I pretend to throw it in the trash...but then put it back on the counting tray.

I've worked for 3 retail chains and floated through various stores and have yet to see anyone throw away a pill that falls on the floor. that is precious inventory!
 
Gross people... I feel bad when the pill drops onto the table!
 
i once dropped a versed vial, and my director is somewhat of a hard-ass. it went under the picking station.
my tech fished it out with a hanger...otherwise i was going to take the picking station apart.
 
sdn1977 said:
:thumbup:yep - toss it....the cost is too small to worry about.
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Agree. I've thrown out quite a few pills. I don't remember ever dropping a C-2 yet (so I can't say what I'd do in that situation), but I've only been allowed to count them the first year and a half I've been working. That was in Indiana where as soon as you're hired, you can right away start counting tablets. Even C-2s! I thought it was crazy myself, but I was always extra careful with them; which is probably why none of them landed on the floor.
 
working as a tech, we wiped it off well and saved it, but if a cusotmer saw it, we tossed it. got to keep up the professionalism ;)
 
piyi said:
Agree. I've thrown out quite a few pills. I don't remember ever dropping a C-2 yet (so I can't say what I'd do in that situation), but I've only been allowed to count them the first year and a half I've been working. That was in Indiana where as soon as you're hired, you can right away start counting tablets. Even C-2s! I thought it was crazy myself, but I was always extra careful with them; which is probably why none of them landed on the floor.
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Hah! I have - threw away a Dilaudid 4mg (brand name) with the cotton. I had to fish through the trash at the end of the day to find the d*mn tablet.

Got it & put it in a bag, lableled & stuffed it in the morgue bag for CIIs. Tussionex - if your facility had to document missing controls - that's why he was such a hard *ss.

Other than rumbling around empty bottles (fortunately, the staff throws food away in different trash bins)....it wasn't too bad.

I've thrown away lots of stuff - tpns, chemos, tpa's - mixed wrong. The amount of money is not worth the risk of error (or g*d forbid - someone accusing you of picking something up off the floor).

If you ever wonder what that one tablet costs - take a look at the monthly invoice for what your facility buys...then look at the cost of that one tablet/capsule - absolutely miniscule.
 
I kind of laughed at this thread because I wondered this myself lately. At the pharmacies I have worked at previously if we dropped a tablet, we picked it back up and used it. I have never even thought of throwing it away. But at the pharmacy I am working at now they insist on throwing anything away you drop...Just my input :)
 
ethyl said:
Do you follow the 5 second rule?

:oops:
Click to expand...

Absolutely. I must work with a bunch of klutzy people (myself included) because we'd be tossing an awful lot of pills if we tossed everything that fell on the floor. I toss some stuff and keep some stuff. If the customer is in view I just set it aside/pretend to toss it and then stick it back in the bottle later. Thankfully we got rid of our Baker cells because you have to hold the vial just right under the chute or the pills end up all over the floor. Heck, sometimes the thing would decide just to shoot them out all over the floor because the stopper wasn't fitted right.

There is this space about 1-inch wide between the counter and the conveyor belt that runs along the back of the counter in my store. The scales we weigh everything in sit above the back splash of the counter, so a few cups of pills have been bumped and fallen right into that little space. One of our pharmacists dumped a whole cup full of some C2 over the back. The cabinets underneath the counter pull out in sections, and I had to crawl under there and fish out the tablets from the dust under there. I'm actually not sure what exactly happened to those in the end.
 
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Funny you ask! Today our P1 intern (first time in a pharmacy) asked me about pills we drop on the floor. When I told her were still use them she was a bit offended -- ah, to be so young and idealistic!

McZyprexalynn said:
One of our pharmacists dumped a whole cup full of some C2 over the back.
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This sounds all too familiar. A couple months ago I dropped a whole boat full of Kadian all over the conveyor belt -- after picking them all up we were down 21! Unfortunately there is no way to get back underneath it without dismantling the entire counter, so they're still sitting down there. I guess some enterprising carpenter will find a nice stash should they ever remodel.
 
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Once a pharmacist I was working with dropped an entire bottle of methylin ontop of and down into the printer. This printer had all sorts of holes for things to fall down into. I got it all back, much to his surprise.
 
McZyprexalynn said:
Absolutely. I must work with a bunch of klutzy people (myself included) because we'd be tossing an awful lot of pills if we tossed everything that fell on the floor. I toss some stuff and keep some stuff. If the customer is in view I just set it aside/pretend to toss it and then stick it back in the bottle later. Thankfully we got rid of our Baker cells because you have to hold the vial just right under the chute or the pills end up all over the floor. Heck, sometimes the thing would decide just to shoot them out all over the floor because the stopper wasn't fitted right.

There is this space about 1-inch wide between the counter and the conveyor belt that runs along the back of the counter in my store. The scales we weigh everything in sit above the back splash of the counter, so a few cups of pills have been bumped and fallen right into that little space. One of our pharmacists dumped a whole cup full of some C2 over the back. The cabinets underneath the counter pull out in sections, and I had to crawl under there and fish out the tablets from the dust under there. I'm actually not sure what exactly happened to those in the end.
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:thumbup: Seems like when the baker cells spew pills all over the floor, we just pick them up asap, dust them off and throw them back in the baker cell... that way it all filters through and everybody gets an even level of contaminated goodness. :oops:
 
Pick em up and use them. Customers can't see me do that...I hope.

They were probably dropped during manufacture. They'll probably be dropped at the customers house too. We might as well add to the fun! ;)

I drop synthroid nearly everyday. We get them in these teeny tiny bottles with a huge piece of paper shoved in there, nearly impossible to shake them out without spilling some. Sometimes when we order them from McKesson they come in larger bottles with bigger openings so those are easier to handle.
 
I must admit that I'm a little surprised to see so many people reuse meds that have been dropped on the floor. Think about where your shoes go during the day. In and out of bathrooms, across parking lots where people have spit and any number of fluids have leaked from cars, over grass that has been fertilized with cow manure. It's really quite disappointing that so many people reuse them and it's such a common practice that no one thinks twice about it. Maybe I'm just a germaphobe but I would be worrying that if I did that, I would make someone sick. You might as well have them lick the bottom of your shoe--same difference.
 
I don't think re-using is such a big deal. I mean, when I'm at home and I drop something on the floor (amoxacillin, singulair, whatever...), I still take it. I'm not gonna go back to the pharmacist and ask for one amoxacillin pill because I'm afraid to eat a little bit of harmless bacteria with it. Not meant to disrespect those that do toss dropped pills...:)
 
sdn1977 said:
Hah! I have - threw away a Dilaudid 4mg (brand name) with the cotton. I had to fish through the trash at the end of the day to find the d*mn tablet.

Got it & put it in a bag, lableled & stuffed it in the morgue bag for CIIs. Tussionex - if your facility had to document missing controls - that's why he was such a hard *ss.

.
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actually, we do account for missing controls in both facilities i work in....the first place [with the normal director], if we drop or break something [like those dilaudid HP amps] we double-sign it as waste.

in facility number two, the director is, in fact, satan personified and his personality has nothing to do with required paperwork, and i do all in my power not to deal with him.

i have tossed lots of expensive stuff that i just didn't feel was "right"... TPNs come to mind, as well as batches of epidurals...can't be too careful.

ps - [in the case of the epidurals, we wasted them within sight and signature of, and with the blessing of director number1, the nice one]
 
I was holding a bottle of brand name oxycontin with the lid halfway on as I was walking back to the counter. Then all of a sudden I had to sneeze and as I was trying to sneeze into the trash can I flipped the bottle over into the trash thus tossing most of the tablets into the trash right into someones lunch they had just thrown away! Most of them had to be written off...
 
mike36 said:
I don't think re-using is such a big deal. I mean, when I'm at home and I drop something on the floor (amoxacillin, singulair, whatever...), I still take it. I'm not gonna go back to the pharmacist and ask for one amoxacillin pill because I'm afraid to eat a little bit of harmless bacteria with it. Not meant to disrespect those that do toss dropped pills...:)
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Now what about the immunocompromised (AIDS, elderly, transplant). What's harmless for you is not harmless for everyone, and the person picking up the meds is not always the person taking them. From their point of view, there's no such thing as "harmless" bacteria.
 
Farmercyst said:
Now what about the immunocompromised (AIDS, elderly, transplant). What's harmless for you is not harmless for everyone, and the person picking up the meds is not always the person taking them. From their point of view, there's no such thing as "harmless" bacteria.
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I don't think anyone is saying that pills dropped in a pile of steaming garbage should be reused. We don't live in a sterile world and I doubt even pills out of the bottle are completely free of bacteria.

Our hands are a bigger source of contamination than a clean floor is, yet I'll bet nearly all of us touch pills more often than we drop them on the floor. Miraculously, our patients survive. :laugh:
 
Farmercyst said:
Now what about the immunocompromised (AIDS, elderly, transplant). What's harmless for you is not harmless for everyone, and the person picking up the meds is not always the person taking them. From their point of view, there's no such thing as "harmless" bacteria.
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Was this an excuse to jump up on the soap box!? lol What about the immunocompromised patient? It's not going to add any additional chance of contracting some immunocompromised condition like PJP (PCP), CMV or whatever in sick patients. It's more beneficial to take the drug than to not take the "dirty" tablet
 
Farmercyst said:
Now what about the immunocompromised (AIDS, elderly, transplant). What's harmless for you is not harmless for everyone, and the person picking up the meds is not always the person taking them. From their point of view, there's no such thing as "harmless" bacteria.
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I agree.

I also find it a bit hypocritical that so many people go on and on about professionalism...but some aren't anymore professional than a 16 year old kid working at taco bell who drops a taco on the floor only to pick it up and serve it. I'm not trying to pick on anyone. Just wanted to point it out as something people need to think about.
 
I wonder how clean the counting trays are compared to the floor. Dropping a taco at taco bell is a little different. The are wet and sticky and good places for bugs to grow. Plus the floor is more inherently dirty than pharmacy seeing how it gets random food bits dropped on it. A tablet/capsule is shiny and dry and not sticky, the opposite of a taco.
 
Caverject said:
Was this an excuse to jump up on the soap box!? lol What about the immunocompromised patient? It's not going to add any additional chance of contracting some immunocompromised condition like PJP (PCP), CMV or whatever in sick patients. It's more beneficial to take the drug than to not take the "dirty" tablet
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I am aware no one meant do you pick them up off the bathroom floor, breakroom floor or other locations notoriously filthy. It's also unlikely a single dirty pill from the floor would be contaminated to the point that one would pass the ID50, I don't really think it's the point of the OP anyway. Let's just say I'm sorry for going there.

What's more beneficial in this case doesn't really matter unless the dropped pill is the very last one and you have no other choice. Sure if there's no chance of getting a clean pill, I'd take a dirty pill. Otherwise, why not just give them a clean one anyway. It's not like it comes out of your pocket. If you'd like my soap box, I'm willing to share. ; )
 
Farmercyst said:
Now what about the immunocompromised (AIDS, elderly, transplant). What's harmless for you is not harmless for everyone, and the person picking up the meds is not always the person taking them. From their point of view, there's no such thing as "harmless" bacteria.
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Point taken. :smuggrin:
 
J DUB said:
I usually take them.:D

Don't want the customer getting a dirty pill or wasting it.

I just make sure I drop the good ones!!!
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Oops, was that vicodin I dropped? Oh well...mine now!:laugh:
 
Glowwyrm said:
I agree.

I also find it a bit hypocritical that so many people go on and on about professionalism...but some aren't anymore professional than a 16 year old kid working at taco bell who drops a taco on the floor only to pick it up and serve it. I'm not trying to pick on anyone. Just wanted to point it out as something people need to think about.
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Hmm...I think this is a bit different though. I mean, fast food frequently is contaminated with animal **** anyways so I don't think it much matters how you handle it after that happens.:eek:
 
Like anything else in pharmacy, it varies for me.

If it's a C-2...no doubt I'm gonna pick it up off the floor and dust it off. I think you'd be hard pressed to find someone who will actually waste a tab that fell on the floor. Really dusty/dirty/wet areas are a diff story though...

Ditto for something that we don't carry a lot of/risk running out of or if I know it's really expensive, like Zofran.

However, anything else, hell, it stays on the floor or goes in the trash...usually stays on the floor...like I'm going to be bothered to pick up anything smaller than a 1 gram metformin tab. If I drop 5 hctz's on the floor it really is not that important/scarce/expensive that I'm going to pick them up AND give them to the patient when I have like 5000 on the shelf.

tussionex said:
i once dropped a versed vial, and my director is somewhat of a hard-ass. it went under the picking station.
my tech fished it out with a hanger...otherwise i was going to take the picking station apart.
Click to expand...

One day I was assigned to stock the med rooms...I straight up dropped a 25 pack of fentanyl 20ml vials and ended up going upstairs with 20. Whoops. Surprisingly the RPhs didn't want to tear me a new one for making them do a bunch of paperwork. Of course, that's really nothing compared to nursing and their handling of narcs but that's a whole nother thread..
 
when a friend of mine was a DOP, he made some nurses search through the dumpster to find narcs they had mistakenly thrown out.

tablets are nothing like tacos...agreed!
 
Depends what it is. If it's furosemide, Ill trash it, or add it to the miscellaneous pill jar. But that one bottle of brand name celexa I dropped on the floor, I managed to scavange each tablet. :)
 
I dropped some pills on the floor one day and immediately tossed them in the garbage, only to have one of the techs tell me to fish them out and use them.. I was so surprised. It's not like the big retail companies can't afford to lose some pills. They had fallen to the floor where people constantly walk on all day. I was also wearing my "work" shoes which I also used to wear on my last job at a chemical plant, which also happens to process radioactive material. In addition, the bathroom at the pharmacy where I work had no soap that day, either. And.. when we dispense, we also go back and forth to the register and to the drive thru where we handle people's cash and credit cards, and come right back to counting when we're done. Let's just say I feel sorry for the person who received those pills.

Another thing.. sometimes pills fall on the table where they are being counted, but I've never seen anyone actually clean the table. The most anyone does is to reuse the cotton that comes in the pill bottles themselves to wipe the counters, and the cotton is full of dust residue from the drugs themselves!! Seriously, it is really weird to me and I wouldn't want to get my drugs from my own pharmacy! I wonder if hospital pharmacies do the same thing.
 
Oh, fcuking gross! :scared: I'm glad I work with blister packs...if a blister pack's OPEN, nevermind having fallen on the floor, it goes in the trash.

Or down the hatch, depending on what it is....
 
starsweet said:
I dropped some pills on the floor one day and immediately tossed them in the garbage, only to have one of the techs tell me to fish them out and use them.. I was so surprised. It's not like the big retail companies can't afford to lose some pills. They had fallen to the floor where people constantly walk on all day. I was also wearing my "work" shoes which I also used to wear on my last job at a chemical plant, which also happens to process radioactive material. In addition, the bathroom at the pharmacy where I work had no soap that day, either. And.. when we dispense, we also go back and forth to the register and to the drive thru where we handle people's cash and credit cards, and come right back to counting when we're done. Let's just say I feel sorry for the person who received those pills.

Another thing.. sometimes pills fall on the table where they are being counted, but I've never seen anyone actually clean the table. The most anyone does is to reuse the cotton that comes in the pill bottles themselves to wipe the counters, and the cotton is full of dust residue from the drugs themselves!! Seriously, it is really weird to me and I wouldn't want to get my drugs from my own pharmacy! I wonder if hospital pharmacies do the same thing.
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You forgot to mention the prescription hardcopies that we handle that are covered in God knows what kind of bodily fluids...(and have any of you ever said anything to the customer or refused to touch their blood covered prescription?)
 
don't forget the nasty, greasy, smushed used tube of ointment that people try to hand you.

ick
:eek:
 
At the retail pharmacy I interned at we would pick them up off the floor.

It would be really interesting to see cultures done on pill and pill bottles at pharmacies and ones that been at a patients house for awhile. If the pills are taken orally wont the patients be ok if they have some bacteria on them?
 
Sharwood said:
You forgot to mention the prescription hardcopies that we handle that are covered in God knows what kind of bodily fluids...(and have any of you ever said anything to the customer or refused to touch their blood covered prescription?)
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Yes, a man picking up AIDS medications had blood all over his hands and people refused to take his money (which he was also getting blood on). He had just gotten in a fight before coming in to pick up his meds.
 
haha, this happened to me yesterday which was my second day of work. while filling a baker cell, 1 tablet fell on the ground and i said "oops, do i throw it out?" and the pharmacist said yeah and then whispers "only cause a customer saw you"
 
kytran40 said:
haha, this happened to me yesterday which was my second day of work. while filling a baker cell, 1 tablet fell on the ground and i said "oops, do i throw it out?" and the pharmacist said yeah and then whispers "only cause a customer saw you"
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:laugh:
 
Glowwyrm said:
I must admit that I'm a little surprised to see so many people reuse meds that have been dropped on the floor. Think about where your shoes go during the day. In and out of bathrooms, across parking lots where people have spit and any number of fluids have leaked from cars, over grass that has been fertilized with cow manure. It's really quite disappointing that so many people reuse them and it's such a common practice that no one thinks twice about it. Maybe I'm just a germaphobe but I would be worrying that if I did that, I would make someone sick. You might as well have them lick the bottom of your shoe--same difference.
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I must admit that I am surprised to see dead cockroachs in the vials and on the shelfs, not at my store, but others. Not to mention dusts and human skin dander in the air. I highly doubt the vials are "sterile."

C-2: pick it up and carry on. others, just depends.
 
Seems a lot are forgetting about the third option....SEND IT BACK FOR CREDIT. Are the major chain pharmacies the only ones doing this? We send back dozens of pills in our salvage returns every month, including C2s, that wandered out of any regular surface.

P.S. Before you think "dozens of pills" a month is a lot of dropped pills....our pharmacy fills about 650 scripts a day.
 
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