Corrections Community

I have a post that includes performing medline for general population. I am aware that a lot of other institutions require inmates to do full mouth gum sweeps, using the fingers to clear the mouth. An inmate was caught, "cheeking", his meds and because of that the OIC oredered the thourough inspection of all inmates mouths before returning to their units. Many inmates complained of the unsanitary consequences of sticking their hands in their mouths, they complained and got their way. Has anyone else encountered this issue, and if so is there a way to handle this situation and still be effective. What does your institution require?

If possible have your nursing staff crush the inmates medication.

The inmate must open his mouth and lift his tongue for a visual inspection. Additionally, we require that inmates use only water with which to take their medication so that if they spit it into their cup, it can be easily seen.

if they know that they are going to have to do a mouth sweep then they should wash their hands. they can open any doors etc between them and where they get meds with one hand leaving the other hand clean. inform them ahead of time that this is going to be the rule and then proceed. not all meds can be crushed so this can be a problem. in our facility two favorites to crush and snort are welbutrin and seroquel. they were recently removed from the first choice on the formulary. deb

in our facilities, seroquel and wellbutrin have been removed from the formulary completely 

Follow is our procedure Direct the inmate to get a full glass of water; we only allow water becuase you can see if an inmate spits the medication into the glass Watch while the inmate puts the medication into their mouth and swallows it. Watch for swallowing movement. Have the inmate drink the entire glass of water. (we use 8oz clear glasses) Require the inmate to show you the empty glass; Check the inmate’s mouth by looking into it, use a flashlight. Do not put your fingers into the inmate’s mouth. Direct the inmate to move their tongue and pull the lips away from the teeth in order to fully check their mouth; Require the inmate to show their hands to you with fingers spread far apart to indicate that they have not “palmed” the medication; Tell the inmate to say something to you to be doubly sure that they have swallowed the medication

At our facility....we are to watch if Inmate does indeed take medicine, to my knowledge we do not do a mouth sweep.Sometimes without doing a visual inspection it is hard to tell wheter medicines are being taken or palmed and taken back to cell  perhaps to barter...I will check with the Head of Nursing at our facility and get more input......policy and procedure...and follow up...Have a great day.

David