Can a Ward Clerk check in controlled Medications in a LTCF?

  1. I need to know if there is some kind of regulation in checking in Controlled Medications. When the medications arrive in the locked red tote from the Pharmacy that supplies this Long Term Care Facility, can a Ward Clerk check in the medication from the transporter or should the red tote only be opened by a License personell LPN/RN. Can a medication tech receive controlled drugs if not a Assisted Living Facility. And if it is a Assisted Living Facility they can receive Controlled Medications!

    Gosh! I am a new DON for a LTCF and I never realized all the Regulations and things that can occur in a Long Term Care Facility, being a Hospital Nurse for 30 years, I have met a interesting field of Nursing.

    If anyone would like to share some resource books so I can read and become more SAVY in all these regulations let me know ASAP!

    Thanks
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  2. 16 Comments

  3. by   momdebo
    I believe checking in controlled substances must be done by LPN/RN. You might want to try Google and see what comes up there. I know what you mean. I've been critical care for 10 years and have recently started at a skilled unit in LTC facility. It's like a whole other world. I'm enjoying it though. Actually get to spend a little time with the people you are taking care of.
  4. by   catlady
    I've never worked in any SNF where even the uncontrolled meds could be touched by anyone but the licensed nurses. However, I've also never worked in a SNF that utilized medication techs. I should think that if they can pass the narcs, they ought to be able to sign them in.

    This is the JCAHO standard for medications, and on cursory check, it doesn't seem to address your concern:

    http://www.infologixsys.com/products...nt/default.asp

    Your BON and state regulators would probably be your best source.
  5. by   meownsmile
    I work in a hospital but i would think the rules would still apply. No unlicensed staff (CNA's, wardclerks) can check in narcotics or go to pharmacy to retrieve narcotics.
  6. by   sirI
    Check with state pharmacy board. They will be able to answer your question/s.
  7. by   NRSKarenRN
    your pharmacy vendor should be able to point you in the direction re medication regulations for your state and answer these questions. if they can't i'd contact your states dept of health, pharmacy board or long term care division to ask them for assistance locating regulations.

    check out our ltc forum for help too: geriatric and ltc
    Last edit by NRSKarenRN on Aug 20, '06
  8. by   banditrn
    Quote from 4rmgirlRN
    I need to know if there is some kind of regulation in checking in Controlled Medications. When the medications arrive in the locked red tote from the Pharmacy that supplies this Long Term Care Facility, can a Ward Clerk check in the medication from the transporter or should the red tote only be opened by a License personell LPN/RN. Can a medication tech receive controlled drugs if not a Assisted Living Facility. And if it is a Assisted Living Facility they can receive Controlled Medications!

    Gosh! I am a new DON for a LTCF and I never realized all the Regulations and things that can occur in a Long Term Care Facility, being a Hospital Nurse for 30 years, I have met a interesting field of Nursing.

    If anyone would like to share some resource books so I can read and become more SAVY in all these regulations let me know ASAP!

    Thanks
    I don't believe that anyone but the nurse can check them in, altho the persons delivering them aren't licensed.

    So, how is it all going for you? I have only worked in LTC for about 4 months, after many in a hospital - an opening has come up in another facility for a DON, and I'd like to apply, but am not sure I have enough experience.
  9. by   catlady
    Quote from banditrn
    So, how is it all going for you? I have only worked in LTC for about 4 months, after many in a hospital - an opening has come up in another facility for a DON, and I'd like to apply, but am not sure I have enough experience.
    I am always surprised when I hear about hospital nurses, or even brand new nurses, walking into a DON position in long-term care. I have many years of both hospital and long-term care bedside and management experience, have considerable expertise in Medicare, know the LTC regulations well, am certified in gerontology, and have continued to be told by more than one facility that I would need to be at least an ADON for two years before being considered for a director position. I'm now at the point where I'm back in acute care and no longer interested in LTC.
  10. by   banditrn
    Quote from catlady
    I am always surprised when I hear about hospital nurses, or even brand new nurses, walking into a DON position in long-term care. I have many years of both hospital and long-term care bedside and management experience, have considerable expertise in Medicare, know the LTC regulations well, am certified in gerontology, and have continued to be told by more than one facility that I would need to be at least an ADON for two years before being considered for a director position. I'm now at the point where I'm back in acute care and no longer interested in LTC.
    Hmmm - well, then maybe I will re-think applying for the job. I would like to try for an ADON position, but most of the facilities around here are too small to use them.

    The hospital where I worked had a lot of geriatric patients, and we had to know what the specifics of taking care of them were - but I suppose that wouldn't be good experience.
  11. by   4rmgirlRN
    Well, as for as banditrn and applying for the DON Job. Never wait until tomorrow cause tomorrow may not ever come. I think it helps having all the credentials to be a DON, but seeing how LTCF are ran I think it does not matter as long as you are a RN with Management experience.
    Since I am a SEASONAL NURSE, I should know better to make this comment. But, after losing my 13 year old son in August of 2004 to a ATV accident. I know all this stuff we worry and fret and argue over means nothing. It is only someone proving who has the most POWER or MONEY in some instances to make it right!
    So you know what I mean when live like today was your last, and go for whatever you think the Lord wants you to handle. God, put us on this earth for a purpose, if it was only for 13 years for some than, Thank God for giving you that time!
    Most Nurses want to be honest and follow the Nurse Practice Act, but we have Administrators and Owners that do not understand our Practice Act and feel Ward Clerks and Aides or smarter than Nurses so they make policy's that Seasonal Nurses have to question???

    Thanks for all the responses I have contacted the State I live Board of Nursing and gone to the DEA site. So hopefully I will get the Answer! The pharmacy the LTCF uses I was told by the Administrator we do not go by their policy we go by the LTCF Policy that they have had for 16 years!
    Which is let the Ward Clerk check it in!!!!!!!!
    Last edit by 4rmgirlRN on Aug 20, '06
  12. by   txspadequeenRN
    In any facility I have worked at anything that comes from the pharmacy MUST be double checked by a licensed nurse. This means OTC , narcs, regular RX meds and ER medications.
  13. by   speckleddove
    i have been in ltc for 12 years.
    as far as i have been in ltc, only a nurse can sign in or out narcotics.

    at assisted living the narcotic laws are broken by some facilities.

    they demand a nurse sign them in (usually on day shift) but yet they allow cnas on night shifts access to narcotics because they are to cheap to hire a night nurse.

    however by law i do believe it is unlawful for anyone but a nurse to sign them in or give them out.

    facilities will lie to nurses.
    if your name signed them in and a cna gives them out more than likely your butt will be held responsible.

    at the jobwhere i had all 3 buildings to care for, i refused to give meds or work at the assisted living building because every tech. and cna had the narcotic keys.

    we all worried about this issue and never, even calling the state boards we never got a direct answer to your question.

    so all nurses but 1 refused to cover that building.

    i would call a malpractice lawyer in your state.
    for someone in your position you better legally find out.
  14. by   suebird3
    Where I am, only nurses sign out for the Narcs. Of course, we also do NOT have Medication Aides, either.

    Suebird

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