Med pass in LTC

I work 3-11 in LTC/Rehab, where the med pass is not as heavy as day shift, however, I call my hall "Accucheck Alley" because I usually have at least 1/3 of the 30 patients have at least a 4:30pm. Recently I had 14 out of 28. What I started doing is keeping an eye on their readings, and if after a couple of weeks they stayed within normal parameters, I would communicate to our NP or MD to see if the fingersticks could be cut back to BID. Most always, they were changed. If your narcs are PRN, know your "pain people", (those that always hit the light routinely) and take care of them before they hit the light. It is also helpful if the person that worked before you has assessed pain, and took care of those folks. I took the time when I was off and made my own "jot sheet", color coded it with information that was of most importance, and it has been much help when I am "muddling thru the muck"LOL unfortunately I have to update it almost every day, but it is well worth it. Perhaps you can somehow communicate with the consult pharmacist , to have them review some of the folks that are polypharmacy. Hang in there.

I have passed alot of antibiotics and am sitting here wondering why in the world someone would be passing them in the middle of the night? I have never heard of that. Even TID doesnt mean wake your patient up in the middle of the night.

People need to sleep at night. No one should be woken up for any routine medication. Treatments shouldn't be scheduled during someone's sleeping hours. If these people were home, would they set an alarm to wake up to take meds? Nope.

I work nights, and the doctors have specifically written orders to give meds every 8 hours. Then we find a lot of meds that are given 12mid, 6am, 12noon and 6pm. This really bugs me, because I need to wake up these pts twice.

As for my 22 accuchecks, I will flag those meds with stickies.

I also make up med cups, that I don't fill, and use them to make sure that all my meds are given. Once I turn over a cup in my cart, I know that med was given, and I don't have to worry about it. I have a 60 bed unit, and get pulled away a lot. I find this works best for me. If I have different meds, antibotics or such, I then flag them with a different colored sticky, just to make sure that I don't miss the odd pills that come up from time to time.