med passing

LilRedRN1973 · Nov 15, 2003

In our state (NV) you must be at least an LPN to pass meds. CNA's are not even allowed to apply ointments and such. I am not sure who is responsible..maybe the one or two RN's on duty?

Todd SPN · Nov 15, 2003

Originally posted by need answers
Hi, I'm new to this. I do have some questions about working at assistant living, for a county home. Who is allowed to pass out meds to the residents? Do you have to be a STNA in the state of Ohio to do this? Who is liable if the wrong meds are given out to the wrong resident? Any feed back would be helpful. Thank you

I have worked as an aide at 3 AL homes. One had a LPN on duty 24/7, so we never passed meds. One AL was attached to a SNF unit who always had a nurse on duty. However, I had one resident that always woke up at 0200 complaining of pain and requesting her prn. I would then have to call the SNF and sometimes it would take the nurse an hour to show up. All the while the resident was complaining. It was decided that I would be allowed to give this med to the resident. A facility RN explained to me what I needed to know about the med, when it should be given, how to chart it etc. This info discussed was written down on paper with the date and both RN and I signed it. In my state (WA), this must be done and done by an RN. The last AL, we were responsible for passing meds. We took an 8 hour course that ended with a test. This was done by the facility LPN, which we were told had been instructed by the RN on what to cover etc. Basically, all we covered were the 5 Rs and how to dispense (pop the bubble pak, don't touch the med). Interestingly, we were not allowed to apply ointments. IMO, this system was very poor. Mistakes were made. Once, a NA poured some DOSS, turned her back after setting in on the counter, a resident who the med was not meant for walked by, grabbed the cup and downed it. The NA was held accountable, but shouldn't have been as not letting the med out of your eyesight was not covered in the class. The RN is ultimately responsible, but you will be held liable for any errors or omissions on your part that you were trained in. (A good reason to carry Liability Insurance.) To find out your state requirements, find out what your facility is licensed as (boarding home etc), find the phone number for those responsible for that classification and give them a call.

AndiMac · Dec 7, 2003

Hi, I'm an LPN at an assisted living home here in the Buckeye State (Go Bucks!). We have 2 units, one for regular residents, and where I work, the Alzeimer's Unit. The regular residents, most generally care for themselves. Most of them have their pills filled by a nurse in a dated and timed pill box for the week. The aides are to remind certain people that need a little more help, that it is time for them to take their meds. There are a few that require a little more. Our meds come in ATC rolls (the rolls are timed and dated for Mon.-Fri. and 8a, 12p, 4p etc), the aides are allowed to get these medications packets out and hand them to the resident, but that's all. The patient has to open them him/herself, and if they decide not to take them, it's their problem. Since it's assisted living, it works a little different. The aide can not actually put the meds into that person's hand/cup and give them to them with a glass of water and say here take them. They have to be un-opened in the packet. That's the rule for us. That's considered a pill reminder, and they are billed for it. You're facility may be different, considering we are a home consisting of 30-35 residents total, both units.

In the Alzheimer's unit, the nurses are to give the meds, simply because these people can't. So, I deal with it.

As far as who's responsible, good question. Since ours are pre-filled packets, and are checked by a nurse for the whole week, and the fact that the aide does not have access to the MAR, I really don't know. I would think in our facility there would be a lot of people in some deep water.

Hope that helped some.

perfectbluebuildings, BSN, RN · Jan 26, 2004

I think a facility that I once worked in would be in possible trouble also (this has been several years ago so the facility may have mended its ways by now and I don't know the exact laws in that state anyway...).

The LPN in charge had the residents' meds in labeled packets for day and time, with each residents' meds in their own drawer, and the PRNs written what they were PRN for and how often they could be taken, etc., in the MAR, along with the regular meds. The LPN gave the meds during the day on weekdays (7-4, I think, or thereabouts).

At all times when the LPN was not there, the CNAs and myself and a few others who like me were completely uncertified, labeled RAs (resident assistants), would be responsible for giving out the meds including PRNs and narcotics, and signing off in the MAR. Since I usually worked the evening shift this meant suppertime and bedtime meds. As well as give eyedrops and ointments and even a couple suppositories once or twice. No injections, though.

I do not know who would be legally responsible in this case if a wrong med were given or if a med were forgotten. It is also kind of a different situation because we did not have to find and count all the meds for the patient, except to measure some liquids; they were already in the packet.

At that time I was an ignorant high school student, and did not realize the implications of this, just thought it was the usual way until I arrived at nursing school and we were taught all the serious implications of passing meds! I did know a lot more about a MAR when we started that segment of class than a lot of the other students, but I do not know if that was a good thing or not! I would cringe in horror now to have that system of passing meds in a facility where I worked!! :eek:

Wow, sorry, I got kind of long-winded here...:imbar