Preventing med errors in LTC...

  1. I'm really concerned about this. I'm a new grad LPN. I've been orienting at my first job for two weeks now. I'll start working 11-7 next week (I've been on days so far) and I still don't know all 40 residents that I'll be responsible for by name. It's a lot to take in and remember. They should all be in their beds with their names outside on the wall when I go out on my own but I can see how it would be easy to get distracted and confused.

    It's just so different from where we did clinical at the hospital. There were name bands and most of the patients were able to give you their name and DOB. Any helpful tips?
    •  
  2. 15 Comments

  3. by   nurse0520
    dont they have a picture of them in their chart? the ltc I used to work at did, even the ltc i did my clinicals at did.
  4. by   arw979
    Never be to Proud to ask another staff member "is this Mr. John Doe" until you remember faces of the residents. Then there is the problem you will incurr if you work a different shift then nights that some residents look totally different up and awake then asleep in the bed. You will get the hang of it. BEST WISHES
  5. by   kcochrane
    I had to float alot when I worked LTC and I always asked other staff - especially CNAs. The CNAs know their residents well. That is of course unless they have been floated and/or are agency. We had pictures, but many times a resident would look much different than the pictures. Some have name tags on their wheelchairs, but they could have the wrong wheelchair.

    Keep with it, it does get easier with time. After awhile I knew my residents like the back of my hand.
  6. by   wifeandmomoftwo
    The pictures aren't always a good guide. So many have lost weight and such. Also it is going to be dark in the room so I'll mostly be going by what's on the wall. I just wish I could ask them and get a reliable answer.
  7. by   CoffeeRTC
    Ask the resident, ask staff, ask family if they are there. Never be afraid to ask.
    Ask the DON if they can update the pictures and name tags. That was one of our duties on 11-7....make new arm bands as needed.
  8. by   Sparrowhawk
    Ask your aides....like the above poster said. I started my first new grad job in LTC...on nights...it'll take you awhile, but your aides are a WEALTH of information...they know who they are, if they're acting right or not...ALWAYS listen to them! A lot of the time they catch things we don't since we have 20-40 residents to care for on a shift. Don't ever be afraid to ask. What med pass will you be doing? At 0600 most residents are being gotten up...the rest of the night are PRNs...
  9. by   coast2coast
    Don't assume that just because they're in the room/bed they are the resident who belongs there ... I took care of some wanderers in my time, and if you asked them "Are you Nancy Smith?" they'd go "YEP!" and swallow any pills you gave them.

    Get some updated photos! ASK! Residents can be far more devious than you expect.
  10. by   CapeCodMermaid
    They shouldn't be getting any meds during the night. People need to sleep. Unless you have a lot of diabetics there shouldn't be too many fingersticks at that hour of the day either. One of these days, we'll stop scheduling meds for our own convenience and schedule them when it's best for the resident.
  11. by   scoochy
    Quote from CapeCodMermaid
    They shouldn't be getting any meds during the night. People need to sleep. Unless you have a lot of diabetics there shouldn't be too many fingersticks at that hour of the day either. One of these days, we'll stop scheduling meds for our own convenience and schedule them when it's best for the resident.
    You've got that right!
  12. by   Selene006
    While you're working the day shift, try to familiarize yourself as best as you can with the residents. The patients that were easiest for me to remember were the ones that I could interact with and quickly learn their mannerisms. Rarely did patients wear name bands in the LTC wing that I worked--except for when there was a possibility that DPH could make their rounds...Our med books had photos, but like yours, the photos were always out of date. So I relied on the CNA's to help me with identification. Often times, some patients who were confused wandered into different bedrooms and could be found lying in someone else's bed. Find out who your wanderers are and keep that in mind when you're giving meds.
  13. by   systoly
    Your 11-7 med pass should be very light, however, most of your meds will probably be due towards the end of the shift which is usually a busy time (phone ringing, rounds, labs, etc). The CNAs will most likely be very busy during this time too, so my suggestion is to look at the 11-7 med pass and familiarize yourself with those residents and do make sure you get some orientation on the shift that you will actually be working.
  14. by   diddo
    I have found some med passes like this. I find it helpful as a reminder to myself, to slow down and do three checks. The GNA's are a wealth of knowledge, also sometimes patient's have labeled clothing, and some patien'ts do help by saying oh that's so and so. Also it is helpful to have a convenient list for yourself of physical characteristics, ex, eye glasses, if they wear oxygen etc. Good luck, I also do ltc and work with Alzheimer patients..

close