Nine Or More Meds?

We have to careplan for this as well. This is a quality indicator and if it is not careplanned you are likely to get a tag. At least here in Kansas. My careplan goes something like this; problem: Potential for complications related to multiple dx's as evidenced by recieves greater than nine medications routinely. Goal; Mr. so and so will recieve therapeutic effect of all medications and will have no adverse effects. Approaches: pharmd to review meds monthly (in ks); observe for s/s that may be indicative of adverse effect; labs as ordered; vs as ordered; any special instructions such as rinsing mouth or take with 8 oz. of water etc. Hope this helps

I have never heard of careplanning an issue because it is a quality indicator??? I thought we careplanned an issue because it is or potentially is a problem for the resident!

We often careplan our high risk meds (insulins, coumadin, psychotropics, htn if unstable, etc), but otherwise, that is just silly and a waste of time.

But, it is interesting to see how others look at/do things.

You're right, we do careplan potential problems but taking nine or more medications does pose a potential problem, that's why it is a quality indicator. Not sure about other states - but Kansas wants to see this careplanned...if not there, they are likely to tag us. There are certainly alot of things that we careplan that are ridiculous. This may be one of them, if you do have to careplan this, I hope my post will help.

have not seen a farting careplan but I know a few DON's and admin's that need one

I've never been in a facility that got cited for not care planning 9 or more meds. Unless it's a problem, it doesn't need to be care planned. If something triggers on the MDS, you don't HAVE to care plan it if in the RAP you document your decision making process.

so funny today was doing rapkeys and looked back at the previous nurses careplans and what I did see but "resident is on 9 or more meds" anyway this resident is now on 5 meds this quarter.

Well, this is where the dumb blonde in me comes out. I just look up at the DON with cow eyes and say, "What should that care plan look like? I think I need to see an example of how you want that written." (This doesn't work as well as it did 35 years ago, but then she's stuck. How can she refuse to instruct you on what she wants done.) She writes on a blank care plan and you shove it in the 67% of charts in the facility, after "personalizing" it. I believe that was the national average on last month's QI-67% of our patients are on nine or more drugs. WE need to CARE PLAN the pharmaceutical companies.

lol - maybe we should careplan the drug reps that give all the docs those freebies lol that makes them choose the most expensive drug for our medicaid residents.