ALF resident out for the day without meds

[311ltc]

I have a resident who's family takes them out for the day on the weekend, but hasn't been taking her meds with them. I work 2nd shift so, I found out they doesn't have the meds when I come on. I spoke with the family member and said that the meds should go with the resident. I was told by the family member that they had been told they didn't need to take the meds with them, that the meds would be given when the resident returns. The resident doesn't usually return until 8-9pm. So they haven't had any of their 5pm meds, which included oral diabetic meds.

Where does that leave me? It's my understanding that since it is so far past the ordered time that I can't give the meds. Can a med be given that late if it's only a once a day med? Is it a med error? Who's error? If I give the meds am I out of compliance, if I don't give the meds am I out of compliance? Is there any lead way for discretion in this situation? Is it a black and white issue or is a gray area?

Thanks for any input.

[VivaLasViejas, ASN, RN]

It's a gray area. There are a lot of variables here; in your place, I would have given the once-daily meds when the resident arrived back at the facility and documented why they were given at that hour. I also would send a fax to the resident's PCP as to the fact that they weren't given in a timely fashion and what is being done to correct the problem.

What I want to know is, WHO told the family that they don't need to take the meds with them when they're going to be keeping the resident out well past the time they are due? (My guess is, it was a med aide who didn't want to be bothered with punching them out and putting them in an envelope for the resident to take with them.) Your DON will also want to know about this, because it's her responsibility to oversee the medication administration process at the facility and ensure that it's done safely and legally.

[morte, LPN, LVN]

actually this would be considered dispensing.....the meds for leaves need to come from the pharmacy, labeled with what and how to give......and given to the responsible party when the patient leaves the institution

[Not_A_Hat_Person, RN]

This happens at my ALF quite a bit. I tell the families to give some advance notice before they go out for the day, so we can pack up the meds ahead of time. Then I give the once-a-day meds late and chart them as "resident unavailable."