AM PM Med Pass

mrfrost · Dec 20, 2012

Your facility must have a medication administration schedule in place. Depending on size of your facility. So you can stay in compliance with your med pass.

You have to have a time policy in effect for each unit.

The only way we give meds different than this schedule is for residents that have an order to give certain meds at times other than scheduled med pass.

BTW, my synthroids are given at 0600(by 10/6), coumadins at 1700.

ABT are given according to order, QD, BID,TID, w/food, etc.

CapeCodMermaid, RN · Dec 20, 2012

I've never heard this HAS to go through CQI. As long as the med is given per manufacturer recommendation, you're okay. My people hated waking up early to take their Synthroid on an empty stomach...so we changed the time to 9pm and they were all fine. I know people take Coumadin in the morning. We've always given it at 5pm or 7pm because that's when the lab results and then the MD orders came through.

LTCRN4LIFE · Dec 21, 2012

We give the Synthroid at 1100 and Coumadins at 8p for the same reason you list...but the idea behind the am and pm is the daily meds that are once a day or BID can be scheduled for am and pm then you are not having to worry about the hour leeway time.....it is done at facilities around this area....I'm in the Northeast. We have done the "staggered" schedule to try to keep the whole pass in compliance but really this way is better....when you have new nurses not aware that rooms 1-10 need their daily med sheduled for 8am but rooms 11-20 need it scheduled for 9am and then the MARS get messed up....you schedule them for "am" and you can give those am meds anytime between 6a and 11am...its up to the person passing the meds....you also have to think about it this way....if that person was home they wouldnt faithfully take that morning colace at 8am on the dot.

It is perfectly acceptable and is the trend....I just thought maybe someone had done it and it would save me the weeding through all the CMS documents...okay.....blazing the trail...I'll let you know how it goes!

CapeCodMermaid, RN · Dec 21, 2012

I'm heading toward the "give once a day in the AM" myself now that DPH survey has come and gone. I know it can be done.

LTCRN4LIFE · Dec 24, 2012

I once saw the terms of how to change this....I need to get back on the hunt for it.

mrfrost · Dec 26, 2012

Well if it works for you and is allowed in your area, I would do it.

In my area we cant. My pharmacist consultant would have a stroke !

Trying to give meds in open blocks of time, we would never get everything passed out.

How many pt. do you have ? Do you med aides or med nurse? What is ratio of med admn. staff/pt. ?

Just curious.

Thanks

LTCRN4LIFE · Dec 27, 2012

Census 120 full. 4 units....30 residents per unit. Other facilities in my area have done it and it is okay. The reasoning is...not everyone takes their Vitamin at 8a, or 7a or 9a every day. If they were in their home they could take it once a day anytime. So in keeping with making this a "home-like" enviroment we are allowed to designate am or pm and give it then. Med Techs/Nurse like this better and I have done this also as a floor nurse. I like that if I get stopped up halfway through my med pass I can deal with the issue at hand and move on without being out of compliance.

I use med techs and LPN's for med passes.

bubblejet50 · Dec 27, 2012

There is one ltc in my area that blocks out a 4hr window for med passes and lets their residents naturally rise. They have never had a problem with it. I used to work ltc and there are times when my patient load was too much and since I was an lpn at the time I would be called to respond to urgent matters as well. My cart when full had 50 residents and that was near impossible to pass in 2hours!

mrfrost · Dec 27, 2012

Most med aides in this area have 60 residents each. Thay dont do anything but medications. My nurses handle PRNs. Never had a complaint from med aides. and they are always in compliance. Here, nurses have to order medications ( or reorders ) because MA cannot. Nurses have to do all transcriptions to MARs because MA cannot. All MAs have to do is pass meds. I can see the positives in open blocks of times to give meds. Just wouldnt work here. Some resdidents are too demanding with wanting their meds. I can imagine my MA on one hall with residents on another hall wanting their meds "right now". Talk about chaos. Dont want to be in the middle of that. But hey if it works.....

bubblejet50 · Dec 27, 2012

Most med aides in this area have 60 residents each. Thay dont do anything but medications. My nurses handle PRNs. Never had a complaint from med aides. and they are always in compliance. Here, nurses have to order medications ( or reorders ) because MA cannot. Nurses have to do all transcriptions to MARs because MA cannot. All MAs have to do is pass meds. I can see the positives in open blocks of times to give meds. Just wouldnt work here. Some resdidents are too demanding with wanting their meds. I can imagine my MA on one hall with residents on another hall wanting their meds "right now". Talk about chaos. Dont want to be in the middle of that. But hey if it works.....

That would have been much nicer! I had to assess any chest pains, SOB, etc for any resident on my cart, reorder meds, update MARS, admin all PRN's and I was expected to help the charge nurse and CNA's if needed. I stuck out my ltc experience for a year and then left and never looked back! I guess my old classmate who had the 4 hr block thing said it worked well for their facility. We moved all med passes for one of our two floors an hour back and boy did we hear about that one! Same with sleeping pills that were scheduled into night med pass...

LTCRN4LIFE · Jan 1, 2013

60 residents on a med pass....my staff would freak! They think they're overloaded now.