again, thank you for your responses!
that is if the med cart is locked then there needs to be an additional lockbox or drawer inside the general med storage area in which the controlled substances are kept. the lock to the room does not count as 1 lock is my understanding; i.e. locked room & locked cart still requires an additional lockbox or drawer inside the cart. in addition any personnel handling those meds should be documenting on a daily basis with another person the actual count of each controlled substance on hand.
super plan! i can start this today. we do lock the room, but i could also put the controlled stuff in the lock box installed inside the bottom of my carts. i keep my md's rx pads in there... never even thought of that! thank you. now- as for documenting counts daily- just don't know how feasible that is? i can't find legal requirements, either? some places (the er i work in- requires bid checks) and others, (nursing homes) count weekly....so it seems to be a personal choice of the facility. does the dea mandate a certain number of counts as far as you know? i could try to meet up with the cottage manager a few times a week so we could count the meds together- then we could see which staff were working if something did turn up missing?
i am not familiar with the licensing policies in your state but here in texas any unlicensed personnel assisting or administering meds must document on a sheet (what you call your tech mar) but i personally don't think you should be documenting any meds you do not actually administer.
i only document that i filled
the med boxes with the accurate medications for those days/times. the uap only documents that they gave
the medications that were in the box on that day/time. so, i am not documenting that i physically administered the med- the uap is initialing that they did (except during the day when i also initial the "tech mar", because i am physically giving the meds). i initial on my mar (uap's don't sign this) that i filled the med boxes per the physician's orders. i do the "right" person/dose/med/time part of med administration, then it is up to the uap to do the "right" person/ time/route. does that sound appropriate? i know there are many agencies that do not believe in medication dispensers, but after taking into account this facilities specific needs, i have decided it does, in fact, make medication passing safer. the blister packs were overwhelming for uaps, who then got nervous and made mistakes or just gave up passing meds all together...
count or inventory control logs are a good idea but if a non nursing person was trying to figure out who gave what med when two different mars would be very confusing to them.
uaps don't use the actual mar- just i do. they only initial the tech mar when they give a child the meds from the pocket of the dispenser that i filled using the actual mar. i keep track of both mars so it can be shown that i did, in fact, fill the box correctly and the uap did, in fact, administer the meds from the dispenser.
per training ideas if your state uses certified medication aides check with the regulatory agency who credentials them for curriculums.
i cannot find that we do use "certified medication aides"... from what i can tell the bon has been working on it for years, but never has actually created a plan? wy is the "cowboy state" and we tend to be the last place laws are instituted.... when i contacted the bon they said they saw no legal reason i shouldn't be training these uap's in my facility- and that maybe i should contact the board of pharmacy for suggestions on a decent training plan??? see? gray areas!!!or better yet if the school would hire or pay for cma training for the staff administering meds that would be great.....if your state has such a thing as a cma.
my "boss" is great and would have no problem paying for any training i thought we could use. i did find a training course established by the developmental disabilities division and the wy department of health called "medication assistance for unlicensed personnel" that was last updated sept. 09. i really like the info. in it, but it is super intensive. i would like to use it and have contacted them about what i need to do to get them here to train our staff or what i need to do to become "certified" to train my own staff, but i am still awaiting response (weeks!) i think i will start planning to train my staff using it anyways- it's not like there are laws about it!!!??? for craps sakes, how do i convince my boss to pay for this stuff it it isn't mandated and is available online??? maybe she could just write me a bonus check instead!!!ugggh.
it is also a good idea to have a list of common medical abbreviations, poison control number and an outline of how to give meds stored in the tech mar notebook as a quick reference. any med errors need to be documented on an incident form and i would suggest you in service that staff if they make a med error to include omitting meds. this shows you are monitoring, training and aware of what is happening.
i agree. i have even considered taking pictures of what each child's meds look like for quick reference in the book... but it would be much easier if drug manufacturers could agree on what a drug should always look like! (big pet-peeve). we do chart med errors on our "incident report" that includes what happened, who was contacted, how child was monitored, etc. i even found a developmental disabilities division site for submitting med errors electronically, so i am planning to contact them to be sure i should be doing that.