Do you send meds along on a Leave of Absence?

[DPRN]

I work in a long term care facility and more specifically, personal care. We have a question at our facility about what to do when a resident goes out for the day or overnight. Does your facility send a resident's meds out with the resident or play "catch up" upon return. We usually order specific leave of absence meds for our residents to take when they go out. The problem is that the families do not tell us ahead of time that they intend on taking their family member out. My question is about the packaging. Do you send the month supply that we get from the pharmacy or do you order an extra set of med specifically for the leave of absence. What do you send if a resident only uses the three month mail order pharmacies? Do your residents or families sign out that they are taking the meds? In PA, nurses are not allowed to repackage the meds to send out because we are not pharmacists. Please tell me how you handle the med issue so we can be better prepared for Christmas. Thank you!

[noc4senuf]

As of today, I am looking at how we dispense to families. Due to refill on demand and insurances, we won't always have the amount of needed meds in-house if they are going for an extended stay. But, by the end of the week, our bubble cards will be getting signed out to families. I will be speaking to the pharmacist on the PRN's though, esp the narcs. I also have an issue with coumadin as several of our residents get INR's drawn more than once weekly, and the dosages get changed.

[CapeCodMermaid, RN]

Do the people who go out on pass have medicaid? Private pay? In Massachusetts I think MassHealth will only pay for 10 days in total for the year for people who go out on pass (unless it's medical). And the way things are going, they really scrutinize the need for someone to live in a skilled facility.

[noc4senuf]

Payor sources are all over the board from private, medicaid, insurances. I believe MN limits the LOA's to somewhere around 35 overnights. Don't quote me but, that number sticks in my hea necause we have a problem with only one son who takes his mom out so much.... another whole story.

[ktwlpn, LPN]

Each state has diffent regs and the regs are different dependent upon the type of facility in which the resident resides (ltc vs assited living,etc) In Pa. LTC residents are entitled to 30 overnight LOA's before they may loose benefits. The Pa. Board of Pharmacy is opposed to nurses "dispensing" meds in LTC so we don't...We also don't send the residents own supply-our policy states we must order the neds for pass from the pharmacy. I can see this becoming an issue when a family forgets to notify us in advance for pass meds and demands all of the resident's meds-aren't they entitled to them? It's always something,you know?

[makes needs known]

Pharmacy prepares but they need 3 days notice.

[sasha2lady]

We got a form from our pharmacy called a LOA form....when a family comes in to take mom out for 2 nights we have to fill out this form..it has places on it for us to write in what the meds are, how many to give, when to give it ....and our meds all of them except OTCs come on cards....we get the cards of meds out and there is a place on the form that we write in the # of pills on each card that is sent with the family and a place that we write in when they return the # that they brought back. We dont send any OTC's, the family is responsible for getting those. Then, at the bottom of the form the nurse signs, then the family member signs it...we give them a copy, keep the original, and fax it to the pharmacy so that when the cards come back all out of whack and they need refills sooner ...they know why. The pharmacy's number is on the form as well as our number. With any narcs, we also send the card and on the narc sheet 2 nurses must sign both when they leave and when they return with the number of pills that were taken and returned. Other nurses , before we got this form from the pharmacy, used to pull the meds and put them in pill crushing packs and label it "am meds, pm meds, bedtime meds" etc etc......and these pills would be loose and unlabeled. I wouldnt send a resident home like that, but mind you this was when we got meds in boxes in little unit dose packs so each was labeled etc,......I left the meds in the original packs and divided them all up accordingly and separated them out by days also. Plus I gave a copy of the med list to the family so they'd know what was what also. The other nurses didnt do this....We only got the LOA forms after a day nurse sent home a MESS of meds and I had to call the family and have them to bring all that medicine back so that I could look at it......the nurse sent the wrong coumadins home with them....so I had to fix all that ...and 3 days and nights worth of meds were wasted and had to be trashed, not to mention she had not gone over any of it with the family about how to give them or what they were. It was a big mess...I suggest you get the DON to call the pharmacy and see if they have LOA forms...Id bet money they do. You probably dont have them because no ones asked for it...or you might have them and they dont get utilized.

[CapeCodMermaid, RN]

".I suggest you get the DON to call the pharmacy and see if they have LOA forms...'

Why does the DON have to call the pharmacy. Why can't one of you pick up the phone and ask?

[DPRN]

Thank you for the explanation. What a coincidence that I just created a form today for my residents to use for their LOA's. Administration has approved it today. We are going to send out the blister packs of meds and have the families sign out the blister pack of each med needed. The form that I created today will list each med being sent and the quantity that was sent out. Upon return, the nurse will sign each card back in making note of the number of meds returned. By the way, I am the DON of Personal Care at my facility. Thank you for your help! Merry Christmas!

We got a form from our pharmacy called a LOA form....when a family comes in to take mom out for 2 nights we have to fill out this form..it has places on it for us to write in what the meds are, how many to give, when to give it ....and our meds all of them except OTCs come on cards....we get the cards of meds out and there is a place on the form that we write in the # of pills on each card that is sent with the family and a place that we write in when they return the # that they brought back. We dont send any OTC's, the family is responsible for getting those. Then, at the bottom of the form the nurse signs, then the family member signs it...we give them a copy, keep the original, and fax it to the pharmacy so that when the cards come back all out of whack and they need refills sooner ...they know why. The pharmacy's number is on the form as well as our number. With any narcs, we also send the card and on the narc sheet 2 nurses must sign both when they leave and when they return with the number of pills that were taken and returned. Other nurses , before we got this form from the pharmacy, used to pull the meds and put them in pill crushing packs and label it "am meds, pm meds, bedtime meds" etc etc......and these pills would be loose and unlabeled. I wouldnt send a resident home like that, but mind you this was when we got meds in boxes in little unit dose packs so each was labeled etc,......I left the meds in the original packs and divided them all up accordingly and separated them out by days also. Plus I gave a copy of the med list to the family so they'd know what was what also. The other nurses didnt do this....We only got the LOA forms after a day nurse sent home a MESS of meds and I had to call the family and have them to bring all that medicine back so that I could look at it......the nurse sent the wrong coumadins home with them....so I had to fix all that ...and 3 days and nights worth of meds were wasted and had to be trashed, not to mention she had not gone over any of it with the family about how to give them or what they were. It was a big mess...I suggest you get the DON to call the pharmacy and see if they have LOA forms...Id bet money they do. You probably dont have them because no ones asked for it...or you might have them and they dont get utilized.