Flexible med times

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Specializes in LTC.

I tried searching for this topic and didn't come up with much. If you know of an existing thread already, let me know.

Our facility is going to be implementing a more flexible med time schedule pretty soon. We currently have traditional med times like 8am, 11am, 5pm etc. We are going to move into an 'am' 'pm' and 'hs' med pass soon. so instead of a med being due at 8am (really 7-9am) it will be due between during the 'am' pass (7am and noon, or something similar). I wondered if any one else has been doing this. Do you like it? I think it will make my routine more flexible but i worry about the med pass taking up the whole day.

How do you handle bid/tid meds? Is there anything that is still on a strict schedule? Do you give antibiotics on the flexible schedule or at the same time each day?

Thanks for your thoughts.

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Specializes in Gerontology, Med surg, Home Health.

With the blessing of both medical directors, we have recently started this. Our once a day meds are scheduled for anytime between 6am and 1145 am. Unfortunately, that's as far as we've gotten. Still working on the 2 x's a day and 3 x's a day. The staff love it. The residents love it...I'll let you know what the DPH has to say when we have our survey.

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I love the idea of it. Nothing like waking up a resident for a breathing tx or a vitamin when they are already sleeping. If they had AM, NOON, PM, HS - they could do the BID, TID meds as long as the nurse passing meds was aware of what was to come instead of blindly giving out meds.

They could do, for example, sinemet early PM and HS successfully.

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Our Am pass is 8-10 (7-11 really) and HS med pass is also 8-10. Since they are 12 hrs apart it isn't a problem for bid meds. We also have noon and supper meds/insulin. Our computer EMAR will also allow very specific times if necessary which we add to the medication administration notes. It works out very well. The seasoned/experienced nurses love the flexibility and the new nurses need the extra time to get all the meds passed anyhow.

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Specializes in Gerontology, Med surg, Home Health.

Mn nurse...thanks for that post! I think we'll try the change for the 2x's daily meds next week.

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We do something like that for most meds. AM pass is like 7-11. Not sure about the specific PM and HS pass times as I don't work that shift.

If its an antibiotic or whatever we are able to put specific times in. BID meds (unless there is a need to have them widely spaced apart) are given during AM and PM pass.

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Our facility has been doing this for a while. Our med pass times are:

Upon Rising (UR) 6am-10am

Prior to Bed (PB) 6pm-10pm

QD: UR

HS/PM: PB

BID: UR PB

TID: UR 2P PB

QID: UR 12P 4P PB

Q12 hours: 6A 6P

Q8 hours: 6A 2P 10P

Q6 hours: 6A 12P 6P 12A

AC: 7A 11A 4P

PC: 9A 1P 6P

SYNTHROID: 6A

FOSAMAX: UR

ACTONEL: UR

COUMADIN: PB

This works well for us and everyone knows when to give meds. There is consistency and nobody is blindly giving out meds.

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We have started changing synthroid to 1600. Before supper so on empty stomach, but then we don't have to wake them at 0600 for one pill. Would welcome some feedback if anyone thinks we shouldn't be doing this? Thanks

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Specializes in LTC.
Our facility has been doing this for a while. Our med pass times are:

Upon Rising (UR) 6am-10am

Prior to Bed (PB) 6pm-10pm

QD: UR

HS/PM: PB

BID: UR PB

TID: UR 2P PB

QID: UR 12P 4P PB

Q12 hours: 6A 6P

Q8 hours: 6A 2P 10P

Q6 hours: 6A 12P 6P 12A

AC: 7A 11A 4P

PC: 9A 1P 6P

SYNTHROID: 6A

FOSAMAX: UR

ACTONEL: UR

COUMADIN: PB

This works well for us and everyone knows when to give meds. There is consistency and nobody is blindly giving out meds.

I would love to see our facility start doing this. This would give so much flexibility to the one giving meds. That way you wouldn't be waking residents up to give HS meds. On the evening shift we have one person to pass meds to 44 residents. (plus a charge nurse to do treatments).

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Micki72 that looks like a great schedule. Thanks for sharing. We will be implementing EMAR in 3 weeks and have been trying to figure out flexible scheduling. :) Glad it is going well for your facility.

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Mn nurse...With UR med pass times, you could give all UR meds with the 0600 meds & wouldn't be waking someone for just a synthroid or an omeprazole.

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