Would you prepour meds for nursing assistant to admin later??

[Kashia]

An assisted living facility I know of asks nurses to prepour medications and leave them for a nursing assistant to admin later. They ( the facility) states it is legal for nurse to prepour and leave med's but not for the NA to pour herself. So my question concerns the legality for the lic nurses ( RN or LVN) I told my nurse friend think it is illegal but asking the minds here on Allnurses..

thank you

Recent post:

Thank all of you for these replies- I omitted information this was an assisted living facility but many of you picked up on that anyways. I have opted to not work at this facility any longer because I simply do not feel comfortable leaving meds up in a cupboard for CNA to dispense in morning. I figure they can make another arrangment or provide additional training to the CNA's...so it is legal and I am not responsible for the medications being given. I am not the only nurse to have left for this reason.

[Marie_LPN, RN, LPN, RN]

Heck no.

I like having my nursing license.

[Silverdragon102, BSN]

No way, license and livelyhood at risk, just wouldn't take the risk

[ICU_floater]

the rules for this DO vary in a group home setting, where the RN sets up meds and an aide, who has passed a med training course delivers the meds, with the 5 rights and signs their own name to the chart. I used to teach this course. If this is a course through people inc. it meets JCAHO standards and I'd bet there are nurses out there who'd fail it. It's VERY tough and these "medication assistants" take it as seriously as RN's do. Your point of liability ends with dosing. The rest is signed off seperatly ,

I know a crazy concept in this setting, but it works, because these health care providers know their patients too!

[lauralassie]

No way ...no how , would I do that. I wouldn't pre pour med either. Good way to loose a nurseing license! Sound like the admin of that ltc facility needs a wake up call.

[Spidey's mom, ADN, BSN, RN]

No, it is an accident waiting to happen.

How many thousands of med errors already exist and are written about every year???!!!

It is crazy to ask staff to do this . . .

steph

[scrubsnhugsRN]

In the state of Alaska, cna's pass meds under a nurses lisence. I know this because I was a cna dispencing medications and passing them. I was given an 8 hour class on hour to properly dispence medications from thier contaniers and how to properly give them to the correct patients and document it.

This was in an assisted living facility. Did I know what all those medications were for and how they worked or what to look for......nope, unless I looked them up myself, which I did alot, nobody expected me too though.

Is it right? Nope, did I get paid more as a cna who was doing med pass, nope. This was one of the reasons I went into nursing. I thought it was ridiculous that I was allowed to pass meds, I knew I was taking a nurse's job, namely a LPN, who would have some knowledge behind her (him), plus I wasn't getting paid for it.

Not all the cna's were allowed to pass meds.

So do I think it is okay, nope, I sure do not, I dont think CNA's should be expected to have additional responsibilities placed upon them, thier work is demanding enough. If it is ultimatly under the nurses lisence then let the nurse do it.

[scrubsnhugsRN]

Just for clarification sake I was not a AMAP, I was a CNA, I did not go through a program that certified me for med pass. I was instructed for 8 hours by my RN who taught me how to document, and pass medications properly. What paperwork she submitted to the state I am unsure of, all I know is that I safely passed medications to the residents. Thier meds very rarely changed and I knew the

residents, even so, I did not have the knowledge base that an LPN or RN has, and even then I knew that.

[CHATSDALE]

if state inspectors find a prepoured medication, even if nurse is intending to give it, it is a serious med error state walked in one morning at 5a and found night nurse with 6a meds all lined up in a row and she and the facility were written up

never rust anyone else to give a med...even if there is no mistake in med or pt the pt may be exhibiting sx that you would want to hold med

if the ptb insist that this procedure be followed, find another place to work

it is easier to find a new job than to defend your license to a board and probably lose the fight

[GingerSue]

would not ask another staff to administer a med that I had prepared -

how would I know if it was actually given?

how do I know if it was given to the right patient?

how would I know if the staff even checked ID?

how can I sign that it was given without seeing it happen?

what would any nurse say to a lawyer about this?

[Quickbeam, BSN, RN]

As bizarre as I find this practice, I've run across it several times in my nursing career. I've seen it most often in facilities that want more from their night staff. Someone gets the brilliant idea to have the night nurse pre-pour the day meds. I think it is stupid all the way around, and unsafe.

Home health or assisted living is a different situation. So is patient teaching for discharge. As a pediatric RN we'd often have family members "take charge" of medications so that we had a chance to observe that they knew what to do.

[lovingtheunloved, ASN, RN]

The rules in ALFs are different from LTC. In some places pretty much any caregiver can dispense medication, extra education or not. Some ALFs don't even employ licensed nurses. However, I'm pretty sure the person who prepares it has to give it, whether they are a nurse, CNA or whatever.

[Chaya, ASN, RN]

A few years back when I had a clinical in Homecare my preceptor had a couple of pts who used those multi-compartment dispensers for their meds (you know the type; Sun AM/ Sun PM, etc). She would pre-fill them on a weekly basis for some of the pts and some pts would have them pre-filled by a local pharmacist. I think the difference here might be that for the most part the meds were taken by the pt themself at the appropriate time, or dispensed by a family member. I'm not sure of that. I do know that many practices not appropriate for a facility were commonplace in Homecare. I know some ALF's were requiring residents to contract with a Homecare agency if skilled nursing was needed so dispensing meds might be a grey area in that case. However if I were an employee of the facility there would be no way I would pre-dispense meds to be administered by another employee!