Would you prepour meds for nursing assistant to admin later?? - page 2
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... Read More
Jan 31, '07Occupation: Registered Nurse Specialty: Medical and general practice now LTC ; From: CA ; Joined: Feb '01; Posts: 63,971; Likes: 14,906No way, license and livelyhood at risk, just wouldn't take the risk
Jan 31, '07Joined: Jul '05; Posts: 66; Likes: 13the 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!Last edit by ICU_floater on Jan 31, '07
Jan 31, '07Joined: Oct '06; Posts: 230; Likes: 14No 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.
Jan 31, '07Joined: Dec '02; Posts: 41,761; Likes: 48,081No, 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 . . .
Jan 31, '07Occupation: ER Specialty: ER/AMS/OPD/UC ; Joined: Dec '06; Posts: 82; Likes: 16In 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.
Jan 31, '07Occupation: ER Specialty: ER/AMS/OPD/UC ; Joined: Dec '06; Posts: 82; Likes: 16Just 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.
Jan 31, '07Joined: Jan '04; Posts: 9,601; Likes: 3,188if 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
Jan 31, '07Specialty: 20 year(s) of experience ; From: CA ; Joined: Oct '04; Posts: 1,975; Likes: 254would 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?
Jan 31, '07Occupation: Nurse Consultant to a government agency Joined: Apr '03; Posts: 1,052; Likes: 806As 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.
Jan 31, '07Joined: Oct '04; Posts: 927; Likes: 588The 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.
Jan 31, '07Specialty: 15 year(s) of experience in Rehab, Med Surg, Home Care ; Joined: Mar '03; Posts: 1,129; Likes: 511A 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!
Jan 31, '07Occupation: Clinical Nurse Specialty: Neuro ; Joined: Mar '04; Posts: 814; Likes: 127I worked as a home health aide both in homes and in a retirement community (for assisted and independent residents). My only experience "passing meds" was a med. "reminder" service for some of the forgetful independents. The nurse set up the pill box weekly, and we would take the proper day's box to the resident's apartment at breakfast time and dinner time, knock on the door and remind them to take the pills. We could open the box (d/t arthritis/neuropathy concerns) but that was it. We could not "administer" the medication.
Similar rules applied for a few companionship cases I did where pts either had a pill box or just the bottles. I could remind them to take the meds, and open the bottles, but that was as far as I could go.
In these situations what I did was fine because the facility was not actually responsible for administering the meds for these patients. The patients were independent in that respect -- I just provided assistance with accessing the meds and reminders to do so at the proper time. When I worked in LTC and even for most of the ALF patients, my hands never touched meds and the nurses had them take the meds under their supervision.
Feb 1, '07Specialty: LTC ; Joined: Jan '07; Posts: 9There is no way I would feel comfortabel on either end of this deal. If I dont pull it I dont give it and I would not let an un-licensed staff administer meds for me! Tell your friend to find a new job!