Herbal medications in long term care

donmomofnine · Oct 21, 2004

We don't have a P&P..... as long as the physician orders them, we're okay! Many of our residents have used these supplements for years and we just get the MD to order their continuation.

Antikigirl, ASN, RN · Oct 25, 2004

We don't have a P&P..... as long as the physician orders them, we're okay! Many of our residents have used these supplements for years and we just get the MD to order their continuation.

Us too, and many residents INSIST on them far more than their other medication! If a doc orders it, they get it...but it is ordered though our pharmacy..so they, unfortunately, pay out the nose! They are not allowed to have them given to them if it is not from our pharmacy...so it isn't like they can get these from relatives or themselves from a discount Rx store or grocery store...really is unfair to them! I mean, glucosimine/chrondritan (sp? I am brain dead today..LOL) costs almost 3 times as much in our pharmacy then say COSTCO or RITEAID (on sale) for 1/4 of the pills...and that is exmemberve as is...and I can't recall a resident that isn't on it!!!!! (it is all the rage in our facility....).

Personally I think there should be a really good checks and balances there, and our pharmacy should really be aware of vits/supp that may cause probelms with medications. I have found people taking high volume potassium vits, while being on Klor con as well...throw in your lasix and dig...you have a rather large probelm! Or grapefruit pills (some rage about loosing weight and lowering cholesterol) conta with many meds! Or using tums for calcium supp, while on oscal and fosamax weekly...and a calcium channel blocker?!?!

It needs to be monitored better...and I am just one nurse, I can't do it all! (my charge nurse and I are working together doing chart/mar reviews and trying to catch these things as they happen or as we notice!).

willjc · Oct 25, 2004

thanks for your input our current policy states that there must be a written physicians order approving the product

-the resident or family can self-admin the desired product and the products will bediscouraged if the resident or family is unable or unavailble to safely admin.

- product must meet all federal or provincial laws and is registered for use

-the identity of the product is properly listed on the manufacturer's label

-the resident /family accepts any established/potential risks of adminitering the product

and the procedure is:

Residents / families may choose to self admin. herbal medications/alternative therapies if:

- the resident/family administers and supplies the medical product. Realizing when the resident/family is unable to admin the medical product will not be given.

-in the event that the resident/family insists on taking this product against the advice of a physician, which has been documented on the resident's chart, a waiver will have to be sighned and a copy kept in the medical record.

-the product is maintained in a secure area by the resident/family for the protection of other residents and the public.

-self administered herbal meds or other alternative therapies are to listed on the resident's chart on the Self-admin. of Medication Monitoring form and filed with the medication record!

Whew!!! Thats about it in a nut shell! LOL

willjc · Oct 25, 2004

don't know that I would want to change anything about this policy!

what do u think?

Antikigirl, ASN, RN · Oct 25, 2004

Maybe something about having to have the residents name on the medication??? That can be helpful if all the sudden that med shows up in another residents room because a resident suggested a friend trys it...(I have run into this before, and with LASIX for loosing weight once...oh scared the heck out of me!!!! We sent her into the ER by MD order because the patient said she took 3 80mg doses that day because she wanted to loose all her water weight that day! EEEEKKKKKKK!!!!!!!...took us forever to find the 'donator'. That is why our residents are basically mandated to have med admin by staff only).

payday · Oct 25, 2004

We were able to purchase these at the drug store of our choice for my MIL but the pharmacist had to have an order and it had to be labeled by a pharmacist. They were ok with it--money for them.

payday · Oct 25, 2004

forgot to mention. only staff could dispense medications.