1 hour window on med pass times...

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I've read several posts describing the 1 hour window on the scheduled med pass time as being 1 hour before or one hour after. I believe this is wrong, it is 30 minutes before or 30 minutes after! Secondly, if Residents want (and are used to) getting their 20:00 meds at dinner, the nurse should send the physician a communication fax asking to change the scheduled time to 18:00. They will usually oblige this if the Resident wants them at that time and as long as it isn't a TID med which cant be given too close together anyway! These points will help keep you in compliance. Otherwise what in the world will you do if someone falls after having BP meds too early or when state is in house? :notgood:

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You are incorrect. It's one hour before to one hour after, but all of those windows are solely a facility policy issue and not a regulatory one. Most of the scheduled times are pharmacy generated defaults that are guided by facility policy, not actual times the MD thought to order. Outside LTC, you can often get the pharmacy to change the scheduled time without ever speaking with the physician.

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Specializes in MICU.
I've read several posts describing the 1 hour window on the scheduled med pass time as being 1 hour before or one hour after. I believe this is wrong, it is 30 minutes before or 30 minutes after! Secondly, if Residents want (and are used to) getting their 20:00 meds at dinner, the nurse should send the physician a communication fax asking to change the scheduled time to 18:00. They will usually oblige this if the Resident wants them at that time and as long as it isn't a TID med which cant be given too close together anyway! These points will help keep you in compliance. Otherwise what in the world will you do if someone falls after having BP meds too early or when state is in house? :notgood:

in nclex world it is 30 min window

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Frequency of administration and times are set by the provider not the pharmacy unless (s )he just states tid or am\pm. The provider can order a change in scheduling.

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Specializes in ortho, hospice volunteer, psych,.

The pharmacist can change most med orders to fit the patient's at-home schedule. For example, I take Keppra 1000 mg. for partial complex seizures. I also take Neurontin as an add-on drug. I take the standard adult dosage, which works like nothing else ever has before. It is usually given in two equal dosages of 500 mg. first thing in the morning and the second dose at HS.

For me, that had to be adjusted somewhat because the entire morning dose makes me very very dizzy, nauseated, gives m a bad headache, and makes me feel generally yuck. There was a very simple solution. On my own, I tried 250 mg. when I got up, then

took the other 250 mg. with lunch or a little bit earlier or later. My neuro said if that schedule worked for me, great. It would be ordered the usual way if I were hospitalized but it would be simple to change it.

I worked in a state psych hospital for years and we often encountered patients who had always been night owls and that didn't change simply because they had been hospitalized. While some patients received their HS meds about 20:00, others got their meds nearer 23:00 or midnight. You have an hour on one side or the other of the ordered time. A little bit of wiggle room is essential because patients get taken to therapy or have tests scheduled, etc. and aren't always where you think they should be exactly when the meds are due.

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Specializes in LTC.

If someone told me I had 1 hour (30 min before/after) to complete my zoo of a med pass I'd laugh. If I finish in 2 1/2 hours thats a good day.

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Frequency of administration and times are set by the provider not the pharmacy unless (s )he just states tid or am\pm. The provider can order a change in scheduling.

You are incorrect. Frequency is obviously prescribed by the physician, but the actual literal schedule times are part of a pharmacy protocol that often times the pharmacy can change without direct permission of the MD.

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VanNurse I understand what youre saying but I dont believe the pharmacy will change a BP med or scheduled narcotic from HS to 1800, I may be wrong but we're talking about those who are combining HS and 1800 med passes and being in compliance.

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Specializes in LTC,Hospice/palliative care,acute care.

Per the DOH it is a two hour window for med admin. The facility sets their policy, the consulting pharmacy will make recommendations, they can't just change the times,not in our facility. The physician can concur or refuse those recommendations. Med admin times should be individualized for each resident. Our dementia residents often won't accept meds after they are in bed and have been asleep ,the doc will agree to change the BID meds from 9a and 9p to 9 a and 6p to facilitate acceptance. HS meds are often ordered for 7 pm for those early to bed people. Eye drops can be admin during the normal bedtime hours for the dementia folks who can not follow directions and open their eyes. When we are assessing B/P meds we will do b/p checks for a week or so.If a resident falls vital signs are part of the assessment. Frequent falls may warrant a med review by the consulting pharmacist in addition to any other appropriate recommendations.

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Specializes in Gerontology, Med surg, Home Health.

A medication scheduled for 9am can be given any time between 8am and 10am and be in compliance. Facilities, at least in Massachusetts, set the med schedule, not the pharmacy, not the doctor. Our once a day meds can be given any time between 6am and 11:45am. That is my facility policy. All the docs signed off on it. If a resident wants their meds at a particular time, we try to comply unless there is a clinical reason not to.

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Specializes in Adult Internal Medicine.
A medication scheduled for 9am can be given any time between 8am and 10am and be in compliance. Facilities, at least in Massachusetts, set the med schedule, not the pharmacy, not the doctor. Our once a day meds can be given any time between 6am and 11:45am. That is my facility policy. All the docs signed off on it. If a resident wants their meds at a particular time, we try to comply unless there is a clinical reason not to.

Not to derail but I have to ask: in your facility a qhs med (once a day) can be given at 6-1145? Or is that just on meds ordered qd without instruction?

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Specializes in Gerontology, Med surg, Home Health.

Without instruction? Our docs write "Lasix 20 mg by mouth daily". Daily is daily.

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