Nine Or More Meds?

Specialties MDS

Published

Hello all my wonderful MDS friends,

Could someone share with me, their Care Plan for a resident on 9 or more meds? Our's is almost not there, lol, a bit embaressing. LOL

Thank you for helping me

Debbie in NY

Specializes in Gerontology, Med surg, Home Health.

Why in the world would you care plan for 9 or more meds? It's not a RAP...most people take at least that many. You should only care plan if it's a problem or a potential problem.

I so totaly hear that, but it comes up on our QI's, so the DON wants us to have CP in all charts . Extra work, but what makes "DON" happy makes everyone "Happy".....LOL

Have a great weekend

Debbie

Specializes in Long-term care, home health.

It's really an alert to assess residents for polypharmacy- do the residents REALLY need all those meds? We cover it with the pharmacist's monthly review- he has a special form for this documentation.

Specializes in LTC & MDS Coordinator.

I don't care plan for this either. We document in our care plan meeting notes that......Res. cont. on # meds, meds are reviewed q month by MD and cont. to be necessarry to treat mult. Dx. We also have the MD doc. q month on rounds to support us if he can't d/c any meds.

Try to suggest an alternative to your DON. Explain that it is not needed for RAP and you are still documenting in the med. record etc.

Is the problem of concern to the resident?

The care plan is not for--staff problems, DN problems, surveyor problems, lab tests, diagnoses, etc.

Don't think I ever heard a resident say "I have an ADL functional decline" or "I'm here for treatment of QI9meds" or "I'm S/P ORIF". :grn:

Specializes in LTC, sub-acute, MDS.

so right! we should be care-planning for the resident, not the staff, the qi’s or the surveyors….but this is what’s happening everywhere, and debbie is right….coordinators are expected to, and instructed to care plan anything and everything whether a problem or a potential problem, or not a problem! it has become a tedious, all day long, never-ending job, and in many cases, without team participation. whenever the resident farts, the first question to the mds coordinator….”did you put a care plan in for that???? did the resident smoke 20 years ago? better care plan that! did the resident complain about a staff member?? better care plan that they are uncooperative and non-compliant!! were they sad and crying 15 minutes ago??? better call psych...and don't forget the care plan! we care plan the disease, the fall, the behavior, the mood, the med, the splint, the meal…and on and on, without really identifying if it is an actual problem for the resident…all to cover our butts….and please the surveyors’.:angryfire

Specializes in Acute Care/ LTC.

All i do is make sure that any major meds are included in the appropriate care plan. EX: atb for infection, or diuretic for edema,or bleed risk for anticoagulant etc etc. as far as QI/QM i make sure all dx are current, match the reason for the drugs, and make sure there aren't any unnecessary dublicates. of course this involves discussion with their physician if needed. i don't see a need to do a specific care plan just for 9 or more meds.

Thank you so much Lisa. :yeah: You are so right, some where along the line the true meaning of care planning was lost, now it's all CYA. I am just as annoyed when the DON wants to CP something totally off the wall, but she tells me, she has been a nurse for 38 years, and is the way she wants it.:confused:

so right! we should be care-planning for the resident, not the staff, the qi's or the surveyors....but this is what's happening everywhere, and debbie is right....coordinators are expected to, and instructed to care plan anything and everything whether a problem or a potential problem, or not a problem! it has become a tedious, all day long, never-ending job, and in many cases, without team participation. whenever the resident farts, the first question to the mds coordinator...."did you put a care plan in for that???? did the resident smoke 20 years ago? better care plan that! did the resident complain about a staff member?? better care plan that they are uncooperative and non-compliant!! were they sad and crying 15 minutes ago??? better call psych...and don't forget the care plan! we care plan the disease, the fall, the behavior, the mood, the med, the splint, the meal...and on and on, without really identifying if it is an actual problem for the resident...all to cover our butts....and please the surveyors'.:angryfire

:yeah::yeah::yeah::yeah::yeah::yeah:

i laughed out loud!! so funny and true!

We have to careplan for this as well. This is a quality indicator and if it is not careplanned you are likely to get a tag. At least here in Kansas. My careplan goes something like this; problem: Potential for complications related to multiple dx's as evidenced by recieves greater than nine medications routinely. Goal; Mr. so and so will recieve therapeutic effect of all medications and will have no adverse effects. Approaches: pharmd to review meds monthly (in ks); observe for s/s that may be indicative of adverse effect; labs as ordered; vs as ordered; any special instructions such as rinsing mouth or take with 8 oz. of water etc. Hope this helps

Specializes in LTC, Hospice, Case Management.
We have to careplan for this as well. This is a quality indicator and if it is not careplanned you are likely to get a tag.

I have never heard of careplanning an issue because it is a quality indicator??? I thought we careplanned an issue because it is or potentially is a problem for the resident!

We often careplan our high risk meds (insulins, coumadin, psychotropics, htn if unstable, etc), but otherwise, that is just silly and a waste of time.

But, it is interesting to see how others look at/do things.

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