med administration by DSP's

Good question- I have not yet explored the MAR application in Therap; my agency is still rolling it out. I have general concerns about Unlicensed Assistive Personal (UAPs) giving meds. How much is the RN considered to be responsible for the adherance to non-RN agency training by UAPs? I certainly correct and intervene proactively when I see bad practice... it is just that that happens so darn much!

Also- who is doing the actual transcribing of the orders into the Therap datebase? Is there RN oversight in this process?

Good questions Larrythenurse. The UAP's in my group homes administer medication using the three-way check method, however we do not use Therap. But I would be interested to hear how this is working because other agencies in my area are using Therap and the idea has definitely been discussed at my facility.

Thanks for the feedback everyone. I am still investigating this . We have no plans on using the MARs in Therap for now as the program needs to have some drastic changes before it will be user friendly for the DSP's. Currently in our program , I as the RN train all the staff in medication administration. Here in ND our DSP's have to be module certified through our Center for Disabilities, and we obtain all materials from them. The module certification is nice, because you know they have had some good training but like life, people do want they want with the information they have. So errors still happen and it is frustrating.

I'm in residential and we use the MARs. My company is backwards so I don't see anything changing with this.

Larrythenurse, at first I was very uncertain about people being able to give medications under my license but this is how it goes. They are required to take a 5 day class and pass 3 exams with 80%. Then I schedule 3 separate medication passes with them. Inbetween I am evil and ask them a million questions about medications, side effects, proper administration, etc. They are recertified yearly; one day class, one exam, one medication pass. Additionally, I come during medication passes without them knowing just to check in. After all is said and done, I feel they are well trained and if a error is made, it lies on them and not me and my license...

I was a residential staff who was med cert before becoming a nurse. My agency is in the works of putting their MAR's on Therap. I will let you know any info when that change occurs. Im curious to know how would that work with new orders that have to start stat or even cutting out that last check. In my state the UAPs are recertified q 2 years and do an annually pass and pour with the RN. My grouphome is pretty good with the meds and have very few med errors ( thank goodness)

We don't use Therap, and the MD orders aren't available in home. Our MAR lists the med, dose, time, and indication, which the DSP check three times against the med cards (blister packs) which list all of the same information except the indication.

Two nurses check the meds in and compare MAR, label, and orders prior to meds being sent to homes. It's pretty straightforward, and works well for us. Virtually all of our errors are of the "Whoops forgot to sign" variety. We also create our own MAR, so they're quite customized. BTW, we stock one calendar month at a time.

We also re-cert them annually, and do Q6 month med passes, as well as in-person error counseling. And we pound into their heads that they should call with any questions, or if they find any mistakes.