Medication error

if you have the hour window, you should be able to start an hour early as well-that's how we handle it at the hospital where I work. See if that is doable where you work, start a little early.....I feel for you guys in LTC, pass meds and run.

are you able to speak to the don or staff development about this issue?

See if some of the 8 am meds can be changed to 6 am or 8 pm if those med passes are lighter. If you are doing eye gtts, nose sprays, NEB tx on the 8 am med pass see if those can be changed to 6 am. Go over the residents meds and see if some of them can be DC'd.

If you have time before your 8 am med pass to do any vital signs that are needed to give meds (ex. AP for digoxin) do those before starting. If the CNAs at your facility are able to do VS see if they can get the BPs for you for your BP meds. Make sure the aides know to stop the resident at your chart for their meds before they go to the dining room, to activities, hair dresser, ect.

These are just some of the suggestions that I can think of off of the top of my head. They are asking an awful lot of you I know, because I do a med pass on about that many residents every day. I am not able to complete the med pass on time. I am sure that there are many short cuts out there, but I refuse to do something that is possible dangerous. I think just passing meds to that many residents in that time frame is running the risk for a med error and I will not take a short cut that will make the risk that much higher.

At our facility, we do have that hour window before and after and unless you have a wing and 3/4 (which would be almost forty people), you really "only" have 23+ people.

What I try to do before I start the med pass is to have everything ready (equipment wise) and prioritized (insulins and accuchecks etc.). I love the idea of getting the AP, before and maybe your O2 sats as well right before you take your cart out?

i work in ltc as an rn and have been told the meds have to administered within an hour before or after the time they are scheduled. the problem is that none of the nurses, including me, can get them done on time. when i was hired the nurse said i would be doing good if i got the 8am meds done by 10 am. we just moved to a new building recently with the capacity for more residents but not more nurses and it is even more challenging to get meds administered on time. management has recently been harrassing the nurses to get the meds done by 9am or it is a med error. can i as a nurse be held responsible for not passing meds to 34 residents on time...or is it the nursing homes problem? i would appreciate any solutions to this stressful situation and any time management strategies. during med pass i tell the cna's to write things down on my notepad so i am not interrupted and i don't talk with the residents other than to say hi, here are you meds.

yes we have that pre/post hour thing window as well in my facility (ltc). nobody can get the med pass done on time and management knows it. i even tell my adon who is in charge of staffing that i cannot finish within the alotted window when she pulls off a nurse to another floor and she does not address the issue.

it is indeed a medication error but what can you do? i have 25 patients on 3-11 shift and i struggle. and you have 34? wow!

good luck!

Honestly, I have problems getting all meds passed within the 1-hour-before-1-hour-after window, and I "only" have 30 residents. If your residents have more than 3 pages of meds, fingersticks with coverage, tube feeders, multiple eye drops, IVs meds, inhalers, etc., then it's practically impossible to get all of the meds passed within 2 hours. I've heard of nurses who have no problems passing meds to 30 residents in under 2 hours, but those residents consist of people who take no more than 3 pills, 1 or 2 diabetics, and no tube feeders/IVs.

It's a staffing problem; 34 residents, unless one is on the 11 to 7 shift, is too many. You can bring this up to your DON, but I don't think there will be changes to staffing.

Where I worked in LTC if I had 34 residents on 7-3 then I had 68 rresidents on the night shift and surely did not need any additional tasks/meds to give out in the AM, as I had the same problem of too much to do in too little time.

I can't say how many times the med schedule was re written to accomodate the 7-3 shift pushing things to the 3-11 or 11-7 shifts.