Medpass at mealtime a dignity issue?

Specialties Geriatric

Published

Our facility is going to make some changes on how and where we do medpass. With the exception of a few residents who insist on getting their meds when they have their meals medpass will now be before and after meals. I am really not sure how it's going to work out. Also, if I understood correctly, we no longer be pinned down to a particular time (with, of course, the exception of certain meds) but it will simply say am medpass or pm medpass. Right now I'm keeping my fingers crossed that the change will be for the better.

Specializes in Rehab.

I work in a small Rehab facility where we usually have around 20 pts. Recently we have implemented a med pass nurse who administers all scheduled po meds. The pts primary care nurse gives all prns, insulins, topicals and GT meds. The team leader does all IV meds and TPN. On our last CARF survey they faulted us for not always explaining medications when they are administered (our rationale was that most patients do not want everyone to know what meds they are taking). The med pass nurse explains to the patients on admit that they will not disclose what medications they are giving if they are administered outside of the pts room (unless the patient asks), but that they are more than willing to review meds in private if the pt requests. The med pass nurse also gives education on new medications as they are ordered. This seems to work really well for us, but I understand that not all facilities/units are the same.

Specializes in LTC.

My facility has also started this type of med pass, and after working out a few kinks it is going well. No more rushing around with the med cart from hell attached to your hip. It is leaving us time to do other things with and for our residents. There are certain meds that have designated times like narcs, psychotropics, Coumadin, PPI's, NSAIDS and night meds are timed btwn 12a n 6a. Like anything new you get familiar and wonder how you did without. Oh I work LTC.

"...after am pass they go right to some type of activity; should we do it then?"

We are not supposed to bother the residents when they're getting their nails done or engaged in other fun activities, but sometimes we have to and try to do so quickly and discreetly.

Specializes in Assisted Living nursing, LTC/SNF nursing.
this sounds dangerous. As fast paced as LTC's are with the large number of residents, someone, somewhere's gonna get the meds on top of the other meds.

Plus it seems like a lot of extra work, communication, and we all know communication breakdown happens a lot. I try to be open to change, but this reminds me of the phase where "our residents live here so they shouldn't have to wear name bands." Sign me one freaked out little agency nurse on the 3-11 shift!

Oh yes, I know what you mean as far as communication breakdown but TPTB said it will work and by golly, you'd better make it work. They want us to all communicate but they also want to know any gossip or whatever is said that doesn't quite fit what they want and reprimand you for being negative and if you can't come up with a better idea, then it's that idea and it had better work. It doesn't matter all the scenarios you could give, until something bad happens (which could mean your license), you do it the way said.

Specializes in Med nurse in med-surg., float, HH, and PDN.
I work in a small Rehab facility where we usually have around 20 pts. Recently we have implemented a med pass nurse who administers all scheduled po meds. The pts primary care nurse gives all prns, insulins, topicals and GT meds. The team leader does all IV meds and TPN. On our last CARF survey they faulted us for not always explaining medications when they are administered (our rationale was that most patients do not want everyone to know what meds they are taking). The med pass nurse explains to the patients on admit that they will not disclose what medications they are giving if they are administered outside of the pts room (unless the patient asks), but that they are more than willing to review meds in private if the pt requests. The med pass nurse also gives education on new medications as they are ordered. This seems to work really well for us, but I understand that not all facilities/units are the same.

!!!! This actually sounds do-able!!!!!!!!!!!!!!!

Specializes in LTC.
When I get to a nursing home - for myself! - I want all of my AM meds WITH my breakfast. So there!

The newest insulin info I have is that I should eat within 5 minutes after taking my injection. So stick my finger before I go to the dining room, and give my injection when I am seated at the table AND MY MEAL IS ON ITS WAY. I will insist on it, privacy/dignity aside. As it is right now, I take my 'works' with me to a restaurant, order my food, stick my finger, draw up my shot, and give it at the table as inconspicuously as possible.

And I've done it at all types of restaurants, cheap & family & pricey.

I think that MOST residents don't need to be told what their meds are every time they are given, most already know. As if most of the residents aren't telling each other what their health issues are!!! Most residents know more about the other residents than the nurses do!

These med times changes are another way to make things more confusing.

I want all of my meds at 9am.. and 9pm... NOTHING IN BETWEEN unless I ask for a tylenol.

Specializes in LTC, ER, ICU, Psych, Med-surg...etc....
We just finished state survey. The surveyor was 'aghast and appalled' that the nurse had given ONE resident meds in the dining room. Come on...one guy? He didn't care. He got the right meds. The surveyor said to me "When you're in YOUR home, you wouldn't want someone disturbing YOUR meal would you." Well...chickieboom, when I am in MY home, some days I take my morning med at 530 and some days 8....so what exactly is your point?!?

We try not to give meds in the dining room. I, too, have heard of places where there is a morning pass and an afternoon pass instead of the strict times most of us use now. It'll all sort itself out one of these days.

If I have to live in a nursing home, I don't think I'll care when I get my meds as long as they remember to give me my big glass of wine with dinner.

Chickieboom! Haha!

I take my meds when I want to. Sometimes at the table, sometimes in the car, sometimes at lunch...just depends on when I remember it!

Getting cited for one resident in the dining room being given meds is silly, I think. If the resident didn't care, why should anybody else?

Your title asks a question that isn't addressed in your post. What is the reasoning behind deeming mealtime medpass a dignity issue? Is it because questions and answers between the resident and nurse can be heard by anyone sitting around the resident, making it a privacy issue?

The state that I work in would say that this is a dignity issue.

Specializes in Pediatrics, Geriatrics, LTC.

State law also governs this. Synthroid and omeprazole are scheduled for 0600. The next meds are given at 0800, or 1000. Then 1300. With an hour before and after being ok, the med pass goes on pretty much all day in LTC.

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