30 minute timeframe to give meds

[marie7217]

We have been told NC law dictates that medications be given within a 30 minute window now instead of 1 hr. We are having a great deal of difficulty adhereing to this regulation. We are a long term acute in pt facility. It is not uncommon for pt's to have 10 or more meds due at 0900. This is only 1 pt! Our general pt load is 3-4 pts. Is anyone else having this trouble or do you have any suggestions

Thanks

[WolfpackRed]

Is this 30 mins on each side of 0900 (i.e 0830-0930, total of 1hr) or 15 mins on each side (0845-0915, total of 30 mins)?

In either case, I would justify any late/early meds, within reason, as nursing judgment. This is a LTAC, so you still have some sick pts that may need more of your attention.

[elkpark]

If that is a NC rule, it is a new, recent development. Even the "one hour before to one hour after" policy was never a state rule; it was up to the individual facility to establish its own policy. I worked as a state hospital surveyor in NC until a few years ago, and can tell you for sure that there was no state rule regarding time frames for meds at that time -- only a rule that the individual facility had to have an established policy and abide by it. When we cited hospitals for med errors re: meds given outside of the established time frame, we cited them for not following their own policy regarding med administration. During the years that I was surveying, we saw many facilities change from a "30 minutes before-after" policy to a "1 hour before-after" policy in response to getting cited for that type of med error; in fact, I recall one hospital that, in response to getting cited for this type of med error, changed its policy to "2 hours before to 2 hours after" the ordered time, and there was nothing we (surveyors) could do about it! :uhoh21: (That meant that you could have, for example, an antibiotic ordered q 4 hours and a nurse could give two doses within a few minutes of each other every 8 hours, and that would not be considered a med error according to that hospital's policy!)

I would be v. surprised if the state now has that specific a rule dictating medication administration -- that would be a big change in the way hospital regulation has been handled all these years.

[WolfpackRed]

Thank you for the above post. I wanted to question the "law", but couldn't research the manner enough. I'm sure if there were ever to be such a law, I would hope that 1) we would hear more about such a proposal prior to passage, and 2) that the NCNA would bring legal pressure to block such a law.

[barefootlady, ADN, RN]

This sounds more like a facility policy than a law. I could be wrong, but it sounds like they want to make sure patients are getting meds in a timely manner. Very good rule, difficult to practice, especially to practice. If there is a problem make sure to chart reason med is late, even the one that facilities do not want to see written"med not available from pharmacy at this scheduled time."

[SuesquatchRN, BSN, RN]

Start your 0900 med pass at 0830. Most LTC's have you banging out meds for 30.

[Viviana, ASN, RN]

You can pre-pull and prepare your meds (leave pills in their wrappers to facilitate double checking) starting at 8:00, then administer after 8:30. That's what I've been doing.

Viv

[sewillia]

When I worked in a LTC facility, we had the same problem. We the nursing staff did to be in guide lines, They would split up the hallway, One have would recieve medication at 0900 and the other have would recieve there medication at 1000. Since you can give medications 30 minutes early and 30 minutes after the hour, we were in the guidelines.