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Question for any DONs at ALFs

Posted
by nurse210 nurse210 (New) New

I am new to assisted living. My CMAs tell me they can give meds one hour before or one hour after. In my day it was 1/2 before or 1/2 after scheduled time. Sometimes it seems they are medicating one drug on top of another to get done and satisfy the restless residents. Is this what they are being taught? Is it OK in ALFS and LTC? I come from an acute care setting.

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

The regs in long term care: one hour before and one hour after the scheduled time. Most people group the meds so the 4p,5p, and 6p meds are all given at 5pm.

Thanks so much capecod mermaid! nurse 210

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

It's an hour before and an hour after the scheduled time in LTC where I live (Oregon) too.

However, don't rely on word of mouth; in fact, you'd do well to get a copy of your state's "Bible", AKA the rules and regs, and take it with you to bed, to meals, and when you need to "roost" in the bathroom, until you can cite them chapter and verse in your sleep!:D

Seriously........every DON in long-term care needs to be thoroughly familiar with her/his state's laws, because ignorance is no excuse when the surveyors walk in the building and cite the facility for violating some obscure rule governing paint chips in the janitor closet, for example. LOL

In different places I've been told one half hour and one hour. I've always wondered about this, but no one has ever shown me the rulebook. Then I've observed the nurses who say "do whatever you do, but chart that you gave it at the right time". Could be difficult when the surveyors are there. That's why certain nurses know when to call out sick.

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

It's an hour before and an hour after the scheduled time in LTC where I live (Oregon) too.

However, don't rely on word of mouth; in fact, you'd do well to get a copy of your state's "Bible", AKA the rules and regs, and take it with you to bed, to meals, and when you need to "roost" in the bathroom, until you can cite them chapter and verse in your sleep!:D

Seriously........every DON in long-term care needs to be thoroughly familiar with her/his state's laws, because ignorance is no excuse when the surveyors walk in the building and cite the facility for violating some obscure rule governing paint chips in the janitor closet, for example. LOL

:clown::eek::jester: I believe in Massachusetts, according to regulation MDPH 27/123/98.436-98 you are allowed to have up to 17 paint chips in the janitor's closet, but will get cited if you have 18.

DPRN

Specializes in long term care, school nursing.

The window of opportunity is a facility policy. I was told that it is not a regulation, but instead is up to a facility. My facility uses the one hour before and after the scheduled time as our window.

Nascar nurse, ASN, RN

Specializes in LTC & Hospice. Has 35 years experience.

The window of opportunity is a facility policy. I was told that it is not a regulation, but instead is up to a facility. My facility uses the one hour before and after the scheduled time as our window.

Just an FYI.. this thread is 1 1/2 years old

In my state there IS a regulation for this and without going thru the trouble of looking it up, I would imagine it is the same for all 50 states as this would be a federal regulation, in other words an F-tag (again.. I didn't bother to look this up to be sure).

Havin' A Party!, ASN, RN

Specializes in ICU, CM, Geriatrics, Management. Has 10 years experience.

One hour before / after scheduled time in PA as well.

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