"pass" or "LOA" meds

[ktwlpn, LPN]

How do you handle pass meds at your facility? Do your docs OK passes for any and all residents? If so how do you handle their meds? We have to order ours from our-off site pharmancy and each med comes in a tiny little plastic bag.I have seen the look of fear in some of these people's faces when we hand them large bags full of little bags with little labels.Do you generate some type of MAR-either hand written or typed from your pharmacy? What exactly is our liability here? I really want the residents to be able to go out with their loved ones and enjoy themselves BUT when something happens I don't want to be involved in a lawsuit with some dysfunctional freak family.How in the heck can we be responsible for diabetic teaching for a weekend pass when we may have 30 0r 40 residents to care for? Our social services dept. has told more then one family that we are NOT responsible-that they must obtain the equipment (glucose monitor,portable O2) and learn how to use it at the point of purchase....I am not comfortable with any of this.....

[RN 4 Life]

In my opinion the facility and releasing nurse has a great deal of responsibility, which begins with evaluating:

- the residents ability to understand how to take his or meds appropriately.

- was teaching and return demonstration performed and documented

- if the resident is leaving with another responsible person, is that person capable of administering meds.

I would look at the risks of allowing the resident to go without meds or receive them early or late when on a LOA. On the other hand I understand some meds can not be missed such as insulin and seizure meds, in this case if adequate understanding and demonstration can not be done than I would make the physician aware of your concerns and the risks and request a denial of LOA until safety issues can be resolved.

Currently where I work it is the same, families are responsible for getting glucose monitors and oxygen when taking a resident on a LOA. In an effort to decrease liability it should be documented the needs of the resident and a LOA careplan should be created and provided to the family so they are aware the care necessary to take the resident on a LOA. We had a resident go on an LOA and fell and sustained a fracture, which had to be reported to the DOH, one of there first questions was..did the family receive training or education on the residents needs with transferring and ambulation.

[fultzymom]

At our facility we package the meds into time groups so they know exactly what meds they are supposed to take at what time. Of course we leave them in the package that they go in that has the name et doseage on it. We also write them all out on a paper with a list of what they are et when they are supposed to take them. These are also listed by time groups so that the baggies we put them in match up with the list they are taking. If there are any insulins to be taken, we write the doseage and make sure that they know how to draw it up and check the correct dose et can properly give it. We also have them write it down so it can be documented in the nurse notes. If there is a family member who will be administering meds, we make sure that they know how to give everything and understand what the medications are for.