Reducing med pass distractions

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

We switched from paper MAR to eMAR within the last year and a half. It's coming up to the dreaded state inspection window and some nurses are getting slammed for signing off meds out of the hour before/after window. In some cases it's becaused a single resident's meds are ordered for 4p, 5p, 6p, etc. and we're trying to get all that straightened out so meds are grouped together and residents are getting them at the same time based on room assignments. And in some cases there are emergencies that require attention and get nurses sidetracked. I know that I have seen a small sign on med carts in another facility alerting residents/family that nurse is doing med pass and to ensure safety questions should be directed to other staff. Anyone else seen these? Anyone have other ideas? I'm just thankful that I'm rarely on a med pass anymore, I'm slow.

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Specializes in kids.

We have those signs, does anyone pay attention? NOPE! Family, LNAs, activities, residents. administrators.....

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Specializes in LTC,Hospice/palliative care,acute care.

It is the nurse's responsibility to limit distractions.Politely inform everyone who approaches you during the pass that they can call you later or come back at a particular time.Stand up for your self...

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Specializes in kids.
It is the nurse's responsibility to limit distractions.Politely inform everyone who approaches you during the pass that they can call you later or come back at a particular time.Stand up for your self...

I do but the hits just keep coming somedays.

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Specializes in LTC,Hospice/palliative care,acute care.

Your administration needs to communicate this message to all departments as well.They will all eventually "get it " ,everyone just has to remain firm.Good luck

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One of the facilities I go to has their med times listed as PTB (prior to bed) or UR (upon rising). They are still paper MARs, but I wonder if something like that could be implemented at your facility. I love having meds listed this way. It's so much easier to stay within a window of time when the window is more flexible. They do have some meds scheduled for specific times still, but only the meds that really need to be timed precisely. I know you were looking for ways to reduce distractions, but to me giving broader time parameters is a more realistic way to tackle the problem.

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Specializes in Med-Surg.

I love the idea of LTC meds ordered as before bed and upon rising! I think I heard on here of them being ordered as morning, afternoon, and night before.

OP, is there also a way to add more leeway to the 1hr before/after rule? When I was LTC, they gave us a 2hr window, which helped a little bit.

Also helps if the facility physician actually reviews the medication orders and cuts down on duplicate therapies and unnecessary medications.

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Specializes in LTC and Pediatrics.

I had a huge distraction last evening while checking out a med from the narcotic drawer. At that moment, they had a fire alarm. As a result of my focusing on the narc, I totally messed up the fire alarm. Grrrr. This after the last couple of weeks of there being issues with the narc count, not only for me but for others.

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Specializes in Geriatrics, Dialysis.
We have those signs, does anyone pay attention? NOPE! Family, LNAs, activities, residents. administrators.....

We don't even bother with anything like signs. What's the point? I don't remember the last time I actually had an uninterrupted med pass. Doesn't matter what shift , there is ALWAYS somebody or something interrupting.

ETA: We have been using EMARS for about a year now and have gone through survey since we changed over. Not a word was ever said about missed time parameters for med administration. From what I am hearing it hasn't been an issue for any facility. At least that's the case in my area, unfortunately I have no idea if this has been an issue elswhere.

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Specializes in kids.
Your administration needs to communicate this message to all departments as well.They will all eventually "get it " ,everyone just has to remain firm.Good luck

And when it is an administrator I just smile, nod my head and keep on working....

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ETA: We have been using EMARS for about a year now and have gone through survey since we changed over. Not a word was ever said about missed time parameters for med administration. From what I am hearing it hasn't been an issue for any facility. At least that's the case in my area, unfortunately I have no idea if this has been an issue elswhere.

Agreed. We've been through survey multiple times since switching over, and I'm not sure giving meds outside of scheduled times was even a ding. Certainly not the biggest of our concerns.

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