Self Administration

[Marija1]

I work at a Retirement Home. Some residents self administer meds. If someone took too many at one time is that an error on the nurses part if it happened on her shift?

[Jory, MSN, APRN, CNM]

When you say, "Took too many at one time" do you mean quantity (swallowing too many at one time) or is your retirement home not doing med passes?

[blondy2061h, MSN, RN]

Most facilities have pretty tight guidelines on what can be self administered and limit it to things like mouth wash, creams, nasal sprays, eye drops, and maybe inhalers- and only if the prescriber orders it as a self administered med. It sounds like your facility has people with bottles of pills in their rooms?

[roser13, ASN, RN]

Most facilities have pretty tight guidelines on what can be self administered and limit it to things like mouth wash, creams, nasal sprays, eye drops, and maybe inhalers- and only if the prescriber orders it as a self administered med. It sounds like your facility has people with bottles of pills in their rooms?

I'm guessing that OP may be talking about an Assisted Living facility where meds are often kept in the patient's apartment.

OP, if that is the case, then I can't see how the nurse or the facility can be blamed for a competent adult's medication mistakes.

[Marija1]

Yes bottles and blister packs etc, that's what they allow at our facility to honour the independent living only if the Dr. orders that they can.

[Marija1]

Swallowing too many.

[Marija1]

Yes that's what happened am saying, most allow us to administer medications for them but the acfew say they can and want to do it!

[Nascar nurse, ASN, RN]

Chances are someone in your facility has done an assessment on their ability to self administer their medications on some kind of standardized form. Once that has been accurately completed (an updated periodically) and a physician order is in place to self administer then you should reasonably be free of liability. They do have a right to maintain their independence if they are deemed safe to do so.

[Marija1]

We get the order when they first move in but no form is filled out for assessing this as the Dr. Already has. But I def find that their should be a form and updated monthly so that this doesn't occur. Their is some responsibility on the part of the family to agree or disagree. We do not have eyes on the back of our heads!

[Marija1]

You are absolutely right! I wasn't thinking right about this, but yes our facility does devise a careplan that would state "is independent with self administration of medications." So in reality the only thing left to do i guess would be to still fill out an incident form as future reference

[Nascar nurse, ASN, RN]

I'm still going to make a very broad assumption here that before a resident is ever allowed to move in, someone has done some sort of service plan to determine that they are in fact appropriate for your setting. I've frequently seen this include a self administration of medication assessment. Chances are, if your facility does pass medications for some residents, than those residents are getting charged more for that service. Again...I'm making assumptions based on what I've seen over the years, but if a facility CAN charge more for a service, than chances are they are probably doing a quarterly or semi-annual reassessment to determine if the residents needs have changed - this is probably where the self assessment determination is coming from, although you might not even know this is getting done.

[Marija1]

I just know that all the "right" processes are not happening that should be happening. Therefore the families etc will put the blame on the nurses is what it boils down to!