state survey med pass questions

txredheadnurse, BSN, RN · Apr 23, 2014

1. Maintain privacy when giving meds....curtain, door shut

2. You can bring everything at once into the room but you need to put the eye drops and inhalers on a barrier of some type (paper towel, tissue, placed into an empty drinking cup if you are putting them down at the patient bedside. I would say wash your hands, gather all the items needed for the med pass (including gloves if doing eye drops and tissue for eye drops) go the bedside, do the po meds, use hand sanitizer then glove up to do eye drops remembering to use a separate tissue for each eye or at least tear one tissue into two portions, remove gloves, do inhalers remembering to offer water to rinse the mouth if the instructions indicate to do so. You can put the eye drops and inhalers on the barrier while giving the po meds. A trick I would use if I had multiple eye drops was give one drop first, then give po meds, then give second drop because usually by the time the resident was done with taking po meds it was 3-5 minutes later. If you do it this way you should use a fresh set of gloves for each drop. I know it seems wasteful but it is better to do a bit of overkill glove wise than cause an eye infection from contamination. If you do it this way then make sure to use hand sanitizer before gloving up the second time. Also remember to wash your hands after removing the gloves. I say use the barrier because it can be an infection control issue to take anything stored in the med cart into the patient room, set it down and then put it back in the cart where it touches other items which get taken into other patient rooms and so on.

3. You open the eyes the best way you can. I frequently had to use two fingers to keep upper lid and lower lids open while the other hand instilled the drops.

4. Always wait 3-5 minutes between instilling more than one kind of eye drops. This prevents one drop washing out the previous medication and allows sufficient time for the med to be absorbed by the tissues.

5. In theory if you do not touch the openings of the capsules it acceptable to open the capsules with bare hands but at least in my area surveyors are finding it poor technique to not use gloves so I always advised to glove up before opening capsules.

Hope that helps.

twinsmom788 · Apr 23, 2014

what is your facility policy? Always follow your policy or get clarification from your supervisor/DON/Regional Nurse.

Then look up the CMS med pass guidelines which are available on the CMS website. Then try to get advice from experienced nurses in your facility who have successfully completed a "survey" med pass.

It actually should be no different from your daily routine.

ptvgirl · Apr 23, 2014

what is the website for cms med pass guidelines?

CapeCodMermaid, RN · Apr 23, 2014

Ask your facility's pharmacy consultant to watch you do a med pass to make sure you're doing everything right.

LPN_FTW · Apr 25, 2014

1. Nope. They get their medications usually at the breakfast, lunch, or dinner table. It is a home, not a hospital. Some residents aren`t keen on being served at a table, so I will deliver to them in their room either before or after. Door is always shut.

2. I wash my hands if they are dirty. Otherwise, I will use hand sanitizer before and after gloving for the eyedrops. Everything is brought at once.

3. I gently pull down the lower lid to create a cup, or ask the resident to pull their own eyes open.

4. I give them 5 minutes apart at minimum.

5. No, only if it`s a medication that is harsh or stains.