Adverse Consequences and Medication-Related Problems



|Adverse Consequences and Medication-Related Problems H5MAPL0051 |

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|Highlights |Policy Statement |

| |The facility evaluates medication usage in order to prevent and detect adverse consequences and medication-related |

| |problems such as adverse drug reactions (ADRs) and side effects. |

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| |Adverse consequences shall be reported to the Attending Physician and Pharmacist, and to federal agencies as |

| |appropriate. |

| |Policy Interpretation and Implementation |

|Monitoring for Adverse Consequences|Residents receiving any medication that has a potential for an adverse consequence will be monitored to ensure that|

| |any such consequences are promptly identified and reported. |

| |An “adverse consequence” is defined as an unpleasant symptom or event that is due to or associated with a |

|Definition of an Adverse |medication, such as an impairment or decline in an individual’s mental or physical condition or functional or |

|Consequence |psychosocial status. An adverse consequence may include: |

| |Adverse drug/medication reaction; |

| |Side effect; |

| |Medication-medication interaction; or |

| |Medication-food interaction |

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| |An “adverse drug reaction” (ADR), a form of adverse consequences, is defined as a secondary and usually undesirable|

| |effect of a drug and is different from the therapeutic and helpful effects of the drug. An ADR is any noxious and |

| |unintended response to a drug and occurs in doses for prophylaxis, diagnosis or therapy. |

|Definition of an Adverse Drug |The staff and practitioner shall strive to minimize adverse consequences by: |

|Reaction |Following relevant clinical guidelines and manufacturer’s specifications for use, dose, administration, duration, |

| |and monitoring of the medication; |

| |Defining appropriate indications for use; and |

| |Determining that the resident: |

|Minimizing Adverse Consequences | |

| |Has no known allergies to a medication; |

| |Is not taking other medications, nutritional supplements including herbal products, or foods that would be |

| |incompatible with the prescribed medication; and |

| |Has no condition, history, or sensitivities that would preclude use of that medication. |

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| |The staff shall report clinically significant adverse medication consequences and medication errors with adverse |

| |clinical consequences to the resident’s Attending Physician immediately. |

| |In the event of a clinically significant adverse medication consequence, nursing staff shall implement and follow |

| |any related Physician orders, and shall monitor closely and document the resident’s condition and response to any |

| |corrective interventions for at least the next 24 hours or as otherwise directed. |

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|Reporting Adverse Drug Reactions |continues on next page |

| |Nursing staff will document appropriately detailed accounts of any incidents on an appropriate report form. |

| |The Medical Director, Director of Nursing Services, and Consultant Pharmacist shall review medication errors and |

|Follow-Up and Monitoring by Nursing|adverse medication consequences as part of the facility’s Quality Assurance process. |

|Staff |As necessary, the Charge Nurse may also contact the Consultant Pharmacist for help in determining whether adverse |

| |consequences might be present. |

| |The Pharmacist is responsible for reviewing the resident’s medication regimen monthly to help identify and report |

| |irregularities associated with the use of medications. |

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|Documenting and Reporting | |

|Quality Assurance | |

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|Notifying Consultant Pharmacist | |

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|Drug Regimen Reviews | |

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|References |

|OBRA Regulatory |483.25(l); 483.25(m); 483.60(c)(1)(2) |

|Reference Numbers | |

|Survey Tag Numbers |F329; F332; F333; F428 |

|Related Documents | |

|Policy |Date:________________ By:__________________ |

|Revised |Date:________________ By:__________________ |

| |Date:________________ By:__________________ |

| |Date:________________ By:__________________ |

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