Catheterization, Intermittent,Female Resident
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|ABHOW Assisted Living Policies and Procedures |
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|Medication Management |
| |Policy Statement |
| |It is the policy of ABHOW trained Assisted Living staff to manage the medications of all residents in Assisted Living and |
| |residential plus, to assure accuracy and the safety of all residents. |
| |Policy Interpretation and Implementation |
| |Residents requiring assistance with their medication will be established on the medication bubble pack distribution system |
| |dispensed by a licensed pharmacy. |
| |Designated trained Assisted Living staff will check in all medications, assuring accuracy. |
| |All medications will be listed on the centrally stored medication log. |
| |Designated trained Assisted Living staff will handle all medication orders. |
| |A MD order is required for all prescription and OTC medications. |
| |all medications will be stored either in a designated locked cabinet in the resident’s room/apartment or in a centrally stored |
| |locked cabinet in the medication room. |
| |PRN narcotics will be centrally stored in a locked cabinet and accessible only to designated trained Assisted Living staff. |
| |Only a licensed skilled medical professional may administer injectable medication, i.e. insulin and B12. |
| |A licensed skilled medical professional or staff with required medical aide training will count PRN narcotics daily. |
| |When a medication in the bubble pack is discontinued, only a licensed nurse or designated trained Assisted Living staff may |
| |remove the medication. |
| |Only a licensed ski8lled medical professional and staff with required medical aid training may assist the resident with their |
| |medication. |
| |At designated times, the medication attendant will go to the resident’s apartment/room and assist with their medication. |
| |Clean hands with soap and water, or an antiseptic water free cleanser. |
| |Check the medications to be given against the Medication Administration Record (MAR). If a discrepancy is found, notify the |
| |nurse immediately. |
| |Place the medications in a medication cup and hand to the resident. |
| |Observe the resident take the medication. Under no circumstances can medication be left with the resident to be taken later. |
| |Initial and sign the MAR. |
| |The staff with required medical aide training may assist a resident with inhalers by shaking and quing the resident to |
| |self-administer. The staff with required medical aide training may not push the plunger on the inhaler. |
| |The staff with required medical aid training may assist a resident with medicated crèmes by placing the cream in the resident’s |
| |hand for self-application. |
| |If the resident refuses to take the medication, document on the back, of the medication sheet and try again within an hour. If |
| |the resident continues to refuse, the attendant will notify the wellness nurse and document on the Medication sheet that the |
| |resident refused their medication. No resident can be force to take medication, nor can the medication be disguised in food or |
| |liquid. If the resident continues to refuse the medication from the attendant, the supervisor will attempt to talk with the |
| |resident. If the resident still refuses, the prescribing physician will be notified. |
| |An MD order is required of a resident requests their medication be given in food for ease of swallowing. |
| |PRN medication orders and prescription labels must contain all of the following: medication dosage, frequency, route, specific |
| |symptoms for which it can be given, and the maximum dosage in a twenty-four hour period. |
| |The attendant may assist a resident with self-administration of PRN medication (non-narcotic) if the resident is able to |
| |determine his/her own need for the PRN medication by describing their symptoms; and whose physician has given prior instruction |
| |on medications to be given for those symptoms. |
| |If a resident is unable to determine his/her own need for a PRN medication the Supervisor or designated trained Assisted Living |
| |staff will assess the resident and call the MD to get direction for each dose. |
| |If a resident id unable to administer their own eye, nose, or ear drops due to tremors, failing eye sight or other chronic |
| |condition, the resident’s physician must authorize the staff with required medical aid training to assist. |
| |Crushed medications may be given to residents who are cognitively aware that their medication s are being crushed, only after |
| |the resident and the resident’s physician have given written permission. The nurse must also consult with pharmacist to ensure |
| |that the medication can be safely crushed. |
| |Crushing medications for residents who lack cognitive awareness requires an exception from Community Care Licensing. Written |
| |instructions for crushing and administering the medication from the prescribing physician and dispensing pharmacist must be |
| |maintained in the resident’s file and a record maintained of each dosage of crushed medication given to the resident. |
| |Medications which are not taken with the resident upon termination of services or which are otherwise to be disposed of shall be|
| |disposed of through a company licensed by the state to handle dangerous and hazardous materials. The facility will sign and |
| |retain a record for at least three years which lists the name of the resident, prescription number, and name of pharmacy, drug |
| |name, dosage, quantity and date. |
| |A Medication Error Report must be completed anytime a mistake is made with a medication; i.e. wrong resident, wrong dosage, |
| |wrong route, and missed dosage. These reports are reviewed by the Director of Assisted Living and Wellness nurse. |
| |If a resident requests to store and administer his or her own OTC medications, it must be approved by the Director of Assisted |
| |living and the resident’s primary physician in writing. The resident must supply a locked box for storage and supply a key to |
| |the staff. The resident must also provide the Supervisor an updated list of all OTC medications. The Supervisor will |
| |periodically review and assess for continued appropriateness. |
| |Every medication brought into Assisted Living must be logged in the Centrally Stored Medication List. This record must be |
| |maintained a minimum of one year. |
| |Residents who are not on bubble pack (Kaiser, VA) will have their medications dispensed by the staff with required medication |
| |aide training for a 24 hour period only. |
| |All medications that are discontinued or expired will be removed from the resident room. Those medications that can be returned|
| |to the pharmacy for credit will be returned. Otherwise, the Supervisor will store the medications in a locked box and dispose |
| |of them appropriately on a monthly basis. |
| |The Assisted Living Supervisor or designated and trained staff will audit resident rooms on a monthly basis for medication |
| |compliance. All AL Staff is responsible for reporting finding any unlocked medications. |
| |A MD order is required to place a medication on hold. The medication on hold will be place in a locked cabinet in the Hawthorn |
| |Med room and labeled as being on hold. The Supervisor will notify the medication attendant and write in the MAR “on hold” date|
| |and initial. Within a reasonable time the MD will be contacted for further orders. |
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|Regulatory Reference Sources and Revision Dates |
|Regulatory | |
|Reference Numbers | |
|Policy/Procedures |Date: By: |
|Reviewed/Revised |Date: By: |
| |Date: By: |
| |Date: By: |
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