A Look at Med Passes

The med pass is a labor-intensive activity that consumes a good part of a nursing home nurse's day. A number of homes have reduced their med pass and found that in doing so, they are more able to individualize care for residents. Here are some tips from their experiences:

1. Times of med pass: Are you doing the med pass while meals are being served? Try changing your times of day. One home changed their med pass times to 10 a.m. and 2 p.m., which freed up their nurses to help out with other care responsibilities during the busy meal time.
2. One-a-days: Give the one-a-day pills on the evening shift or another time that is less busy, to free up time during the most hectic part of the day.
3. TIDs to BIDs: Some meds that are currently prescribed for 3 times a day can easily be given 2 times a day without any negative outcomes.
4. Discontinue unnecessary meds: Many residents are taking too many medications. They may be taking vitamins or other supplements that they cannot even absorb. One home that reviewed its meds found they could easily eliminate 40% of what they were giving.
5. Waking people up for meds: Re-evaluate timing of any meds that residents are currently being awakened to receive. Change med times for as many as possible so that they are given before sleep or as residents awaken.

A PROCESS FOR CHANGE

Several homes described their process for change. It involved a couple of days of work by the nurses, working together with a consultant pharmacist and the medical director.

• Create a chart with each resident's meds by time of day.
• Identify meds that should be discontinued and change the orders.
• Identify meds that can be given fewer times a day and change orders.
• Redistribute the meds so that they are given at a time that works well for the resident and for the staff. Change policies to allow a wide time range for administration of meds.

 From Ohio KePro

For use by the Louisiana Long-Term Care Stakeholders, prepared by Barbara Frank, B&F Consulting, December 2005, based on consultation with Anna Ortigara, Life Services Network