Perfect Med Pass – Technical Aspects of Passing PO Medications

hello my name is Carrie Allen and I am a consultant pharmacist I'm here to talk to you today about the five elements of a great med pass if you pass meds you know that there's a lot more than five but these are the five major basic areas that you should be concerned with when someone's watching you do a med pass but also just on a day to day basis when you're going we're gonna go through some pio some per Oram medication rules and these might seem basic but let's just bone up on these a little bit you're gonna clean and disinfect that work area that med cart and you may have to do that several times during the shift you're gonna ensure that all your equipment you need is on hand including your water and your med cups in your spoon etc perhaps you might also need a med crusher with the little med crusher pouches that is an important tool to have make sure that you have a blood pressure cuff make sure you have a place to write down your vitals those kind of things do you have the vitals related to the Med are they applicable and desirable did you do an apical pulse for digoxin digoxin generally requires an apical pulse and not all people know that blood pressure meds is the blood pressure too low is the heart rate being affected are we doing orthostatic blood pressure checks do we need to is the resident alert and acting normally if you go in and you know resident Polly is just not acting right go get the nurse or if you're the nurse do an assessment before we start giving people medications wash your hands the fourth setting up the Med you could possibly use sanitizer if that's appropriate as well but make sure hand-washing is in there somewhere prepare the right med at the right dose at the right time if if it's crushable you need to know its crushable make sure you have a crush order first and keep a list in your Mar book about which meds are or are not possible call the pharmacy if you have any questions you want to crush things into a fine powder not to the jagged edges don't touch meds with your hands when you're going to punch them out or when you're taking them out of the pouch when you're crushing them so for example you have a med cup we've all seen this little med cups I see a lot of this sometimes people were you know just thinking I'm not watching oh look it touched it that's gross don'tdon't oh don't do that well you want to do let's make sure you've got the right med the right dose for in physician it right over and you're going to push it out and there you go as time goes by you know you're gonna get more proficient at that but you're also gonna get busier and you're gonna make mistakes now I didn't touch that med that's great I'm gonna take it to give to the resident but what if I have five or six meds or different things going should i stack things on top that maybe have touched the bottom of other carts and just carry them all into the room no that's not sanitary so what you're gonna do is make sure that nothing else touches it and you're just gonna carry it like so it if you're wearing gloves that doesn't protect you from everything still don't touch people's meds okay now check that you have the right med at the right dose and time and make sure that they're not expired every time you give a medication you should check to make sure that is not expired especially PRN medication those go expired before we know it lock the Med storage area while meds are given and you want to keep those keys hit that key thing hard don't leave those C's around identify the residents ensure it's the right person if the resident likes to hold the meds in their hands some of them you know they like to hold them and they like to count so I have five pills I always take five pills in the morning make sure that their hands are clean explain what meds you are giving and why always explain the reason for the meds or any treatment or procedure it's important that you know and it's important that the resident knows ensure the resident is correctly positioned to prevent choking you may have to rewash your hands because you're touching people use those gloves when you're touching people administer meds by the right route of administration and make sure that if you're setting medications or creams or in down on that bedside table that you've cleaned that bedside table that's probably not very sanitary by the time you get in there always encourage water or fluids I get a lot of well she only drinks you know this or show me drink maybe a couple sets well maybe that's true but you want to encourage that all the time not just what you think they usually drink try to get them to drink more older people are chronically dehydrated everyone these days is practically chronically dehydrated I think what that person wait to ensure that all meds are swallowed with no issues are they going like this after you give them the big potassium pill is it burning because that's not a good thing that potassium can literally burn a hole in your esophagus if it sits there long enough especially if they've had other issues and in your stomach make sure there's some water it's going down are they coughing or choking or clearing your throat are they complaining of reflux make sure they've swallowed all those things dispose of your supplies after you're done wash your hands after giving the meds possibly using some sanitizer are the residents hands now clean did they touch their mouth and get slobber all over it wash their hands document immediately after giving the meds or you could shirt by exception I'm not gonna go into great detail but that is also acceptable where you would just initial everything as you pull it out and then you'll go back and circle and explain thereafter those are both acceptable per the state's operations manual double-check those Mars before you move on to the next resident ensure you gave all those meds and that you initial them if you didn't give it circle it and then on the back document why you didn't give it note and report any issues either to the nurse if you're the med aide or to your superior or to the doctor if you're the nurse if you had any issues with the past or maybe some unusual responses to the meds

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