Medication errors – where a resident is given the wrong medication, given the wrong dose, given a medication at the wrong time, or not given a prescribed medication at all – happens in almost 20% of doses, according to some studies. These potentially lethal errors are mostly preventable, and understanding medication distribution in facilities is important in order to be a good advocate for your loved one.
Because many residents are on 5 or more medications, understanding how mediations interact with other medications, food, and within the body is important. Oftentimes, medications must be given at specific times during the day or within a certain time of a meal to be effective and safe.
Medication are given out either by a nurse, or a specially trained Certified Nurse Aide. The process of distributing medications is “med pass.” Typically, the medications are placed on a “Med Cart” that’s wheeled through the facility and medications are administered.
After a medication is given, a document called a Medication Administration Record (MAR), is initialed to indicate the medication was either given, or initialed and circled if the medication was not given. If the chart is electronic (an EMAR), then the box is clicked on, or gets a special designation if the medication is not given. If a medication is not given on either a MAR or EMAR, the nurse or aide must state why it was not given.
The MAR or EMAR is a part of the chart, and must be produced if a request for one is made. Since documentation must be done when the medication is given, an up to date MAR or EMAR should be available.
Most medication errors are preventable with adequately trained staff. However, in many facilities and despite the importance of medication distribution, short staffed facilities force nurses and aides to rush through med pass often making mistakes. Additionally, many facilities use undertrained aides who cannot recognize adverse events when there is a medication error to distribute medications. Sometimes, because staff do not have the time to both distribute mediations and correctly document, MARs are initialed for multiple days and shifts all at the same time.
Many times, medication errors are discovered because a resident is lethargic, or worse they suffer a serious adverse event or death.
Adequate staffing is the key to a safe and effective med pass. Making sure nurses or aides do not have to rush through med pass is critical to doing this important job correctly. Also, aides trained to know the medications they are distributing and how to recognize a problem is extremely important.
At the next care conference, ask about your loved one’s medications. You can request the last MARs and ask about the med pass procedures. Find out who’s doing med pass and why they were chosen. Understanding how to avoid medication errors can help you be the best possible advocate for your resident.