Medication Management in Assisted Living Lessons from Current Research.
-
Upload
bruno-hoover -
Category
Documents
-
view
219 -
download
3
Transcript of Medication Management in Assisted Living Lessons from Current Research.
![Page 1: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/1.jpg)
Medication Management in Assisted Living
Lessons from Current Research
![Page 2: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/2.jpg)
85%of assisted living residents require assistance with medications
NCAL
![Page 3: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/3.jpg)
NSRCFFirst time national assisted living data collection effort by the CDC/NCHS/ASPEwww.cdc.gov
![Page 4: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/4.jpg)
NCALAssisted Living State Regulatory Review 2012 – www.ncal.org
![Page 5: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/5.jpg)
CEALNonprofit collaborative of 11 national organizations:Alzheimer’s Association, AALNA, AAHSA, AARP, ASHA, ALFA, CCAL, NCAL, NCB Capital Impact, PVA, Pioneer Network
![Page 6: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/6.jpg)
BackgroundResearch
Challenges
Recommendations
![Page 7: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/7.jpg)
Older adults take an average of5 prescription medications per month
CEAL
![Page 8: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/8.jpg)
Those with 3+ chronic health conditionsAverage 6-7 prescription medications per month
CEAL
![Page 9: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/9.jpg)
Assisted Living Residents 10 routine medications per
day
3 PRN medications per day
![Page 10: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/10.jpg)
state regulations
are all over the
map
![Page 11: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/11.jpg)
10 statesutilize nurse delegation
![Page 12: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/12.jpg)
20 statesallow unlicensed assistive personnel to administer medications
![Page 13: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/13.jpg)
20 statesrequire “assistance with self-administration”
![Page 14: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/14.jpg)
“assisting with self-administration”a regulatory play on words
![Page 15: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/15.jpg)
Background
ResearchChallenges
Recommendations
![Page 16: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/16.jpg)
Observational Study:Oregon Health and Sciences Institute, Rutgers, University of Washington, and Northern Illinois University
![Page 17: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/17.jpg)
28.2%medication error rate in assisted living
![Page 18: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/18.jpg)
70.8%of medication errors in AL are related to dose timing
![Page 19: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/19.jpg)
8.2%error rate when “time” errors are removed
![Page 20: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/20.jpg)
![Page 21: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/21.jpg)
No errors were judged highly likely to cause harm (out of 1373 errors)
![Page 22: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/22.jpg)
CEAL/UNC Research:
![Page 23: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/23.jpg)
35%of medication administrations involved an error
![Page 24: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/24.jpg)
71%of errors were again related to dose timing
![Page 25: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/25.jpg)
< 3%of errors had moderate to significant potential for harm
![Page 26: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/26.jpg)
Med Techsdid NOT have a higher error rate than nurses
![Page 27: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/27.jpg)
Written testresults “predicted” likelihood of errors
![Page 28: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/28.jpg)
Background
Research
Challenges
Recommendations
![Page 29: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/29.jpg)
Challenges:
Large volume of routine medications
![Page 30: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/30.jpg)
Challenges:
PRN Medications
![Page 31: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/31.jpg)
Challenges:
Injections
![Page 32: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/32.jpg)
Challenges:
Healthcare providers who do not specialize in geriatrics
![Page 33: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/33.jpg)
Background
Research
Challenges
Recommendations
![Page 34: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/34.jpg)
Focus on high-riskmedications
![Page 35: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/35.jpg)
1/3 of emergency room visits by older adults presenting with ADE are caused by 3 drugs:
•Warfarin•Insulin•Digoxin
![Page 36: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/36.jpg)
CEAL/UNC Research Showed majority of errors with potential for harm related to:
•Warfarin•Insulin•Risperidone
![Page 37: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/37.jpg)
Warfarin• Monitor for s/s of bleeding• Coordinate lab tests• Monitor OTC use
![Page 38: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/38.jpg)
Insulin• Follow delegation procedures• Monitor residents who self- administer
![Page 39: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/39.jpg)
System Redesign
Consistency in medication management regulations across states
![Page 40: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/40.jpg)
System Redesign
Improve training of unlicensed assistive personnel
![Page 41: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/41.jpg)
System Redesign
Streamline documentation, perhaps through use of electronic health records
![Page 42: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/42.jpg)
Individualized Medication Plans Promote person-centered care in all aspects of resident care
![Page 43: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/43.jpg)
Individualized Medication Plans Tailor medication schedule and use of PRN medications
![Page 44: Medication Management in Assisted Living Lessons from Current Research.](https://reader035.fdocuments.us/reader035/viewer/2022062409/56649e5f5503460f94b59e54/html5/thumbnails/44.jpg)
Individualized Medication Plans Based on resident decision-making capacity, needs, and lifestyle choices