Atria Medication Training

Atrius Medication Training Notes

Overview

• Introduction to roles and responsibilities within the Atria medication program.

• Importance of having necessary materials:

  • Pen and pencil.

  • New Hire Medication Training Participant Workbook.

• Workbook usage:

  • Following along in the course.

  • Taking notes.

  • Using as a study guide for Atria Medication Test.

• Important to pause course if workbook is not available.

• The training typically includes video modules, interactive quizzes, and practical demonstrations to ensure comprehensive understanding.

• The full course generally takes several hours to complete, followed by a mandatory proctored examination covering all modules.

Resident Medications

• Methods for filling and delivering residents' prescriptions:

  • Atria's preferred pharmacy.

  • Local pharmacies.

  • Resident family members.

  • Mail order systems.

Special Circumstances

• In special circumstances, residents may deliver their own medications, but this is not common.

• This requires a specific assessment by the Resident Services Director (RSD) to ensure the resident can safely and independently manage their medications.

• The primary concern is resident safety, as incorrect self-management can lead to medication errors and adverse health outcomes.

• Encouragement for all residents on medication programs to use the preferred pharmacy ensures clarity in medication packaging and labeling.

• Example of a preferred pharmacy: Omnicare (not universally used; check with RSD or supervisor for local preferred pharmacy).

Medication Assistance Types

• Types of Assistance Available:

  • Assistance with self-administration.

  • Self-administration by resident.

  • Administration by a licensed nurse.

Assistance with Self-Administration

• Residents receive assistance from MedTechs who offer medications at scheduled times.

• The resident is responsible for taking the medications with observed assistance.

• All MedTechs must document the administration outcome (taken or refused) using the EMAR system.

Self-Administration

• Some residents can manage their own medications.

• Requires a written physician's order ensuring safe management and storage by residents.

• Assessment by RSD to confirm capability for self-management.

• Staff must notify RSD or executive director of signs indicating unsafe self-management (e.g., loose pills, unsafe storage, unlocked doors).

Nurse Administration

• In communities allowing it, medications may be administered by a nurse based on state regulations and community service model.

• Consult RSD regarding local forms of medication assistance.

Key Principles of Atria's Medication Program

1. Prevent medication errors:

   • Address the dangers of errors leading to emergencies or resident death.

   • Errors can be attributed to staff, residents, family members, pharmacies, and physicians.

   • Policies to prevent errors:

     • Use EMAR system.

     • Close observation for adverse reactions.

     • Report errors/adverse reactions immediately.

     • Every medication error or adverse reaction, no matter how minor, must be reported to the RSD or Executive Director immediately.

     • An incident report must be completed thoroughly, detailing the medication involved, the resident's condition, the actions taken, and any contributing factors.

     • This reporting is critical for investigation, corrective action, and continuous quality improvement to prevent recurrence.

2. Respect residents' privacy:

   • Confidentiality of health information is paramount.

   • No public discussion of medications; use discretion when communicating with residents.

   • Use EMAR hide screen function when stepping away from the computer.

3. Infection control measures:

   • Importance of handwashing after preparing for medication pass and assisting residents.

   • Use gloves for certain types of administrations (e.g., eye/ear drops).

   • Follow additional precautions during outbreaks.

Medication Categories

• Types of Medications:

  • Prescription Medications: Require a written order from a licensed professional (e.g., physician).

  • Over-the-Counter Medications: Can be purchased without a prescription; must still have a physician's order at Atria for self-administration.

Common Medication Acronyms

• PRN (pro re nata): As needed. This indicates that a medication should be given only when a specific symptom or condition arises, as determined by the resident's needs and physician's orders.

• QD (quaqua die): Once a day.

• BID (bis in die): Twice a day.

• TID (ter in die): Three times a day.

• QID (quater in die): Four times a day.

• QHS (quaque hora somni): Every night at bedtime.

• STAT (statim): Immediately.

• PO (per os): By mouth.

• NPO (nil per os): Nothing by mouth.

Examples of Over-the-Counter Medications

• Common OTC medications include:

  • Tylenol (acetaminophen).

  • Advil (ibuprofen).

  • Aspirin.

  • Robitussin.

  • Mucinex.

  • Claritin.

  • Vitamins (C, D, B12, etc.).

Misconceptions About OTC Medications

• OTC drugs can be powerful and harmful, especially when combined with food or alcohol (e.g., alcohol and Tylenol can cause liver damage).

Prescription Drug Categories

• Controlled Drugs vs. Non-Controlled Drugs:

  • Controlled drugs: High potential for addiction; subject to strict regulations.

  • Non-controlled drugs: Less restrictive and can be stored without special requirements.

Schedules of Controlled Substances

• Schedule 1: No medical use (e.g., cocaine, heroin).

• Schedule 2: High potential for abuse (e.g., oxycodone, morphine).

• Schedule 3: Moderate potential (e.g., codeine).

• Schedule 4: Lower potential (e.g., Xanax, Valium).

• Schedule 5: Lowest potential (e.g., cough medicines with codeine).

Medication Effects and Interactions

• Desired Effects: Successful symptom relief (e.g., antibiotics eliminating infection).

• Adverse Reactions: Unexpected harmful effects of medications, which require reporting.

• Side Effects: Predictable reactions such as drowsiness from antihistamines.

Drug Interactions

• Occur when multiple medications cause unexpected effects; report any changes in behavior or health to RSD.

Psychotropic Medications

• Types and Side Effects:

1. Antidepressants: Side effects include nausea, changes in appetite, fatigue, and potential for serious reactions (e.g., suicidal thoughts).

2. Antianxiety Medications: Side effects can include drowsiness, gastrointestinal issues, and risk of dependence (especially with benzodiazepines).

3. Antipsychotic Medications: Side effects include sleep disturbances, weight gain, and serious reactions like neuroleptic malignant syndrome.

Geriatric Considerations

• Age-related changes affect drug metabolism, absorption, and excretion, necessitating adjusted dosages.

• Complications like decreased kidney function and heart output affect medication management.

Pain Management

• Importance of recognizing and managing pain as a health issue, not a normal aging symptom.

• Recognizing behavioral and facial cues of pain.

Medication Control Safeguards

• Controls in Place:

  • Current physician orders for all medications.

  • Accurate documentation of medication services.

  • Strict storage and labeling compliances.

  • Investigation of medication errors with appropriate reporting.

Medication Storage and Access

• Designated medication rooms only accessed by authorized personnel.

• Strict key control protocols for medication carts.

• Refrigerated medications must be monitored and logged.

Organization in Medication Carts

• Carts should store medications organized by route and resident for easy access.

• Controlled substances stored separately with locking mechanisms.

Medication Labeling and Packaging

• All medications must be labeled correctly per state and federal guidelines; incorrect labels cannot be accepted.

• If a medication arrives with an incorrect or incomplete label from the pharmacy, it must be immediately returned to the pharmacy for correction.

• Under no circumstances should staff attempt to correct or alter a medication label.

• Essential information required on labels includes resident’s name, prescriber’s name, dosage, route, and specific