As SNF consultants, we often see medication mis-handling and storage issues that can lead to non-compliance. For example, nurses handling medications with bare hands and expired stock in med rooms and supply closets. We share a few basic competencies below. If you see violations to the following, so will the surveyor on your next survey!

Medication Administration Nurse Competencies

• 5 Rights when administering meds (safety checks to avoid medication errors); right resident, right drug, right time, right dose, and right route.
• Medication carts should have all necessary supplies available before initiating a medication pass. The cart must be clean, sanitary, and well organized. Drawer bottoms must be free of spilled liquids, dust and other debris.
• Medication cart/narcotic keys should always be in the nurse’s possession.
• Narcotics are in a properly double locked drawer on the med cart.
• Never leave an unlocked med cart unattended.
• Nurse’s hands must be clean when handling medications and hands should never come into contact with medications.
• Pre-pouring medications is NEVER allowed.
• Medications should not be crushed if the manufacturer indicates “Do Not Crush” – such as enteric coated or time-released medications.
• Medications administered via G/J-Tube should not be crushed and combined when administering unless ordered to be combined by the physician/extender.
• Hand hygiene must be performed after administering resident medications.
• Medications must be administered under the supervision of a nurse and never left at the bedside.
• Document medication administration ONLY after the medication is given to the resident, not before.

Stock Rotation

• Medication rooms must be properly maintained. Cleanliness, organization and rotation of stock is essential.
• Insulin/insulin pens, ointments and other prescribed medications are clearly labeled with the nurses initials and date/time opened.
• Unopened insulin pens are kept refrigerated.
• All expired Medication should be discarded appropriately and not stored with other medications beyond the expiration date.

Coretactics has developed policies and competencies on proper medication handling and administration. If your staff could use a refresher, give us a call. Our consultants can provide hands-on guidance for your nurses.