PART III. Limit Transmission in Medication Administration

Overview

The recent pandemic has given us cause to reexamine the role of medication administration in disease transmission and assess how we can mitigate potential risks in both clinical and non-clinical settings.

Nurses and caregivers play an important role in disease transmission prevention. By implementing best practices and taking proactive measures, they can have a significant impact on limiting the spread of disease during medication administration. 

Physical distancing is one of the most effective ways to prevent disease transmission. However, this strategy is often not realistic or feasible in the senior environment. 

Download a PDF of the complete “Raising Awareness of Transmission Risks” series.

Healthcare workers must continue providing resident and participant care, pandemic or not, to ensure their charges are receiving the medications they need, when they need them. While we can’t eliminate contact in senior care altogether, nor would we advise it due to the health benefits of human connections, we can limit contact for safety purposes. Reducing the frequency of medication administrations is an effective way to limit the spread of disease.

Strategies for Skilled Nursing Facilities to Reduce Transmission in Medication Administration

Consider Medication Formulations

Analyze resident medication regimens to identify opportunities to optimize medication administration. For medications that are dosed multiple times a day, consider switching to a long-acting formulation or another agent that can be given less frequently. If there are multiple individual medications being given, determine if there may be a combination product available to reduce the total number of medications and pills being administered.

Adopt Flexible Administration Schedules

For medications that do not require administration at specific times, consider switching to a flexible or universal medication schedule. This includes evaluating medications that can safely be given at the same time in order to reduce outlier medication administration times. This strategy will help minimize the total number of administration times per day, allow more flexibility for the nursing staff to consolidate administrations, and generally provide a more patient-friendly experience.

The overall goal is to eliminate multiple medication administrations in close time proximity to one another other by consolidating. This effectively eliminates unnecessary touch points.

Reduce Transmission Potential by nearly 70%

Scenario: A resident has three medication orders – one for evening, one for bedtime and one to be taken every 12 hours. As long as there are no contraindications or restrictions, these medications can be given “in the evening” at the same time. This effectively reduces the number of medication passes from three to one and transmission potential by 2/3rds.

De-prescribe Medications

Continually monitor resident regimens for unnecessary medications that were previously prescribed but are no longer needed. De-prescribing reduces the number of medications in a resident’s regimen, in turn reducing the frequency of administrations. Eliminating unnecessary medications has the added benefit of minimizing interactions and adverse events.

Meds2Home Takes PACE Medication Administration out of the Center and into the Home thereby Reducing Transmission Potential

Grane Rx’s Meds2Home program provides the optimal solution for transmission reduction. All participant medications are packed at a Grane Rx off-site pharmacy using no-contact automation and then shipped directly to participant homes. This contactless delivery method eliminates virtually all touches with a participant’s medications. From there, a participant is either self-administering their medications, or a single caregiver in the home is administering their medications. In nearly all cases, the caregiver is someone the participant already lives with or is in regular contact with via daily care. In either case, external influences and potential for transmission are reduced to the greatest extent possible.

 

By adopting the above medication administration strategies for skilled nursing facilities and implementing the Meds2Home program for PACE, we can significantly reduce transmission of diseases and streamline how medications are administered.

Next Up: Part IV. De-prescribing to Reduce Transmission

When it comes to medication regimens, less is actually more in reducing transmission. The fewer number of medications that need to be administered, the fewer opportunities for potential disease transmission to residents and participants…