Part I. Packaging: High vs. Low Risk


Packaging makes a big difference when it comes to transmission. The type of packaging used determines the number of times it needs to be handled. There are two predominant types of packaging: punch cards and pouch packs. Here is a look out how each fairs when it comes to transmission potential.

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Risk Factor HIGH: Punch Cards

Punch cards–also referred to as blister or bingo cards–are a high-touch packaging system. Nurses and caregivers have to handle them each and every time they administer medications to a resident or participant, typically multiple times a day. Each pill that needs to be “punched-out” requires touching the packaging, thereby increasing the chances of transmission. The very nature of the punch card, while useful for “pill counting”, creates a scenario where cards are handled frequently by multiple individuals up to dozens of times a day. 

Nurses also come into regular contact with punch cards (even those they don’t need), when rifling through crowded med carts to find a particular card they are looking for. Not only is this filing system cumbersome, but it adds additional unnecessary touches to medication packaging.

The punch card system dramatically adds to transmission potential in both SNF and PACE environments.

104 Touches a Day

It’s not uncommon for a resident to have as many as 13 daily medications that need to be taken twice a day. This scenario requires a nurse to touch each card a minimum of 52 times PER medication pass (flipping through, pulling out, punching out and returning each card to the medication cart). At two medication passes a day, that’s a minimum of 104 touches in a single day. This number increases exponentially if a card is missing, misfiled or dropped on the floor.


Risk Factor LOW: Pouch Packs

Medication pouch packs, on the other hand, require the least number of touches per day. Grane Rx SimplePack pouches are “touch and toss”. Each participant or residents’ medication regimen comes in a neatly organized roll of multi-dose packs separated by day and time of dose. All medication rolls are created in the pharmacy using automation, thus eliminating any touches during assembly. Once medication leaves the pharmacy, the SimplePack system reduces the number of touches by consolidating medications in single pouches as part of a sequential roll of tear-off pouches. Each pouch necessitates a single touch and then is immediately disposed of. The Grane Rx SimplePack solution significantly mitigates risk and saves measurable amounts of time on administration.

SimplePacks in the Nursing Home

Grane Rx delivers its SimplePacks to nursing homes in single rolls transported in disposable totes. This system reduces the number of required touches to as little as two. A nurse handles the roll of SimplePacks a single time to separate them by resident, placing each resident’s regimen in its respective, individual bin. The only other touch that occurs is during administration itself. The packaging is then immediately disposed of via Grane Rx’s “touch and toss” system.

Grane Rx’s SimplePack barcode printing capability is an added benefit and transmission mitigator. For SNF’s equipped with a barcode scanner, Grane Rx can produce barcodes from the facility’s EHR. This enables quick, easy and contactless medication verification for accuracy and documentation.

SimplePacks in PACE

PACE home delivery through Grane Rx’s Meds2Home program takes medication administration out of the center and directly into the home. This contactless delivery method eliminates virtually all touches with a participant’s medications. In this scenario, participants are either self-administering their medications that arrive in personalized Meds2Home boxes, or a single caregiver in the home is administering their meds via the SimplePack roll system. In nearly all cases, the caregiver is someone the participant either 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.

NEXT UP: Part II. Hands-off Storage Solutions

When storing prescription medications, it’s not the storage itself that’s problematic for transmission, it’s how the medications are stored and accessed that makes the difference.