Risks and Safe Med Passes - Agency CMA
Passing medications in a facility as an agency CMA can be difficult especially when you are not familiar with the residents. Here are some tips to help.
1.) Report. Do not go straight to the med cart and expect to jump right in, rather even if you are behind med pass time, take a little time to get report, even if this means locating the nurse and asking for information, such as:
a.) are there any residents that are on new meds or have had their meds changed?
b.) are there any residents that are having acute health issues or need close monitoring for side effects?
c.) have any residents experienced a fall in the last few days?
d.) what other concerns do you have that I need to be aware of?
Take notes on these, write down those resident's names and room numbers and any medication changes, use this information for observations as you conduct the med pass and report to the nurse as needed.
Know the drugs and the side effects. Look them up if needed. Basic common one might be:
1.) Antihypertensives can cause hypotension, watch for light headedness. This can result in a fall risk. Blood pressure monitoring is important.
2.) Anticoagulation drugs such as warfarin have side effects of bleeding aka hemorrhaging, watch for excess bruising and ask about the Coumadin flow sheet to ensure the dosage is the latest and correct.
3.) Cardiac glycosides (digitalis) drugs can cause brady cardia (slow pulse) and dangerous dysrhythmias (irregular pulse), take the pulse BEFORE preparing the meds for administration.
4.) Psychotherapeutic drugs and any CNA depressants including anxiety medications and sleep aids have side effects of drowsiness, dizziness which of course can lead to falls and injury. Keep and eye out for these and make the C.N.As working with those residents aware. Do not forget that many psychotherapeutic drugs such as Haldol carry a risk of tardive dyskinesia, a repetitive movement disorder, notify the nurse if this is observed.
2.) Ask the staff as you are passing meds questions regarding a resident that you are needing clarification, such as " I see Dorothy has consistent sis to side mouth movements, is this normal for her? How long has she been doing this?" If the answer is she has done this for as long as she has been here last year then you have good reason to believe that this is her baseline, she has tardive dyskinesia, and not something you especially need to stop and report to the nurse before administering the medication. You should however make note of it and report it after the med pass.
