Q:

Our facility is thinking about implementing flexible time ranges for medications rather than a specific time to help us stay in compliance with our heavy morning and evening medication passes. What are the pros and cons of making this change?

 

A:

Deciding between using a specific scheduled time (e.g., 8:00 AM) versus a time range or window (e.g., 8:00 AM–11:00 AM) for medication administration can significantly impact compliance, safety, and workflow. Here’s a breakdown of the pros and cons.

 

Pros include:

    • Improved time management by giving the nurse flexibility in prioritizing care based on resident needs.
    • Reduced stress and risk for medication errors during high-volume times.
    • Supports resident-centered care by allowing med times to be adapted to resident routines (e.g., meals, sleep schedules, therapy sessions), improving resident satisfaction and compliance.
    • Decreased late administration errors.

 

Cons include:

    • Risk of staff unintentionally delaying critical, high-risk medications beyond the safe window (e.g., insulin, anticoagulants)
    • Some medications require strict timing for optimal therapeutic effect.
    • Documentation confusion if the eMAR system requires a specific time unless range-based administration is programmed correctly.
    • Regulatory risk if misused to justify noncompliance with timely administration for time-sensitive medications.

 

Best Practice Recommendation:

    • Consider using time ranges for non-critical medications to improve workflow efficiency and resident-centered care.
    • Use specific scheduled times for time-critical medications, including:
      • Insulin (especially rapid-acting)
      • Parkinson’s meds
      • Antibiotics
      • Anticoagulants
      • Seizure medications

 

 

Written By:

 

Angie Hamer, RN, RAC-CT

Senior Consultant

Proactive LTC Consulting

 

 

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