Medication Pass Audit - ageiahealthservices.net

1 Medication pass Audit Medication Assistant: _____. Date: _____ Time: _____ State: _____. NOT DELEGATIONS*. OBSERVATION MET MET CBG. 1. Medication room door closed and locked (OR)? Cart and narcotic bin locked Resident Name: at all times when MA not within visual sight and arm's reach of the cart (WA)? _____. 2. Hands washed prior to beginning of the Medication pass ? pass /Fail 3. Medications pre-popped after all previous medications given (OR)? No pre- popped medications in cart (WA)? SQ Injection (OR). 4. Different forms of medications kept separate in cart? Name: _____. 5. Has this Medication Assistant signed the current MAR (not applicable to pass /Fail communities that utilize E-MAR)? 6. Preparation and assistance with administration of medications done in SQ Insulin Injection accordance with the 5 rights? (OR/WA): 7. Each Medication sheet initialed according to Community procedure and state Name: regulations?

2 _____. 8. Are any pills touched by hands? pass /Fail 9. Medications yet to be passed are with Medication Assistant at all times? 10. Are medications left on tables or unsupervised? Wound Care Name: 11. Insulin given according to onset times? _____. 12. Medications are passed to meet time requirements (within 1 hour prior and 1 pass /Fail hour after scheduled time)? 13. Appropriate time allowed between use of eye drops and inhalers? Ostomy Care: 14. Inhalers, eye drops, ear drops, nasal sprays, and topical medications Name: administered properly? _____. 15. Narcotics signed out at time of removal from locked area? pass /Fail 16. Multi-use Medication containers checked for date opened and/or expiration date ( eye drops, nose spray, insulin, etc.)? Other: 17. Different forms of medications kept separate during Medication pass ? Name: _____. 18. Are medications passed to support dignity, privacy and home-like pass /Fail environment?

3 19. Were all residents observed to swallow medications? *All delegation tasks 20. Were hands washed for adequate cleansing between residents? must follow the 21. Shift to shift schedule Medication count process correct? delegation instructions in order to pass .. Comments: _____. _____. _____. _____. _____. _____. _____. _____. _____. _____ _____. LN/RCC MA Signatur