Controlled Med Administration and Counting
With RTask's E-mar, users can track counts for controlled medications electronically both at the point of medication administration, and any time on-demand (typically during shift changes).
Before you Begin:
- Ensure that any med requiring a pill count is marked as a "controlled" medication. This is done on the Global Generic Medication List screen in ResiDex, or can be checked from the med entry screen for that resident.
- If residents have both a scheduled order and PRN (as needed) order for the same medication, ask that the pharmacy supply this in two separate bottles, cards, or cartridges. This allows you to maintain accurate records for each order.
- RTasks offers two different configurations for the EMAR; identify what configuration is in use at your campus. If your medications are setup by the nurse in a dosage box or are supplied by the pharmacy as a group of meds packaged together according to time of administration, you may be using the Dosage Box Configuration. If staff punch out meds from individually-packaged bubble packs, you are likely using the Standard EMAR configuration.
Receive Medications Count
This screen allows users to document quantities of medications received from the pharmacy and add them to the number on hand for a new total.
- From the Clinical tab in RTasks, select the option "Receive Medications"
- Select the name of the resident and the medication you are documenting as received. Once the medication is selected, the dosage information appears.
- If you choose to have a witness document the count, select the name of the witness and have them enter their RTask password in the appropriate field. This is optional.
Scrolling down, there are fields allowing additional entry:
- Count/Quantity Received- enter the number of pills or quantity received from the pharmacy
- Count/Quantity Remaining- add the quantity received to the quantity already on hand to enter a total quantity remaining
- Received date- enter the date received from the pharmacy
- RX number- list the RX number of the received medication. Note: there is room to include two RX numbers here, so users can enter both the old and new RX number so both are displayed and can be viewed when staff are administering
- Pharmacy- the name of the pharmacy from which the medications were received (only the resident's own pharmacies will be listed)
- Provider- the name of the prescriber (only the resident's own health care providers will appear)
- Note field- is optional and allows users to add any additional details they wish (such as if the pharmacy is sending only a partial fill of a given medication and more are expected).
Med Setup/Nurse Review Count
From the Clinical button in RTasks, select the option allowing nurses to document medications setup or reviewed by the nurse. Because the title of this is configured per facility, the name may vary-- Med Setup, Nurse Review, etc....
- Select the resident you wish to setup or review medications for and
- Select the date range of the medications being setup or reviewed. The resident's medications will then populate.
- You are able to select each medication and document the setup or review. If the medication is a controlled medication, you have the ability to enter a count
- If your database has the Dosage Box configuration, nurses will be subtracting the number he/she is setting up and entering the total number remaining. In Dosage Box configuration, meds are grouped for administration and so staff will NOT be asked to perform a count when administering scheduled medications.
- If using the Standard EMAR configuration, the nurse will simply be entering the total count on hand. Staff will be subtracting each dose upon administration.
- An optional note can be entered if needed.
E-mar Today Screen Pill Count:
- Log into RTasks
- Click on a med assist service
- A "banner" will appear if the medication is a controlled medication
- If using the Dosage Box EMAR configuration, staff will not need to enter a count with each administration; this was done by the nurse at setup/review.
- If using the Standard EMAR configuration, staff will be asked to enter the following:
- Enter the number of pills given
- Enter the number of pills remaining
- View medication count history (optional)
Staff can document counts at any desired interval using the Clinical/Medication Counting screen. This allows facilities to document at what interval is required in their state, under their license or facility policy. To do this
- Click on the Clinical button in RTasks and select
- Medication Counting from the dropdown menu
- Select the name of the resident; that person's controlled medications will populate below
- Enter the name of a witness. This can be configured to be either an optional or a required field. If using a witness, have them enter their RTask password in the appropriate field
- Scroll down and enter the current count of the first medication listed.
- An optional note field could be used to document if this is a count correction- if a dose needs to be wasted or to explain an incorrect count.
- Click on "Save" and scroll to the next medication listed.
- At the bottom, users have the option to go "back" and close out of the Medication Counting Screen, or
- Click on "Next Resident" which will allow you to document counts for the next resident alphabetically (saving time if you are counting all controlled meds for a group of residents).
Correcting Med Counts
- While RTasks will alert users if a count being entered is incorrect or does not correspond with the last count entered, it WILL allow you to override that and enter a number.
- If a correction to a count needs to be entered, this should be done under the Clinical/Medication Count screen-- any note entered in conjunction with this screen will be included in the count history. The RTask Report "Pill Count History" can be used to document controlled med counts by resident.
View Medication Count History
- Click on "View Medication Count History"
- Enter a date range
- View the details below including the number of pills given, the count remaining and the staff who documented
Incorrect Pill Count:
As you are entering a pill count, you may notice a warning message if the count does not match. You can edit the count or look at the view medication count history to find out if the previous pill count was incorrect. Below is an example of the message that will appear if the count is not consistent.