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Keys to safer medication management and distribution
MEDICATION distribution can be one of the riskiest procedures in any correctional facility due to the high volume of inmate patients, possible black market selling scenarios and violent situations that could occur. Pharmacists, nurses and support staff administer thousands of doses of medication to inmate/patients in the general population, segregated units, and specialty housing areas on a daily basis. To make sure that things go smoothly, there are steps that must be followed to the letter. The three most common ways medications are administered are: Med Line (Watch Take), Keep on Person (KOP) and Pre-Pour meds.
Annual Training is a Key
Martha Ingram, RN, CCHP, CPHQ, director of Management & Performance Improvement at Wexford Health Sources, Inc., Pittsburgh, Pa., says their nurses are expected to annually train and refresh themselves on medication administration due to high volume and high risk of medication administration in corrections environments.
"There are several processes in place to ensure this happens. We have policies that spell out the expectations for a safe and accurate med pass which include ensuring the nurse uses two identifiers for patient ID to performing mouth checks to ensure meds are swallowed and not stashed for trafficking purposes."
She points out that administration at each site determines if the site allows a KOP system. "If a KOP system is in place at the facility it is limited medications that the patient can keep in their cell. Obviously medical staff has little control once the blister pack is given to the inmate. A KOP system is usually limited to medications for chronic conditions and not psychotropic medications, to cut down on the potential for trafficking of these meds."
EMR Technology Lacking
Ingram says that technology in corrections is far behind other health care industries (e.g., hospitals, long-term care facilities). "While electronic medical records [EMRs] are being installed in more facilities, we are far behind those electronic systems in hospitals. Nurses can rely on technology a great deal in hospitals but very little in corrections. Many EMRs that are out there for corrections do not yet have a medication administration capability. Correctional facilities are often physically old buildings with no ability to accommodate wireless technology and much of the care...