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1、MedicationManagementandMedicationErrorsinAssistedLiving药物管理和生活辅助用药错误FundingSources: WAandOR:NationalInstituteofNursingResearch NJ:RobertWoodJohnsonFoundation,AssistantSecretaryforPlanningandEvaluation,DHHSIL:SarahS.FullerMemorialScholarship,NIUSchoolofNur
2、singIllinoisDepartmentofHealthcareandFamilyServices,MedicaidAdvisoryCommittee,Long-TermCareSubcommitteeFocusofthissymposiumPresentfindingsfromtwostudiesofmedicationsafetyinAssistedLivingOverviewofpolicyvariationacross4statesVariationsamongmedicationaidean
3、dRN/LPNrolesinassistedlivingMedicationerrorsandstrategiestopreventerrorsConclusionsDesignandMethodsDescriptive,multiplemethodsMedicationAdministrationObservations(n=4802medications)FocusedinterviewswithRNs,medaides,administrators,physiciansandnursepractit
4、ioners,pharmacists(n=113)Residentrecordreview(n=187)ThesettingsFifteenassistedlivingsettingsinWashington,Oregon,NewJersey&Illinois4inOR,WA&NJ;3inILStateassistedlivingvariations: OregonandWashingtonWashington3profit/1non-profitChain/stand-aloneFavorprivate
5、pay,someMedicaidLighterlevelofcareOregonMostarefor-profitAllpartofachainHigherMedicaid,someprivatepayFocusonfrailolderadults,retainlongerStateassistedlivingvariation:NewJerseyandIllinoisNewJerseyChain/stand-aloneFavorprivatepay,someMedicaidFocusonfrailold
6、eradultsIllinoisChain/stand-aloneTwoPrograms:AssistedLiving(AL;privatepay,lighterlevelofcare)SupportiveLivingFacilities(SLF;Medicaidwaiver,nursinghomealternative)NursingDelegationTrainingandassigningtasksrelatedtonursingcareand/ormedicationadministrationS
7、omestatesallowmedicationadministrationwithoutdelegation,variationsinamountsofnursingoversightMaybegovernedbystatenursepracticeactandadministrativerulesImpactedbystatelicensingstatutesandrulesforcommunitybasedfacilitiesNursingDelegationLegalliabilityInsome
8、states,thereisanstatutoryimmunityfortheactionsoftheunlicensedpersonsfornurseswhodelegateStatepolicyvariation: OregonandWashingtonWashington>10yrsdelegationSpecificdelegation(notinsulin)+superviseself-adminofmedsRegi
