Summary of Wisconsin's Assisted Living Medication
Management Initiative Workgroup Activities and Introduction of the Assisted
Living Medication Management Initiative Website
PDF Version of DQA 08-024
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Summary of Wisconsin's Assisted Living Medication
Management Initiative Workgroup Activities and Introduction of the Assisted
Living Medication Management Initiative Website (Link)
The purpose of this memo is to report on the outcome of the Medication
Management Workgroup Initiative workgroup's endeavor and introduce the
Assisted Living Medication Management Information Website, which is the
product of the initiative.
In recent years, there has been an increase in the number of
higher-acuity residents living in assisted living facilities in Wisconsin,
prompting a need for more sophisticated medication management in these
facilities.
Additionally, there has been concern about the occurrence of medication
errors and the adequacy of medication administration and monitoring in
assisted living facilities. Although medications can improve the functional
status and quality of life for residents, improperly managed medications can
also cause serious adverse consequences.
In a proactive response to address these concerns, the Division of
Quality Assurance's Bureau of Assisted Living formed the Assisted Living
Medication Management Initiative Workgroup in March of 2007 and consists of
the Assisted Living Regional Directors from each of the Bureau's five
regional offices.
The primary focus of the workgroup was to provide information, guidance,
recommendations, and resources for assisted living providers in all aspects
of medication management and administration.
The workgroup established the following goals:
- Reduce medication errors in assisted living facilities
- Improve medication management systems in assisted living facilities
- Provide guidance to assisted living providers in improving
communication with practitioners regarding medications
- Promote the use of accepted standards of practice related to
medication dosages, interactions, side effects, and lab values
- Establish a website with information and resources related to
medication management
- Examine the RN role in medication management in assisted living
- Identify training needs and resources
- Develop sample forms/tools for assisted living providers for pharmacy
review, communication, medication administration record, etc.
- Provide information and resources about the safe use of psychotropic
medications, including PRN usage, benefits/risks, and side effects
The workgroup researched various aspects of medication administration in
Wisconsin's assisted living facilities to determine website content.
Information sources included:
- Completion of a detailed survey by all Bureau of Assisted Living
surveyors. The survey included questions related to medication errors,
medication storage and disposal, physician orders, controlled
substances, psychotropic medications, medication administration,
documentation, RN delegation, self-administration, medication
interactions, medication side effects, monitoring of lab values and
therapeutic blood levels, and the use of multiple medications in the
same drug classification. Surveyors were asked for examples of medication errors they had
encountered, including the factors that contributed to the error, and
for suggestions about ways that DQA can assist the assisted living
industry in reducing medication errors, improve medication management,
and resolve medication related issues.
- Assisted living surveys entered in the Automated Survey Processing
Environment (ASPEN) from January 2005 to March 2007 were searched for
any citations related to medication errors, medication management, and
medication administration. Citations were reviewed to identify common
causes of medication errors and the outcome to residents and to
determine possible contributing factors.
- "Mistake-Proofing the Design of Health Care Processes," a
document produced by the Agency for Healthcare Research and Quality (AHRQ),
was reviewed by the workgroup as a potential resource for assisted
living providers in the reduction of medication errors.
- The Medication Management Topic Group Recommendation Adopted by
Two-Thirds Majority of the Assisted Living Workgroup Report to the U.S.
Senate Special Committee on Aging (2003) was reviewed by the workgroup
for recommendations that related to workgroup goals and also as a
resource for assisted living providers.
We are pleased to announce that the Assisted Living Medication Management
Initiative website is now available with links to multiple topics and
resources related to medication management. It is our intent that this
website will serve as a "living document" to which information can
be added on an on-going basis.
We encourage you to view the content of this website at http://dhs.wisconsin.gov/rl_dsl/MedManagement/asstlvgMMI.htm
If you would like
to submit materials for possible inclusion on the website, please contact
the Assisted Living Regional Director in your region.
The website is designed to provide information related to many aspects of
medication management and includes links to all previously issued BQA/OQA/DQA
memos related to medication management in assisted living facilities. The
topics included on the website are:
- Communication & Reporting
- Controlled Substances
- Documentation
- Insulin Administration
- Medical Abbreviations
- Medication Errors (including a definition developed by the workgroup)
- Medication Monitoring
- Medication Storage & Disposal
- PRN Medications
- Packaging & Labeling
- Policy/Procedure Development & Quality Assurance
- Psychotropic Medications
- Role of the Pharmacist
- Role of the RN & RN Delegation
- Self-Administration
- Staff Training
Each of these topics link to additional information/resources related to
the specific topic. There will be a general discussion for some of the
topics, with links to related BQA/OQA/DQA memos and other resources,
relevant regulations for each provider type, and sample forms or tools, if
available.
We are hopeful that this initiative will support the improvement of
medication delivery systems in assisted living facilities in Wisconsin.
Thank you for your commitment to the health and safety of Wisconsin's
assisted living consumers.
If you have questions/comments about the website or wish to submit
materials for inclusion on the website, please contact the Assisted Living
Regional Director in your region. http://dhs.wisconsin.gov/rl_DSL/Contacts/ALSreglmap.htm
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