THINGS TO KEEP IN MIND
• TB solution EXPIRES 30 days after it has been
opened. Keep track of this. You can put it in
the calendar so that it isn’t missed.
• As a general rule of thumb…..any meds (other
than pills) expire at 30 days of opening. This
includes flu vaccines.
• Make sure you are dating everything when
you open it. Not just on the package but the
• Any time supplies are
ordered, they have to
send safety sharps and
• You have to document
all blood sugar results.
• We cannot have “house
stock” diabetic supplies.
• If the pharmacy does
not send safety
supplies, call them.
• Initialing the MAR is mandatory. No holes can
be in the MAR. Blood sugars need initialed,
filled out, etc. If state finds a hole in the MAR
for insulin or a blood sugar, they can issue an
Immediate Jeopardy tag.
• Daily MAR audits will occur. If there are holes,
disciplinary action will occur.
• Any verbal order in the charts must have an
MD or NP signature. If no signature, then no
chart. Place in mailbox in med room that is
designated for these.
• On the MARs, the residents’ code statuses
need to be on there. I hand wrote them in for
July and I hope that Omnicare will put them
on the August batch.
• There are now forms called “72 Hour Observation”.
• This form is used for a Change of Condition. (ie: s/p fall, 911
being called with refusal to be transported, generalized
complaints with an assessment and no new orders.
• The regular Nurses’ Notes are for anything requiring longer
than 72 hour documentation.
• All narcotics will be counted with the on-
coming and off-going shifts every day. CNAs
are witnessing in counting of the narcotics.
• DO NOT forget to sign the count sheets.
• Make sure you are keeping track of any
Coumadin changes on the form that is
• This is critical to complete…….
Beginning in July
• MARs and TARs will be in the same binder.
• Our nursing staff will be responsible for
completing the monthly weights and vital
signs as we are no longer allowed to have
hospice come in and do these. Our plan is to
make an activity out of this.
• All residents’ have to have a master signature
log with their MARS. These will stay with them
until they are discharged or deceased.
• We are not allowed to
• We are in the process of
getting Med-Lab to come
in and do our blood
• KDH will no longer be
doing our blood draws.
• We will let you know
when this transition
• When a resident goes out
for a visit and meds need
to be sent, you have to
send the entire cards,
bottles, etc. No more
individual doses in
• There is a form for this.
Please sign and date below stating that you have
read and understood the content of this
information. Detach this page and return to ALD.