RCFE - Residential Care Facility for the Elderly Medication Management Procedures Questions and Answers 1 — Questions and Answers
Question 1: A staff member at a 20-bed RCFE discovers they gave a resident the wrong dosage of their morning medication. What is the MOST critical immediate action for the staff member to take?
- Document the error in the resident's file and on the Centrally Stored Medication and Destruction Record (LIC 622).
- Immediately notify the resident's physician and the facility administrator, and monitor the resident for any adverse reactions. (Correct answer)
- Wait to see if the resident shows any adverse effects before reporting the incident to avoid unnecessary alarm.
- Ask the resident to take the correct dosage immediately to counteract the error.
Correct answer: Immediately notify the resident's physician and the facility administrator, and monitor the resident for any adverse reactions.
According to best practices and regulatory expectations, the immediate priority after a medication error is the resident's safety. This involves assessing the resident, notifying the prescribing physician for medical guidance, and informing facility management. Documentation is crucial but secondary to the immediate health and safety response.
Question 2: According to California's Health & Safety Code, what are the initial medication training requirements for a new staff member hired at an RCFE licensed for 12 residents?
- 16 hours of hands-on training and 8 hours of instruction within the first four weeks.
- 8 hours of preparatory training and 8 hours of hands-on training within the first two weeks.
- 6 hours of hands-on shadowing and 4 hours of other instruction within the first two weeks. (Correct answer)
- 4 hours of instruction and passing an exam before handling any medications.
Correct answer: 6 hours of hands-on shadowing and 4 hours of other instruction within the first two weeks.
California Health and Safety Code section 1569.69 specifies different training requirements based on facility size. For facilities licensed for 15 or fewer persons, staff who assist with medication self-administration must complete 10 hours of initial training: 6 hours of hands-on shadowing before assisting with medications and 4 hours of instruction within the first two weeks of employment.
Question 3: Which of the following is a requirement for assisting a resident with a PRN (as-needed) non-prescription medication if the resident cannot determine their own need for it?
- The administrator can give verbal approval based on the resident's described symptoms.
- A written order from the physician must be on file, and staff must contact the physician before each dose. (Correct answer)
- The resident's family member can provide authorization for the staff to administer the medication.
- As long as the instructions are on the product label, staff can assist the resident.
Correct answer: A written order from the physician must be on file, and staff must contact the physician before each dose.
Title 22 regulations stipulate that if a resident cannot determine their own need for a PRN medication, staff must contact the physician to describe the resident's symptoms and receive direction prior to assisting with each dose. A standing physician's order outlining the specific symptoms, dosage, and frequency is also required.
Question 4: A resident's prescription medication is discontinued by their physician. The medication is centrally stored at the facility. According to Title 22, what is the proper procedure for handling the discontinued medication?
- The medication should be immediately returned to the resident for them to dispose of.
- The medication must be destroyed by the administrator and one other adult witness, with the event documented on a form like the LIC 622. (Correct answer)
- The medication can be used for another resident if they have the same prescription.
- The medication should be flushed down the toilet to ensure it cannot be misused.
Correct answer: The medication must be destroyed by the administrator and one other adult witness, with the event documented on a form like the LIC 622.
Title 22 regulations require that discontinued, expired, or leftover medications be properly destroyed to prevent misuse. The destruction must be performed by the administrator (or a designated representative) and witnessed by one other adult. This event must be documented, and the record kept for at least three years.
Question 5: Under what circumstances must medications be centrally stored in a locked location within an RCFE?
- Only when the medication is a controlled substance.
- When the resident prefers the staff to manage their medications.
- When a physician determines a medication is hazardous if kept in the resident's possession. (Correct answer)
- All medications for all residents must always be centrally stored.
Correct answer: When a physician determines a medication is hazardous if kept in the resident's possession.
Title 22, Section 87465, specifies that medications must be centrally stored if a physician, the administrator, or the licensing agency determines they would be a safety hazard to the resident or others. While residents can self-administer and keep their own medications with a physician's written approval, central storage is required when safety is a concern.
Question 6: Which of the following actions is considered permissible "assistance with self-administration" of medications by RCFE staff?
- Crushing a tablet and mixing it into a resident's food without their knowledge to ensure they take it.
- Administering an injection as long as the staff member has been trained by a nurse.
- Reminding a resident to take their medication and handing them the pre-filled container. (Correct answer)
- Altering a prescription label to make the instructions clearer for the resident.
Correct answer: Reminding a resident to take their medication and handing them the pre-filled container.
RCFE staff are permitted to assist residents with the self-administration of medications. This includes reminding the resident, opening containers, and handing the medication to the resident. Staff, unless they are licensed professionals, cannot administer injections. Hiding medication or altering prescription labels is strictly prohibited.
RCFE - Residential Care Facility for the Elderly Medication Management Procedures Questions and Answers 1
A staff member at a 20-bed RCFE discovers they gave a resident the wrong dosage of their morning medication.
What is the MOST critical immediate action for the staff member to take?