Investigation of Medication Administration for Adult Family Homes in Washington State AFH Centers
Problem statment: DNP project.
AMA style ,
WAC 388-76-10475 Medication—Log. The adult family home must: (1) Keep an up-to-date daily medication log for each resident except for residents assessed as medication independent with self-administration. (2) Include in each medication log the: (a) Name of the resident; (b) Name of all prescribed and over-the-counter medications; (c) Dosage of the medication; (d) Frequency which the medications are taken; and (e) Approximate time the resident must take each medication. (3) Ensure the medication log includes: (a) Initials of the staff who assisted or gave each resident medication(s); (b) If the medication was refused and the reason for the refusal; and (c) Documentation of any changes or new prescribed medications including: (i) The change; (ii) The date of the change; (iii) A logged call requesting written verification of the change; and (iv) A copy of written verification of the change from the practitioner received by the home by mail, facsimile, or other electronic means, or on new original labeled container from the pharmacy. (4) Ensure that the changed or new medication is received from the pharmacy.
Problem Statement
The Adult Family Homes (AFH) in Washington State was established by the Department of Social and Health Services (DSHS) and serve vulnerable populations especially the elderly. They also serve those with physical and developmental disabilities, mental illness and the elderly, multiple diagnoses, complex medication in lists, special needs, and those whose needs have not been adequately coordinated. Approximately 75% of the residents in AFHs in the country receive funding from Medicaid. Currently, AFH providers are not required to have health care background or training for medication administrations, but they are trained and supervised by the nurse delegators. In Washington state there are strict laws on dispensing medication and there are AFH citations for repeated violations like WAC 388-76-10475 (Medication Log) which needs to be current.
The Adult family Home council is an organization that was established to ensure homes in Washington State are well supported and equipped with the necessary resources to accommodate increased needs in living facilities. Adult family homes reportedly have been regularly cited for failure to follow Washington Administrator Codes (WAC),...