The number of residents in long-term care facilities is continuing to climb as the baby boomer
generation enters the golden age. Long-term care facilities, seeking to meet the medication and care needs of this population while adhering to a strong bottom line, are staffing slanted ratios of UAP’s (unlicensed assistive personnel) to licensed nurses.
Many of the care needs of this patient population are well suited for such ratios but a growing concern is mounting over the use of UAP’s such as medication aides for the dispensing of daily patient medication with scarce licensed nurse supervision. In a research article, Paula Carder and Janet O’Keeffe (2016) determined that most regulating bodies have insufficient provisions for what constitutes oversight of such unlicensed personnel in these facilities. The article goes on to say that 32 states actually require facilities using UAP’s as medication administrators to hire a licensed nurse for oversight. Of those 32 states, only six give parameters as to when nurses are available for support and oversight of such personnel.
Because UAP’s lack the extensive training of licensed practical nurses and registered nurses, it has long been a concern that poor understanding, training, and supervision is a recipe for avoidable medication errors and harm to patients. The aforementioned study by Carder and O’Keefe highlighted observational findings of medication errors from UAP’s to be as high as 42%. Additional studies listed in the Carder/O’Keefe work showed that 52% of UAP’s surveyed believed medication training to be insufficient (Paula Carder, 2016).
In the care setting of 2018, with nursing shortages becoming ever increasing, it is understandable that long-term care facilities wish to extend their coverage through the use of UAP’s for many patient needs, but that does not absolve the facilities of the need for proper supervision of such tasks. These facilities, as a whole, do an adequate job of taking care of the nation’s aging population.
When safety nets are inadequate and supervision is insufficient to keep resident’s safe from harm as a result of medication errors, ADROIT® is an experienced resource to aid legal teams in the pursuit of justice.
Paula Carder, J. O. (2016, September). State Regulation of Medication Administration by Unlicensed Assistive Personnel in Residential Care and Adult Day Services Settings. Research in Gerontological Nursing, 9(5), 209-222.
The complete Carder/O’Keefe article can be read here.