{"report_id":203,"form_id":"23","user_id":81,"organization_id":10,"question_id":"100","question_type":"Free_Text","text_answer":"The staff not following the policy that requires three medication checks prior to giving medications was influenced by the staff feeling comfortable and experienced with medication delivery after having worked at the facility for 6 years.  The people in the home being easy going and independent with some of their personal cares contributed to the staff feeling comfortable.  The Provider has a 2 step process for checking in meds from the pharmacy.  The first check is completed by the LPN, Program Manager, or Location Coordinator and the second check is completed by any of the aforementioned or a DSP.  The provider\u2019s medication administration policies are influenced by 245D and outlined in the CSSP.  The provider\u2019s policy are in place to protect the health and safety of people and to reduce errors that could result in Vulnerable Adult Maltreatment.  Medications are received in pill packs from the pharmacy and are checked two times, this further supports staff feeling comfortable when passing medications\r\nAnother influence to staff not completing the three medication check was that staff felt pressure to hurry to give person their morning medications. Person has a history of being inpatient to get morning medications as they then have to wait 30 minutes to eat as directed by their Physician.  The person being served has 12 morning medications that have to be recorded in the online Medication Administration Record which takes time for staff to complete. Staff was in a hurry to pass medications to avoid behaviors from person and to attend to other duties and responsibilities prior to the end of their shift.  Medication delivery is right before a shift change, so staff typically have to finish up with a number of tasks.   The home has 4 people and the people are active, interactive with staff, and need staff support which are additional influences to why the staff felt rushed.   \r\nAnother contributing factor to staff feeling rushed was that the home is single staffed in the mornings. Staffing patterns are impacted by the staff ratio, which is determined by the MNCHOICES assessment and Disability waiver rate system, as well as the expectation that person centered choices at the home are provided.  This allows for the work schedule to be adapted to accommodate more staffing during day shifts to allow for more outings, resulting in morning staff being limited to one, further influencing staff need to hurry to ensure all morning task were completed.  COVID-19 lead to the Governor\u2019s executive stay at home order and Day services were then closed.  This increased the need for more staff to cover shifts at a time when staff shortage was at an all-time high.","created_by":81,"updated_by":81,"updated_at":"5\/26\/2021 4:29:37 pm","created_at":"5\/26\/2021 4:29:37 pm","id":37174}