{"report_id":232,"form_id":"23","user_id":81,"organization_id":10,"question_id":"100","question_type":"Free_Text","text_answer":"Agency staff administering the incorrect medication was influenced by passing medications in apple sauce to two people at the same time. Staff punched out medications for two people from pre-packaged bubble packs at the same time, placed them both in apple sauce but then could not differientiate between the medications in apple sauce.   An additional factor influencing giving the incorrect medication to the person was that the provider had one less staff working than they typically did during medication administration. The provider typically had a 2 staff to 4 person ratio until 8pm, so that two staff would be on during the 6p-8p med administration window. On this day, the person\u2019s mother kept him out past the medication window, so that when he returned the second staff had left, leaving one staff on to administer the person\u2019s meds when he arrived. The provider's staff ratio and schedule is influenced by the county\u2019s service agreement with the provider to deliver services. MNCHOICES also influences how the county determines how many staffing hours to include in their service agreement and what medication administration responsibility they assign to the provider.    \r\n\r\nStaff had further constraints on their attention while assisting another person in the home with a blood check. This was further supported by staff worrying about the adverse effects of not passing seizure medications within the window of the medication protocol.  The pressure to pass timely seizure medications is based on the provider\u2019s medication protocol. 245D licensing and nursing protocols further complicated the medication protocol which connects to the person\u2019s physician who established specific times and dosages. Medications for both people were in apple sauce and when the person arrived staff felt pressure to pass medications and did pass the incorrect nighttime medications to the person.  \r\n\r\nThe DWRS, MNCHOICES assessment, and county service agreement also impacted the staff schedule and further complicated the medication protocol.","created_by":81,"updated_by":81,"updated_at":"5\/26\/2021 5:29:33 pm","created_at":"5\/26\/2021 5:29:33 pm","id":38643}