By Katherine Jankauski, RN, BSN

Overview

Private Duty Nursing Home Care is skilled care provided one-on-one by a Private Duty Nurse (RN or LPN) to medically fragile adults and pediatric patients in the comfort of their homes. A patient's unique and complex health challenges require personalizing care, tailoring it to the physician-ordered Plan of Care. Private Duty Nursing home care is different from traditional home health as the service is typically provided in longer shifts, anywhere from 8 to 24 hours over a long period.

Private Duty Nursing patients usually have many medications, with one or more controlled substances (Narcotics), to be administered during the shift. Medication management is one of a Private Duty Nurse's most essential responsibilities while working with patients with chronic complex medical conditions. Private Duty Home Care agencies should have a corporate policy to monitor narcotic counts and the safe handling of narcotics. Effective Narcotics Monitoring Program will maintain compliance with regulations, prevent the diversion of drugs and medication errors, and maintain accountability.

This blog will discuss the benefits of the Narcotics Monitoring Program and the best practices for implementing the program in Private Duty Nursing Home Care agencies.

Benefits of Narcotics Monitoring Program

A good Narcotics Monitoring Program should help Private Duty Nursing Home Care agencies prevent drug diversion and medication errors and maintain compliance and accountability.

Diversion of Drugs

Narcotics are potent and controlled substances that have the potential for abuse. The primary function of narcotic counts is to ensure that they are not being diverted or stolen for purposes not intended by the prescriber. Diversion of narcotics will endanger the patient's health through over or under-medication. By conducting narcotic counts per shift, nurses can identify any discrepancies in their medication supply chain, such as missing or excess medication, and report them to the relevant authority, preventing the diversion of drugs.

Medication Errors

Medication errors are a significant threat to patient safety. Overmedication or undermedication, especially with controlled substances, can lead to adverse drug reactions, patient harm, addiction, or even death. Narcotic counts help nurses keep track of their medications, and they can quickly identify if a patient has received a drug overdose or missed a dose.

Compliance

According to the Federal Controlled Substances Act, all narcotics must be accounted for and tracked through a drug inventory system, and narcotic counts are essential to compliance with these regulations. Non-compliance with these regulations can result in penalties or legal action against the home care agency and the responsible parties, including the nurses.

Accountability

The accountability of nurses, as well as the home care agency, is an essential aspect of responsible controlled substances management, and narcotic counts make it easier to identify the responsible party in case of any discrepancies or errors. This accountability system ensures that all parties involved in the mediation process know their responsibilities and are held liable for any mistakes, negligence, or abuse.

Best Practices for Narcotics Monitoring Program

Private Duty Nursing Home Care agencies should adhere to a set of best practices for an effective Narcotics Monitoring Program. The following are some of the best practices agencies can adhere to.

Corporate Policy

It is essential to develop a clear and well-defined agency policy with best practices to handle, document, administer, and track narcotics for patients with the explicit goal of recognizing signs of diversion and abuse. The policy should be clear for the staff to be informed of and understand the policy to ensure proper narcotics tracking and management.

Narcotic Count

Agency policy should indicate how often the staff should conduct narcotic counts at a patient's home. The ideal approach for Private Duty Nursing Home Care agencies is to count narcotics at the beginning and end of the shift. Narcotic counts must be recorded on a Narcotic Count Sheet, preferably electronic, at the time of each count.

Verification System

Home Care Agencies should establish a two-person verification system for narcotic counts. Two staff members should participate in the count process at the beginning and end of the shift. The second staff member should sign the narcotics count sheet as a witness. A two-person verification process will help agencies minimize errors and promote accountability.

Discrepancies

Agency policy should establish a process to address any discrepancies promptly. If there are discrepancies in the narcotic count, it is essential to report them, investigate them promptly, and take appropriate action. This helps ensure errors are corrected and patient safety is not compromised.

Conclusion

Private Duty Nursing Home Care Agencies should develop an effective Narcotics Monitoring Program and establish best practices to implement the program. A good Narcotics Monitoring Program will help agencies prevent drug diversion and medication errors and improve compliance and accountability. Agencies should also leverage technology to successfully implement the program.

About CareVoyant

CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.

CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.

For more information, please visit CareVoyant.com or call us at 1-888-463-6797.