Medication Refusal and Physician Notification

It is not uncommon for residents to refuse medication.  Some are “chronic refusers” while others refuse only rarely.  Licensing expects us to notify the physician of every missed medication.  While this is certainly ideal, in the real world it can be challenging.  It is not unheard of for a physician to even become disgruntled with the constant calls.  If a community does not notify the physician, however, there is inherent risk.  By not notifying the physician the provider is in essence saying, “I know there are no medical risks to this resident not taking this medication.”   Most providers do not want this level of decision making, so calling the physician is the safest route.

Is there any short cut to this process?  Yes!  Many LPAs are satisfied with a physician order that reads “Notify MD after 3 consecutive missed doses.”  By having such an order, then you are required to communicate with the physician less frequently.  Remember: 

1.  Make sure your LPA is comfortable with such an order.

2.  Be sure to have than order in writing, before implementing.

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