A Tuesday Tip subscriber recently emailed to ask us about the common practice of giving routine medications within a two-hour “window.” This got us thinking about what standards are out there regarding medication delivery times? While it is fairly common practice to give medications within a two-hour timeframe of the scheduled delivery time, there are very few state assisted living regulations that actually address this issue.
Fortunately, the Institute for Safe Medication Practices (ISMP) [LINK: www.ismp.org] offers guidance. The ISMP is a nonprofit organization devoted entirely to medication error prevention and safe medication use. The organization is known and respected worldwide as a resource for impartial, timely, and accurate medication safety information.
The ISMP provides the following recommendations for medication delivery timeframes for “non-time-crticial scheduled” medications:
- Daily, weekly, or monthly medications
Administer these medications plus or minus 2 hours from the scheduled time. (Although it is generally safe to administer daily/weekly/monthly medications within a timeframe that exceeds 2 hours, ISMP recommends keeping the timeframe to 2 hours before or after the scheduled time to prevent accidental omission of doses that might be more easily forgotten if delayed more than 2 hours.)
- Medications administered more frequently than daily but not more frequently than every 4 hours (e.g., BID, TID, q4h, q6h)
Administer these medications plus or minus 1 hour from the scheduled time.
- Medications administered more frequently than every 4 hours (e.g., q1h, q2h, q3h)
Administer these medications within 25% of the dosing interval (e.g., plus or minus 15 minutes for hourly doses, plus or minus 30 minutes for every 2 hours dosing, plus or minus 45 minutes for every 3 hours dosing).
Always follow your state regulations and organizations policies and procedures.