Long-Term Care Survey Alert

Question: We've found residents taking herbal remedies that could interfere with their medications. How should we go about managing these potential resident safety issues?

Answer: The facility and its healthcare professionals have a duty to meet the standard of care.

And that involves doing a comprehensive history on the patient, including a medication history where you ask about traditional OTC medications, as well as herbal and nontraditional medications, says Mardy Chizek, RN, FNP, BSN, MBA, AAS, CLNC, a legal nurse specialist in Westmont, Ill. Also ask the right questions, such as "Do you take anything that you or someone buys at a health food store?" or "Do you take over-thecounter medications that you buy at the drugstore or anything that anyone else gets for you?"

"The facility staff also has to research or consult with someone to determine the side effects and drug interactions that the OTC or herbal remedies might cause," adds Chizek. The facility itself cannot prohibit the resident from taking an OTC med or supplement, says Joseph Bianculli, an attorney in private practice in Arlington, Va. "But make sure that the MD and/or pharmacist counsels the resident/representative about any contraindicated medication or substance. The MD or pharmacist should document the counseling."

Also: The facility "absolutely" should have a policy requiring families to inform staff of any over-the-counter medication or supplement they are bringing the residents, adds Bianculli.