Legacy House of Bountiful Telephone: (801) 294-2925 Address: 79 East Center Street Bountiful, Utah

Night Box Policy

Communicating With the PM Med Techs:
The PM med techs will pull any medication scheduled during the graveyard shift, and commonly given PRN medication. After they have done this they will check the medication that they have pulled against the Night Box MAR. And if they add any medication to the night box they will write it on the Night Box MAR. When the graveyard med aide arrives they will check the medications in the Night Box against the Night Box MAR to verify that all needed medication is present. After both the PM med techs and graveyard med aide have verified that all of the medication on the Night Box MAR is present they will sign in the appropriate place. After the night box has been checked the PM med techs will give the graveyard med aide a brief report about any PRN medication that was given on the PM shift, any residents that are LOA and any other pertinent information. The PM med techs will also give the graveyard med aide any 48-hour follow-ups that need to be completed and the 24-hour communication sheet.

Graveyard med aide responsibilities:

Along with handling graveyard meds, the graveyard med aide has other responsibilities. These include sending residents to the ER and handling a resident death. Below is a description of what to do in these situations.

Sending Residents to the ER:

If a resident needs to be sent to the ER because of an injury, fall, or illness the graveyard med aide must notify the emergency contact person, the building director and RCC. BEFORE sending a resident to the hospital, check and make sure that the resident isnt a hospice patient; if the resident is a hospice patient then the hospice agency MUST be called first. The hospice nurse will determine whether or not the patient needs to be sent to the hospital, and will give instructions on how to proceed. A list of the hospice patients and their hospice agencies (with phone numbers) is located on the whiteboard in both the Wellness Center and the Cottage Office. When the AM med techs arrive, the graveyard med aide will need to report any residents have been sent the hospital during the graveyard shift, which hospital the resident went to, and any updates that were received during the graveyard shift about the residents status. It will be the responsibility of the AM med tech to contact Flex Care, if any residents on Flex Care were sent to the hospital during the night. DO NOT send a hospice patient unless instructed to do so by the HOSPICE nurse.

Resident Death:
If a resident passes away during graveyard shift, it is the responsibility of the graveyard med aide to contact the appropriate people and take charge in preforming post mortem care. If the resident is a hospice patient then the hospice agency needs to be contacted first. The

graveyard med aide will need to ask the hospice nurse if hospice will contact the family and mortuary and if they will come and preform post mortem care, or if they would like the graveyard med aide to do those things. If the resident isnt a hospice patient then the graveyard med aide will be responsible for preforming post mortem care and contacting the family. When contacting the family, the graveyard med aide will need to ask if they need to contact the mortuary, if the family would like to do so, or if the family would like some time before the mortuary is contacted. The building director and the RCC need to be contacted as well, if a resident passes away. When a death occurs the graveyard med aide will need to fill a Record of Death form. These forms are located in the filing cabinet in the CNA room. The form will need to be filled out COMPLETELY and be signed and dated by the graveyard med aide. The graveyard med aide will need to have the mortician sign and date the form as well. When the AM med techs arrive, the graveyard med aide will give them the completed form.

Communicating With the AM Med Techs:

When the AM med techs arrive, they will check the night box with the graveyard med aide. After the night box is checked, the AM med techs and the graveyard med aide will write any remaining medication down on the Night Box MAR and sign it. The graveyard med aide will then give a brief report about any PRN medications that were given during graveyard shift; if any scheduled medication wasnt given and why it wasnt given; falls that occurred, if a resident was sent to the hospital; if a resident passed away and any other pertinent information. The graveyard aide will also give the AM med tech any Incident Reports and 48-hour follow-ups and Records of Death.