Original studyNursing Home Medication Administration Cost Minimization Analysis
Section snippets
Methods
This is a cost minimization analysis using observational data from a time-motion analysis of nurses administering medications. The analysis identifies the cost of administering different dosage forms and regimens of medications, allowing for calculation of product administration costs. The Institutional Review Boards of Campbell University and East Carolina University approved this study.
Results
At each facility the 5 observed nurses administered medications to a total of 51 residents. Of those, we analyzed 41 residents at each facility. Each nurse administered medications to an average of 10.4 ± 1.4 residents per medication pass. Each resident received an average of 7.3 ± 3.7 medications during the observed medication pass. Nursing experience averaged 9.6 years with a range of 2 to 21 years. The average number of years the nurses had administered medications was 6.3 years with a range
Discussion
This is the first study that takes into consideration the cost of administering different dosage forms and the cost when additional medication passes are added for a resident. The reader can calculate the medication pass cost using our data results in conjunction with local nurses’ salaries with benefits (Figure 1).
Compared to a previous study,5 the time to administer a crushed medication was longer (80.3 versus 124.0 seconds in our study) but the time to administer an oral medication was
Conclusion
The cost of medication administration is important to consider in nursing home residents since it requires nursing time and salary. Frequency of dosing should be considered when choosing between otherwise equivalent medications or dosage forms. If extended release products are equally or only slightly more expensive than the immediate release products, then choosing the extended release product would be less costly by saving medication administration costs. The cost differential is dependent on
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2020, Journal of the American Medical Directors AssociationCitation Excerpt :By extrapolation, a reduction in the average number of medication administration times for regular medications from 4 to 3.66 times per day could therefore free up 51 minutes of staff time per resident per month, or 85 hours of staff time per month in a 100-bed RACF. Similarly, a United States study estimated that reducing the number of administration times from 3 times per day to once per day could save 63 minutes of staff time per resident every month.39 However, time estimates may differ based on country of residence, resident care needs, local medication administration practices, the total number of residents included in the medication round, polypharmacy, time of day, and use of dose administration aids.
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2012, Journal of the American Medical Directors AssociationCitation Excerpt :Medication costs were compared using paired t tests, with separate analyses for overall, scheduled, and PRN medication costs. The overall administration time was calculated by multiplying the number of doses of discontinued medications by the average nursing time required to administer medications, previously reported to be 45 seconds per medication.24 The nursing costs for medication administration were estimated based on nursing staff average hourly wage of $23.10 using publicly available labor statistics25 and registered nurse/licensed practical nurse staffing ratios at this facility.
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2012, Clinics in Geriatric MedicineCitation Excerpt :Nursing time for medication administration was estimated at 45 seconds for each oral medication pass.69 The cost of adding an oral medication once a day for a patient was between $7 and $10 depending on timing of administration, and the cost of adding an oral crushed medication once a day was between $21 and $31, depending on whether the medication was given at an existing medication pass or a new medication pass needed to be added.69 Nursing medication administration times also differed, depending on type of nursing home unit (62 minutes per 20 residents on physical support units, vs 84 minutes per 20 residents on behavioral care units).
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