Nursing Home Question

[BidingMyTime]

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Not sure if anyone here will have an answer, or maybe this is just a problem in my local area....but why when a patient is discharged from the hospital to a nursing home, and then readmitted a few months later, they suddenly have like 10 new allergies? This happens more often then it doesn't happen. Like, pt will be discharged with normal allergies like penicillin and sulfa, and when they come back, they suddenly have allergies to penicillin, sulfa, lisinopril, codeine, robitussin, amlodipine,vitamin D, paxil, trazodone, metformin, niacin, and benadryl.

Do nursing homes just put in as an allergy, anytime the patient has any kind of side effect from a drug? Or maybe if a drug was ineffective, they decide to list it as an allergy so they remember not to prescribe it again for the pt? Or is this some kind of nursing home game I don't know about, where the LPN that documents the most allergies wins a prize?

Obviously this is annoying from a pharmacy standpoint, when it's obvious that many of these new allergies can not possibly be real allergies, yet we have to treat them all as genuine allergies. I just can't figure out why this would be a positive from the nursing home viewpoint, since it obviously is since they are the ones adding these new allergies.

 

[owlegrad]

I wonder the same thing actually. I don’t think it is quite as bad here but some of the allergy lists are rediculous. So much wasted time to call to get ‘clarification’ when they order it next week.

 

[lord999]

Sigh, there's order set protocols in Cerner that automatically apply soft-stop allergies if not asked explicitly. Example is if I don't ask about penicillin, it's listed as an allergy until otherwise, but on discharge, it sticks on as an allergy. More like the LPN is too lazy to ask. Beggar thy neighbor strategy.

 

[Idk17]

I've come across plenty of allergies I'll call nursing homes about where the nurse will tell me the patient thought the tablet was just too big, or tasted bad. I feel like it's not much different than retail, except in retail the follow up questions get asked.. "ok, what kind of a reaction was it? oh.. yeah, that's not an allergy."

 

[owlegrad]

On a totally different topic, any Florida LTC pharmacies care to share how y'all are dealing with HB 21 and needing to check PDMP before dispensing controls? We are having a heck of a time trying to build that into our workflow...