Overview 

In this article we will review the process of administering orders in reconcile.

Instead of using the paper MAR and TAR, ACCUflo will be used to administer and record the results of medications and treatments.  Once users are logged into ACCUflo, they can begin the medication pass.  The residents assigned to the Selected Group will display onscreen.

Show/Hide Icon

Users should remember to use the Show/Hide Icon when the med cart must be left unattended.

Note: Select the Show/Hide Icon to hide the screen before leaving the med cart computer unattended. 

Note: Select the Show/Hide Icon to unhide the screen when returning to the med cart computer.

Resident Status

If a resident has a status of LOA, Hospital, or Bed Hold selected, the resident’s screen will display “Couldn’t find any orders.” 

Note: Orders cannot be administered when a resident's status is anything other than 'Active' or 'Discharged'.

Charting Options

Depending on how each facility is configured, you may see more then the default options of Administer and did bot administer medications when charting.

Note: Home Health and Self-Administered charting options are optional and set up in configurations.

• Administered
• Did Not Administer
• Home Health (optional)
• Self-Administered (optional)

Procedure for Administering Orders in Reconcile

When the Controlled Substance Count Configuration Allow Charting while in Reconcile is active, users may continue to document controlled substances with a known count discrepancy after receiving approval from the appropriate staff member based on the community’s policies and procedures. If this configuration is inactive, users will be prohibited from administering any orders that are out of compliance.

Step 1: To begin a medication administration, select the desired resident on the Main Residents’ Screen.  Alternatively, if scanning is enabled, users can scan a barcode on the resident’s medication packaging to be automatically taken to the Resident’s Screen.

Step 2: The Resident’s Screen will display all orders due to be given at this time.  Users can narrow the view to a specific order type by selecting a specific order type from the Left Panel.

Step 3: To select an order, users can click the desired order tile on the screen or, if scanning is enabled, users can scan the barcode on the medication’s packaging.

• If the selected order is in reconcile and Allow Charting while in Reconcile is active, the user will receive a prompt warning them that the inventory count is out of compliance and ask if they want to continue.

• Select yes, if you have received authorization to either administer or not administer the medication that is out of compliance.
• Select no, you have not received authorization and need to be returned to the medpass.

• After selecting yes, the user will be prompted to enter the appropriate staff member that authorized the out of compliance medication to be given from the list of available ACCUflo users.

Note: The users response will be stored and can be audited by administrators by running the Orders Charted While in Reconcile report.

Step 4: The order tile(s) will now have a check mark, and many tiles change to a lighter shade indicating that the order has been selected for administration.

Step 5: Once all orders ready to be administered have been selected, users should hide the screen if they must leave the med cart computer unattended during the administration.

Step 6: Upon returning from the administration, the orders are ready to be charted as:

• Administer: Used if the orders were given to the resident and completed.
• Did Not Administer: Used if the orders were not able to be completed.  Do not select this option if the orders may be administered later—orders should be charted as Did Not Administer once users are sure the orders will not be given.
• Self-Administration: Used if the resident or the resident’s family administers the orders.
• Home Health: Used if a staff member from Home Health, a Hospice nurse, etc. administers the selected orders.  Refer to the community’s policy for correct use.

Once the orders have been charted, they will no longer display on the Resident’s Screen.  To return to the Main Residents’ Screen, users can select the Residents Tab.

Note: If the community has enabled the Black Box Warning Feature or the Give Quantity Warning feature and there is a warning associated with a medication or a quantity set above one, the Black Box Warning and/or the Give Quantity Warning will display when the medication is selected. Read the warning and select Close; As well as any Note that is assigned to a specific order.

If an order was not checked in prior to an attempt to administer a pop up will appear that warns the user to go to Medication Check In to check in the narcotic prior to administration to keep the count accurate.