On Friday, April 27, Guardian Pharmacy of Atlanta had the distinct pleasure of hearing Elaine Wright, Director of State Programs, speak to the Georgia Senior Living Association’s Luncheon meeting, sponsored by Guardian Pharmacy of Atlanta.  After a brief report on Disaster Preparedness and Proxy Regulation changes, she went right into the topic everyone wanted to hear about:   Oral Morphine administration in Assisted Living and Personal Care.

Assisted living communities and Personal care homes are not allowed or authorized to provide nursing services to residents.  All nursing services must be provided or directed by licensed health care agencies such as home health providers or hospice providers.  This rule is in place as there are no oversight agencies who monitor nursing in AL or PCH.  Therefore, all nursing activities must come from outside the community.

Morphine is a Schedule II opioid analgesic, used for pain management and end of life comfort.  It is a very good drug in that it is highly effective; however, it is also dangerous, in that along with pain relief, it slows heart rate and respirations.  Overall, it produces generalized Central Nervous system depression, and can result in death.  Use of this medication must be monitored by a Registered Nurse, who has the knowledge and assessment skills to observe for respiratory depression, and other effects of the morphine.  Also, as with all medications, solutions are more quickly absorbed into the system, and thus can work faster.

Elaine indicated that the state does not recognize that any staff member of an ALC or PCH may administer oral liquid morphine to a resident due to the fact that administration of oral liquid morphine must include assessment and observation.  This must be done by an outside Registered Nurse who has the skills to make nursing judgement.  In addition to oral liquid morphine, administration of any opioid analgesic in any form that would be administered during transition or at end of life would also have to be completed by an outside Registered Nurse

Guardian Pharmacy of Atlanta partners with you to help keep you in compliance with our Georgia State rules and regulations.  Our ultimate goal is the same as yours; providing high quality care to your residents.   In this ever changing environment, you can depend on us to help navigate you through the medication and pharmacy guidelines.  If you have questions or would like more information about our compliance management programs, please call Lori Newcomb at 404-309-4958.