Anyone who has ever “worked the floor” or “pushed a med cart” knows the challenges of passing medications timely and accurately, especially morning meds. There isn’t a day where something critical doesn’t happen—you’re pulled from your cart to assist in an urgent situation, a family member needs your attention, or you’re simply facing too many medications to pass within the required timeframe. From splitting units in half and staggering medication times to hiring additional med techs or nurses for short shifts, communities have tried creative ways to make medication administration less challenging.
One of the biggest hurdles I hear about during visits to senior living communities is the large number of medications ordered for the morning hours—usually around 9:00 a.m. This leaves a two-hour window for administration, beginning at 8:00 and finishing by 10:00. Seems manageable, right? It might be, if you didn’t also have to take vitals on residents with cardiac or blood pressure medications, hang enteral feedings and administer each medication individually via a PEG tube, give sliding scale insulin before breakfast, and more.
That’s why I was intrigued by a study on the timing of blood pressure medication—specifically Azor—and its efficacy. According to the research, bedtime administration of Azor provided better control of nocturnal blood pressure without reducing the effectiveness of daytime or 24-hour blood pressure. Most blood pressure medications are given in the morning, partly because some can cause more frequent urination. However, it’s worth talking to your pharmacist about whether nighttime dosing could be a good option for certain residents. If you could remove just one pill from the busy morning pass while improving outcomes, why wouldn’t you?
Consider being creative with other medications as well—vitamins, supplements, or non-urgent prescriptions may be shifted to later in the day without compromising care. Making these adjustments could lead to fewer morning medication bottlenecks and happier nurses. Sometimes, a small change like rethinking medication administration times can make a big difference in resident health and workflow efficiency.
Stay well and stay informed!
