top of page

Transfer of Accountability and Its Importance in Long-Term Care

The transfer of accountability (TOA) in nursing is a critical component of patient care and safety in long-term care (LTC) facilities. TOA is the process of transferring information, responsibility, and authority from one healthcare provider to another, ensuring continuity of care and minimizing the risk of errors or omissions. Proper TOA is essential in LTC facilities, where residents may have complex medical needs and require multiple caregivers.


TOA ensures that the information about the patient's care is accurately communicated from one healthcare provider to another, ensuring that the patient's needs are met and that there is no duplication or omission of care. This is particularly important in LTC facilities, where residents may have multiple healthcare providers who work in different shifts, and coordination of care is essential to ensure continuity and safety.


In addition, TOA is critical in ensuring that the patient's medication regimen is accurately managed. Medication errors are a leading cause of harm to patients in LTC facilities, and proper TOA can help prevent these errors. The transferring nurse should provide the receiving nurse with complete and accurate medication administration records, including any changes or adjustments that have been made to the medication regimen.


Proper TOA can also help identify potential risks to patient safety. For example, if a resident's condition changes, and the transferring nurse notes this, the receiving nurse can be alerted to this change and take appropriate action. Proper TOA can help prevent adverse events, such as falls, pressure ulcers, and infections, by ensuring that all healthcare providers are aware of the resident's needs, risks, and care plan.


The transfer of accountability (TOA) is a critical component of patient care and safety in long-term care facilities. Proper TOA ensures that information is accurately communicated, medication is appropriately managed, potential risks to patient safety are identified and addressed, and continuity of care is maintained. LTC facilities must ensure that their staff is trained in proper TOA and that this process is followed consistently to ensure the safety and well-being of their residents. By prioritizing TOA, LTC facilities can improve patient outcomes, reduce the risk of harm, and ensure high-quality care for their residents.


The “Med Pass” process is a critical aspect of patient care and safety in Ontario long-term care (LTC) facilities. Med Pass refers to the process of administering medication to residents in a timely and accurate manner. Typically one Registered Nurse cares for 30 residents in a long term care facility. Should that RN be absent for a shift, the remaining RN should not be expected to complete med pass for 60+ residents. Doing so can have negative consequences for patient care, patient safety, and the RN's legal liability.


When a registered staff member is absent, the other RN’s are often asked to fill in and complete the Med Pass process. This can put significant stress on the staff members who are not registered nurses and who may not be as familiar with the medications and potential side effects. Furthermore, when staff members are stretched too thin, there is a greater risk of errors or omissions in the Med Pass process.


Patient safety is the major concern. The Med Pass process requires careful attention to detail, and mistakes can have serious consequences for residents' health and well-being. The process of administering medication involves complex interactions between medications, residents' medical conditions, and other factors that require the expertise of a registered nurse.


In addition to the negative impact on patient care and safety, there are also legal consequences to consider when there is a limited number of RN’s available to complete the Med Pass process in a long term care facility. Registered nurses have a higher level of liability when it comes to administering medications, and if something were to go wrong during the Med Pass process, the RN could be held legally responsible.


The Med Pass process is a critical aspect of patient care and safety in long-term care facilities in Ontario. Having a limited number of RN’s available, will put undue stress on staff members, compromise patient safety, and create legal risks for the RN. LTC facilities must prioritize having adequate staffing levels and trained registered nurses available to complete the med pass process to ensure that residents receive the highest quality of care and remain safe.

16 views
bottom of page