How Do I Count Controlled Meds?

👥 Who This Is For

Direct Support Professionals (DSPs), nurses, and program directors

📘 What You’ll Learn

How to count and document controlled medications accurately, what to do if something doesn’t add up, and best practices for Dispill packaging

When to Count Controlled Meds

At the start and end of every shift
Before and after each administration
When opening a new card or med pack
As part of regular audits or monthly reviews

💡 Tip: Frequent counts help catch discrepancies early and protect both staff and individuals.

How to Count Controlled Meds

Always count with another staff member when possible
Start with the quantity listed on the packaging or eMAR
Count tablets one by one and don’t guess or estimate

For Dispill Packaging:

You can flip the pack over as the cups are clear for easy counting
Count the pills in each full cup and total what’s remaining
Do not open or tamper with the sealed cups

For Cards or Bottles:

Manually count all remaining tablets
Use the label instructions and last documented count as a reference
For liquids, read the level carefully and only estimate only if you’ve been trained to do so

How to Document the Count

Record each count in your organization’s Controlled Med Log
Include the date, time, quantity, and initials of both staff (if required)
Log all doses immediately after administration

📝 Note: Neighborhood LTC Pharmacy recommends using your eMAR system for documenting counts whenever possible. eMARs improve accuracy and accountability compared to paper logs.

What If the Count Doesn’t Match?

⚠️ Caution: Any discrepancy in the count should be reported immediately.

Re-count with another staff member
Double-check the MAR and recent med passes
If you still can’t find the issue, notify your nurse or supervisor
Follow your agency’s protocol for reporting and documentation

🚨 Warning: Never adjust a count without reporting it. Missing or incorrect controlled med counts must be investigated and resolved.

Best Practices for Dispill-Controlled Meds

Neighborhood LTC Pharmacy recommends including controlled meds in Dispill packs (rather than separate cards) to reduce med errors
When controlled substances are packaged with routine meds, all safety and lock requirements still apply
Be aware that storage protocols for controlled medications vary by agency and may depend on location, staffing, or individual needs

Important Reminders

Never pre-pour or pre-count controlled substances
Always keep controlled medications double-locked
Count with intention and don't multitask
Only dispose of controlled meds following approved destruction protocols

💡 Tip: Ask Neighborhood LTC Pharmacy about med packaging options that support your count and storage process.