Current through Register Vol. 30, No. 38, September 20, 2024
A. If a
facility provides medication administration or assistance in the
self-administration of medication, an administrator shall ensure that policies
and procedures for medication services:
1.
Include:
a. A process for providing
information to a participant about medication prescribed for the participant
including:
i. The prescribed medication's
anticipated results,
ii. The
prescribed medication's potential adverse reactions,
iii. The prescribed medication's potential
side effects, and
iv. Potential
adverse reactions that could result from not taking the medication as
prescribed;
b.
Procedures for preventing, responding to, and reporting:
i. A medication error,
ii. An adverse reaction to a medication,
or
iii. A medication
overdose;
c. Procedures
to ensure that a participant's medication regimen is reviewed by a medical
practitioner to ensure the medication regimen meets the participant's
needs;
d. Procedures for
documenting medication administration and assistance in the self-administration
of medication;
e. Procedures for
assisting a participant in obtaining medication; and
f. If applicable, procedures for providing
medication administration or assistance in the self-administration of
medication off the premises; and
2. Specify a process for review through the
quality management program of:
a. A
medication administration error, and
b. An adverse reaction to a
medication.
B. If a substance abuse transitional facility
provides medication administration, an administrator shall ensure that:
1. Policies and procedures for medication
administration:
a. Are reviewed and approved
by a medical practitioner;
b.
Specify the individuals who may:
i. Order
medication, and
ii. Administer
medication;
c. Ensure
that medication is administered to a participant only as prescribed;
d. Cover the documentation of a participant's
refusal to take prescribed medication in the participant's medical
record;
2. Verbal orders
for medication services are taken by a nurse, unless otherwise provided by law;
and
3. A medication administered to
a participant:
a. Is administered in
compliance with an order, and
b. Is
documented in the participant's medical record.
C. If a substance abuse transitional facility
provides assistance in the self-administration of medication, an administrator
shall ensure that:
1. A participant's
medication is stored by the substance abuse transitional facility;
2. The following assistance is provided to a
participant:
a. A reminder when it is time to
take the medication;
b. Opening the
medication container for the participant;
c. Observing the participant while the
participant removes the medication from the container;
d. Verifying that the medication is taken as
ordered by the participant's medical practitioner by confirming that:
i. The participant taking the medication is
the individual stated on the medication container label,
ii. The participant is taking the dosage of
the medication stated on the medication container label or according to an
order from a medical practitioner dated later than the date on the medication
container label, and
iii. The
participant is taking the medication at the time stated on the medication
container label or according to an order from a medical practitioner dated
later than the date on the medication container label; or
e. Observing the participant while the
participant takes the medication;
3. Policies and procedures for assistance in
the self-administration of medication are reviewed and approved by a medical
practitioner or registered nurse;
4. Training for a personnel member, other
than a medical practitioner or registered nurse, in assistance in the
self-administration of medication:
a. Is
provided by a medical practitioner or registered nurse or an individual trained
by a medical practitioner or registered nurse;
b. Includes:
i. A demonstration of the personnel member's
skills and knowledge necessary to provide assistance in the self-administration
of medication,
ii. Identification
of medication errors and medical emergencies related to medication that require
emergency medical intervention, and
iii. The process for notifying the
appropriate entities when an emergency medical intervention is
needed;
5. A
personnel member, other than a medical practitioner or registered nurse,
completes the training in subsection (C)(4) before the personnel member
provides assistance in the self-administration of medication; and
6. Assistance in the self-administration of
medication provided to a participant:
a. Is
in compliance with an order, and
b.
Is documented in the participant's medical record.
D. An administrator shall ensure
that:
1. A current drug reference guide is
available for use by personnel members, and
2. A current toxicology reference guide is
available for use by personnel members.
E. When medication is stored at the substance
abuse transitional facility, an administrator shall ensure that:
1. Medication is stored in a separate locked
room, closet, or self-contained unit used only for medication
storage;
2.
Medication is stored
according to the instructions of the medication container; and
3.
Policies and procedures are established, documented, and implemented for:
a. Receiving, storing, inventorying,
tracking, dispensing, and discarding medication, including expired
medication;
b. Discarding or
returning prepackaged and sample medication to the manufacturer if the
manufacturer requests the discard or return of the medication;
c. A medication recall and notification of
participants who received recalled medication;
d. Storing, inventorying, and dispensing
controlled substances; and
e.
Documenting the maintenance of a medication requiring refrigeration.
F. An administrator
shall ensure that a personnel member immediately reports a medication error or
a participant's adverse reaction to a medication to the medical practitioner
who ordered the medication and the registered nurse required in
R9-10-1405(I)(6).