Current through Reg. 50, No. 187; September 24, 2024
(1) A "medication
error" is any of the following:
(a)
Administration or supervision of self-administration of a wrong medication,
including:
1. Administration or supervision
of self-administration of medication for any symptom, illness, or reason other
than the one for which the medication was prescribed;
2. Administration or supervision of
self-administration of medication for which there is no current prescriber
order;
(b) Administration
or supervision of self-administration of a wrong dose, including;
1. Administration or supervision of
self-administration of an incorrect dose of medication;
2. Administration or supervision of
self-administration of more than one dose of the same medication in a scheduled
time period;
(c)
Administration or supervision of self-administration of a medication to the
wrong client, which means the administration or supervision of
self-administration of medication to a client that is prescribed or ordered for
someone else;
(d) Administration or
supervision of self-administration of medication via the wrong route;
(e) Failure to administer or supervise the
self-administration of medication within 60 minutes of the prescribed dosage
time;
(f) Failure to immediately
and accurately document administration or supervision of self-administration of
medication on the MAR;
(g)
Administration or supervision of self-administration of a medication which has
expired or is improperly labeled;
(h) Failure to conduct an accurate medication
count for controlled medications;
(i) Failure to administer or supervise the
self-administration of a medication, for any of the following reasons:
1. Client refused the medication;
2. MAP or licensed health care practitioner
did not administer or supervise the self-administration of the
medication;
3. Medication was not
available;
4. New order not
initiated within 24 hours;
5.
Refill not ordered timely;
6.
Insurance issue;
7. Pharmacy
issue;
8. Family error;
9. Other not given;
(j) Administration or the supervision of
self-administration of medication by a MAP not validated as required by rule
65G-7.004,
F.A.C.
(2) Immediately
following an error as listed in subsection (1), the MAP, licensed health care
practitioner, or facility administrator must take the following steps:
(a) Notify supervisory personnel;
(b) In the case of administration of a wrong
medication, a wrong dosage, or the provision of medication to the wrong client,
immediately notify the client's health care practitioner, observe the client
closely for a minimum period of 60 minutes after the medication was
administered or self-administration was supervised, or for as long as directed
by the health care practitioner, and immediately report any observed changes in
the client's condition to the prescribing health care practitioner, and call
911 to request emergency services if the client exhibits respiratory difficulty
or other potentially life-threatening symptoms;
(c) For all errors listed in subsection (1),
with the exception of paragraphs e., f., g., h., and j., notify the client's
prescribing health care practitioner of the error, and if there is no licensed
health care professional present, request that the practitioner prepare and
electronically transmit via fax or secure email a medication directive
addressing the error to the client's home, facility, or pharmacy, and document
the client's health care practitioner's response or lack of response;
and
(d) Fully document all
observations and contacts made regarding a medication error in a "Medication
Error Report, " APD Form
65G-7.006 A, effective April
2019, incorporated herein by reference, which may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10598.
The MAP or licensed health care practitioner shall place a copy of the Report
in the client's file. It is permissible to use an alternate Medication Error
Report form generated by an electronic system, provided that the alternate
electronic form collects all the information required and collected on the
Agency form.
(3) If a
medication error occurs in a facility, the MAP or licensed health care
practitioner must:
(a) Submit the Medication
Error Report to the facility administrator and to the Regional Office within 24
hours of discovering the error; and
(b) Maintain a copy of the report in the
client's record and also with the MAR for review.
(4) If a medication error occurs in a
client's home, the MAP or licensed health care practitioner who committed the
error must:
(a) Submit a Medication Error
Report to the Regional Office within 24 hours of discovering the
error;
(b) Maintain a copy of the
report in the client's record and with the MAR for review.
(5) If a discrepancy in the accounting of a
controlled substance occurs following a medication count, the MAP or licensed
health care practitioner must report the discrepancy within 24 hours following
discovery of the error to:
(a) The Regional
Office; and
(b) The MAP's or
licensed health care practitioner's supervisor, if
applicable.
(6) If an
Agency MCM determines that the medication error justifies corrective action,
the Regional Office will notify the MAP, licensed health care practitioner, or
his or her supervisor in writing of the necessary corrective action plan,
including a specific and reasonable timeframe for completion of the corrective
action plan. If the MAP or licensed health care practitioner fails to comply
with the corrective action plan, the Agency may take action against:
(a) The MAP's validation, including
prohibiting the MAP from providing medication administration services;
or
(b) The provider's residential
facility license, and
(c) The
provider's Medicaid Waiver Services Agreement.
Rulemaking Authority
393.501,
393.506 FS. Law Implemented
393.506
FS.
New 3-30-08, Amended
7-1-19.
