Current through Register Vol. 50, No. 9, September 20, 2024
A. The CRC may provide pharmaceutical
services on-site at the center or off-site pursuant to a written agreement with
a pharmaceutic al provider.
B. All
compounding, packaging, and dispensing of medications shall be accomplished in
accordance with Louisiana laws and Board of Pharmacy regulations and be
performed by or under the direct supervision of a registered pharmacist
currently licensed to practice in Louisiana.
C. The CRC shall ensure that a mechanism
exists to:
1. provide pharmaceutical services
24 hours per day; and
2. obtain
STAT medications, as needed, within an acceptable time frame, at all
times.
D. CRCs that
utilize off-site pharmaceutical providers pursuant to a written agreement shall
have:
1. a physician who assumes the
responsibility of procurement and possession of medications; and
2. an area for the secure storage of
medication and medication preparation in accordance with Louisiana Board of
Pharmacy rules and regulations.
E. A CRC shall maintain:
1. a site-specific Louisiana controlled
substance license in accordance with the Louisiana Uniform Controlled Dangerous
Substance Act; and
2. a United
States Drug Enforcement Administration controlled substance registration for
the facility in accordance with title 21 of the United States
Code.
F. The
CRC shall develop, implement and comply with written policies and procedures in
accordance with applicable federal, state and local laws and ordinances that
govern:
1. the safe administration and
handling of all prescription and non-prescription medications;
2. the storage, recording and control of all
medications;
3. the disposal of all
discontinued and/or expired medications and containers with worn, illegible or
missing labels;
4. the use of
prescription medications including:
a. when
medication is administered, medical monitoring occurs to identify specific
target symptoms;
b. a procedure to
inform clients, staff, and where appropriate, client's parent(s), legal
guardian(s) or designated representatives, of each medication's anticipated
results, the potential benefits and side-effects as well as the potential
adverse reaction that could result from not taking the medication as
prescribed;
c. involving clients
and, where appropriate, their parent(s) or legal guardian(s), and designated
representatives in decisions concerning medication; and
d. staff training to ensure the recognition
of the potential side effects of the medication;
5. the list of abbreviations and symbols
approved for use in the facility;
6. recording of medication errors and adverse
drug reactions and reporting them to the client's physician or authorized
prescriber, and the nurse manager;
7. the reporting of and steps to be taken to
resolve discrepancies in inventory, misuse and abuse of controlled substances
in accordance with federal and state law;
8. provision for emergency pharmaceutical
services;
9. a unit dose system;
and
10. procuring and the
acceptable timeframes for procuring STAT medications when the medication needed
is not available on-site.
G. The CRC shall ensure that:
1. medications are administered by licensed
health care personnel whose scope of practice includes administration of
medications;
2. any medication is
administered according to the order of an authorized licensed
prescriber;
3. it maintains a list
of authorized licensed prescribers that is accessible to staff at all
times;
4. all medications are kept
in a locked illuminated clean cabinet, closet or room at temperature controls
according to the manufacturer's recommendations, accessible only to individuals
authorized to administer medications;
5. medications are administered only upon
receipt of written orders, electromechanical facsimile, or verbal orders from
an authorized licensed prescriber;
6. all verbal orders are signed by the
licensed prescriber within 72 hours;
7. medications that require refrigeration are
stored in a refrigerator or refrigeration unit separate from the refrigerators
or refrigeration units that store food, beverages, or laboratory
specimens;
8. all prescription
medication containers are labeled to identify:
a. the client's full name;
b. the name of the medication;
c. dosage;
d. quantity and date dispensed;
e. directions for taking the medication;
f. required accessory and
cautionary statements;
g.
prescribed name; and
h. the
expiration date;
9.
medication errors, adverse drug reactions, and interactions with other
medications, food or beverages taken by the client are immediately reported to
the client's physician or authorized licensed prescriber, supervising
pharmacist and nurse manager with an entry in the client's record;
10. all controlled substances shall be kept
in a locked cabinet or compartment separate from other medications;
11. current and accurate records are
maintained on the receipt and disposition of controlled substances;
12. controlled substances are reconciled:
a. at least twice a day by staff authorized
to administer controlled substances; or
b. by an automated system that provides
reconciliation;
13.
discrepancies in inventory of controlled substances are reported to the nurse
manager and the supervising pharmacist in accordance with federal and state
laws.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
36:254 and
R.S.
28:2180.14.