Current through September 24, 2024
A. Nurses
employed by an agency enrolled as an Intellectual Disabilities/Developmental
Disabilities (ID/DD) Waiver provider must practice within the current
guidelines outlined in the Mississippi Nurse Practice Act and applicable state
and federal laws and regulations, regardless of the setting.
1. A registered nurse (RN) and/or licensed
practical nurse (LPN) must be supervised by appropriately qualified staff
through a home health agency or other entity allowed by state and federal laws
and regulations.
2. RNs and LPNs
must be employed by a Medicaid provider and work under the direction of
physician, physician assistant or nurse practitioner.
3. If a participant cannot self-administer
medications and the guardian or legal representative is unavailable, only a
licensed nurse, nurse practitioner, physician, physician assistant or dentist
may administer or oversee administration of medications at ID/DD Waiver program
sites in the community or in the home setting.
B. The following practices must be in place
to protect the health and safety of a participant who requires medications or
medical procedures/treatments:
1. Medications
must be stored appropriately in their original containers if a licensed nurse
is to administer them.
2. Licensed
nurses may not prepare medications in a medication planner for a non-licensed
provider(s) to dispense in his/her absence.
3. All medications must be documented in the
participant's record by the appropriately licensed medical professional
administering them.
4.
Documentation must reflect whether the guardian or legal representative
administers the participant's medications or if a participant self-administers
his/her medications.
5. RNs must
assess the participant for medication side effects and report any suspected
side effects or untoward effects to the practitioner who prescribed them.
Suspected side effects or potential health issues noted by an LPN must be
reported promptly to an RN or appropriately qualified staff.
6. The first-line responsibility for
monitoring a participant's medication regimen lies with the licensed medical
professional who prescribes the medication. A licensed medical professional is
defined by the Division of Medicaid as a physician, physician assistant,
certified nurse practitioner, or licensed dentist who meets the state and
federal licensing and/or certification requirements.
7. Second-line monitoring must be provided by
the staff in the supervised living setting which focuses on areas of concern
identified by the physician and/or pharmacist.
C. Supervised Living providers must make
arrangements for a licensed nurse to administer medication(s) if a participant
who requires medication cannot self-administer while receiving services. With
the participant's permission, the licensed nurse or employing agency may
accompany the participant to physician visits and/or communicate with the
participant's physician. After communicating with the physician, the licensed
nurse employed by the Supervised Living provider or employing agency, must
document the following:
1. Physician visits
including the reason for the visit,
2. Physician instructions/orders,
3. New prescriptions including any detailed
pharmacy information supplied with the prescription, and
4. Any pertinent information regarding the
participant's medical status.
D. All medical treatments prescribed by a
physician, physician assistant, or nurse practitioner must be provided or
administered by a licensed nurse.
1.
Documentation must contain an assessment of the treatment and the name of the
healthcare professional, including credentials, who performed the required
medical treatment.
2. If the
physician, physician assistant, or nurse practitioner orders the participant
and/or guardian or legal representative be taught to provide or administer
treatments, only an RN may provide this service in accordance with current
Mississippi nursing laws, rules and regulations.
E. Providers must have policies and
procedures for the frequency of monitoring behavior, medication administration,
side effects and adverse reactions.
Miss. Code Ann.
§§
43-13-121,
73-15-1 to
-35.
