Current through Register Vol. 56, No. 24, December 18, 2024
(a)
The facility shall provide pharmaceutical services under the direction of a New
Jersey licensed pharmacist, in accordance with N.J.A.C. 13:39.
(b) The facility shall provide pharmaceutical
services, both dispensing and consultant, either directly or through written
contractual agreements.
(c) The
facility shall have written policies and procedures, describing the methods for
obtaining, dispensing, storing, administering, and usage of medications. The
policies and procedures shall be reviewed and updated annually.
(d) The facility shall have a policy and a
procedure for the use of "as needed" (PRN) orders.
(e) The facility shall comply with Federal
and State rules and regulations governing the order, storage, dispensing,
administration, recording and disposal of medications.
(f) Any medication or change in medication
dosage by the physician or advance practice nurse shall be immediately noted on
the current written medication record by staff.
1. Verbal orders from the physician or
advance practice nurse shall be confirmed in writing within 24 hours or by the
first business day following receipt of the verbal order.
2. The prescription or medication sheet shall
be revised at the earliest opportunity.
(g) Medications shall be distributed by
either a unit dose or an individual prescription system.
1. All medication shall have the label
affixed by the pharmacy, in accordance with N.J.A.C. 13:39.
i. All medication shall be kept in their
original containers from the pharmacy and shall be properly identified with the
pharmacist's label.
2.
When medication is prescribed "as needed" (PRN), the prescription label shall
include the following:
i. The individual's
name, date, name of medication, dosage, specification of interval between
dosages, maximum amount to be given during a 24 hour period, a stop date, an
under what conditions the PRN medication shall be administered.
3. Discontinued and outdated
medications and containers with worn, illegible, or missing labels shall be
returned to the dispensing pharmacy within 30 days for proper disposal or
disposed of by the facility in accordance with
N.J.A.C. 13:39-9.6(a)13.
(h) The facility shall have a
system of accountability for drug administration that identifies each
medication to the point of administration.
1.
Medications shall be administered by authorized employees to the right
individual, in the right amount, through the right route and at the right
time.
2. Medications prescribed for
one individual shall not be administered to another.
3. Each dose of medication administered shall
be recorded in the medication administration record immediately after
administration.
4. The
administration of PRN medication shall be documented in the medication
administration record and communicated to the oncoming shift.
5. Medication errors shall be reported in
writing in accordance with the facility's written procedures. Medication errors
with serious or potentially serious consequences should be considered an
unusual incident and reported in accordance with
N.J.A.C. 10:47-3.8(j). In
addition, the physician shall be notified immediately.
(i) All adverse drug reactions shall be
reported to the attending physician immediately and a description of the
incident shall be included in the individual's record.
(j) The facility shall provide a locked
storage area for all medications.
1. All
medications shall be kept in a locked cabinet, closet or medication
cart.
2. Storage areas shall be
locked at all times except when medications are being prepared for
administration or placed into storage.
3. Poisons and external preparations
(including eye and ear medications) shall be stored separately from internal
medications.
4. A refrigerator
shall be provided for medications requiring refrigeration.
i. The refrigerator shall be maintained at a
temperature between 36 degrees Fahrenheit and 45 degrees Fahrenheit.
ii. Medications stored in multi-use
refrigerators shall be kept in a locked box and properly labelled.
(k) Aseptic techniques
shall be maintained in the handling of instruments, surgical supplies, syringes
and needles.
(l) Needles and
syringes shall be stored, used, and disposed of in accordance with N.J.A.C.
7:26-3A.
(m) A record shall be
maintained of the purchase, storage, and disposal of needles and syringes.
