Current through Register Vol. 56, No. 6, March 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 Discontinued and outdated medications and containers with worn, illegible, or missing labels shall be returned to the dispensing pharmacy within 30 days for proper disposal or disposed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 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 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.
