(A) Participants shall be encouraged to
retain and administer their own medications while attending the adult day care
program.
(B) When a participant has
been determined to be unable to be responsible for his medication, the
following procedures shall be followed:
(i)
The medication shall be retained in a safe, secure, locked area for storing
medications or drugs until prescribed time.
(ii) Medications maintained by the center
shall be retained in containers in which they were dispensed from the pharmacy.
The containers shall be labeled with the participant's full name, the name and
strength of the medication, and the dosage and administration
instructions.
(iii) Medications may
not be administered without an order from a physician.
(iv) Physician's phone orders may be taken
only by a licensed nurse.
(v) The
phone orders shall be signed and dated by the physician within three (3)
working days after giving the phone order. Orders by facsimile are acceptable
as original signatures.
(vi) Phone
orders shall be written into the participant's record and date noted by the
licensed nurse who received them.
(vii) Orders regarding medications and
treatments shall be in effect as indicated by the physician for a specified
number of days.
(viii) Changes in
health status, including reaction to medication and/or treatments, shall be
communicated immediately to the participant's physician by the licensed nurse.
If the facility is unable to contact the participant's personal physician,
emergency medical procedure shall be followed.
(ix) All medications shall be packaged and
labeled in accordance with professional pharmacy standards, state and federal
drug laws and regulations, and the United States Pharmacopeia (USP). Labeling
shall include cautionary instructions, as well as expiration date, when
applicable, and name of medication specified by the physician.
(x) Over the counter drugs for individual
participants shall be labeled with at least the participant's name.
(xi) Schedule II drugs shall be kept in a
locked box.
(xii) Medications
requiring refrigeration shall be kept refrigerated in a locked refrigerator or
in a locked box within the refrigerator or in a refrigerator within a locked
room.
(xiii) The temperature range
of the medication refrigerator shall be 36o F.
(2o C) to 48o F.
(8o C).
(xiv) No food shall be stored with
refrigerated medication except for food used for medication and
administration.
(xv) The
administration and storage medication system shall be reviewed by a licensed
nurse not less than every three (3) months.
(xvi) A written medication administration
record shall be maintained for medications administered.
(xvii) Documentation of medications
administered shall be done within one hour after administration of
medication.
(xviii) Records of all
Schedule II drugs shall be maintained.