(A)
Storage and
Maintenance.
(i) Medications shall be
stored in an area that is locked, is well lighted, and room temperature not to
exceed 86 degrees Fahrenheit.
(ii)
Medication requiring refrigeration shall be kept in a refrigerator within a
temperature range of 36o Fahrenheit to
48o Fahrenheit and separate from food and other
items. A method of locking these medications shall be provided.
(iii) Medications shall not be stored with
any other non-drug item.
(iv) Each
individual's medications shall be kept separate.
(v) Externally applied medications shall be
stored separately from medications taken internally.
(vi) The medication of each resident shall be
kept or stored in the original container.
(vii) No prescribed medication or
over-the-counter medication for one resident may be administered to or allowed
in the possession of another resident.
(viii) All prescription medication shall be
clearly labeled to include the resident's full name, physician's name,
prescription number, strength of drug, dosage, directions for use, date of
issue, quantity,m and name, address, and phone number of pharmacy or physician
dispensing the drug.
(ix)
Resident's name shall be on all over-the-counter drugs used.
(x) All drugs shall be kept locked, and
documented when taken by the resident.
(xi) Only persons responsible for
administering medications shall have possession of the key to the locked
medication area.
(xii) Labels on
containers shall be legible and firmly affixed.
(xiii) No one shall alter labels on
prescription containers. If a medication dosage change is made by the
physician, then the container must be flagged showing a label change is to be
made.
(xiv) An individual inventory
record and documentation for accountability shall be maintained for each
Schedule II drug prescribed for each resident.
(xv) Schedule II drugs shall be kept in a
separate locked box within the locked medication area.
(xvi) All new or refilled prescribed
medication shall be counted upon receipt in the home and documented in each
resident's medication record.
(xvii) Discontinued medications may be kept
up to three (3) months and must be separated from the current medications
within the locked medication area.
(xviii) The home shall have a written policy
for safe disposal of discontinued medications and it shall be a method approved
by the Department of Health. Documentation shall be retained in the individual
resident's record.
(xix) When a
resident is admitted to a home, or returns to a home from a temporary leave,
the medication brought into the home shall be counted and documented by the
person admitting the resident and countersigned by the resident or responsible
party.
(xx) When a resident is
discharged, moves, or goes on a temporary leave from the home, the unused
medication shall be sent with the resident or the responsible party. The
resident record shall contain documentation of quantities of medication sent,
as well as the signature of the resident or responsible party receiving the
medications and of the staff person releasing the medications.
(xxi) Unused drugs prescribed for residents
who have died shall be kept for one (1) month and then destroyed in accordance
with item xix of this section of the Standards.
(B)
Administration of
medications.
(i) Only persons who have
completed an approved course in medication administration shall administer
medications.
(ii) The person
responsible for medication administration shall personally prepare the dosage,
observe the resident swallowing the medication, and chart the
medication.
(iii) The person
administering the medication shall maintain an accurate written record of
medications administered.
(iv)
Charting the administration of medications shall be done within an hour after
it is taken and correct procedure followed to assure that medications are not
documented by memory.
(v) All
medications shall be administered according to label directions.
(C)
Monitoring
medications.(i) Only persons who have
completed an approved course in medication administration shall monitor
medications.
(ii) An accurate
written record of medication monitoring shall be made by the individual
monitoring the medication. This record must identify the individual responsible
for the medication monitoring.
(iii) Charting the monitoring of medication
shall be done within an hour after it is taken and correct procedure followed
to assure that medications are not documented by memory.
(iv) All medications monitored shall be taken
according to label requirements.
(v) Records of medications monitored for
residents preparing for self-administration shall be documented by the resident
and acknowledged by the staff member monitoring the medication.
(D)
Self-Administration.
(i)
Self-administration of all medications, prescription and over-the-counter, is
permitted only after the resident has been monitored and documentation shows
the resident capable of self-administration of medications. Monitoring shall
include observation of resident taking the proper medication, in the proper
dosage, at the correct time, documenting medication taken, and storing the
medication in a safe manner.
(ii)
The home staff shall conduct at least a monthly documented review of the
individual's self-administration program which shall include a count of each
medication included in the self-administration program.
(iii) All medications must be stored in
locked containers.