Ariz. Admin. Code § R9-10-421 - Medication Services
A. An
administrator shall ensure that policies and procedures for medication
services:
1. Include:
a. A process for providing information to a
resident about medication prescribed for the resident including:
i. The prescribed medication's anticipated
results,
ii. The prescribed
medication's potential adverse reactions,
iii. The prescribed medication's potential
side effects, and
iv. Potential
adverse reactions that could result from not taking the medication as
prescribed;
b.
Procedures for preventing, responding to, and reporting:
i. A medication error,
ii. An adverse response to a medication,
or
iii. A medication
overdose;
c. Procedures
to ensure that a pharmacist reviews a resident's medications at least once
every three months and provides documentation to the resident's attending
physician and the director of nursing indicating potential medication problems
such as incompatible or duplicative medications;
d. Procedures for documenting medication
services ; and
e. Procedures for
assisting a resident in obtaining medication; and
2. Specify a process for review through the
quality management program of:
a. A
medication administration error, and
b. An adverse reaction to a
medication.
B. An administrator shall ensure that:
1. Policies and procedures for medication
administration:
a. Are reviewed and approved
by the director of nursing;
b.
Specify the individuals who may:
i. Order
medication, and
ii. Administer
medication;
c. Ensure
that medication is administered to a resident only as prescribed; and
d. Cover the documentation of a resident's
refusal to take prescribed medication in the resident's medical
record;
2. Verbal orders
for medication services are taken by a nurse, unless otherwise provided by
law;
3. A medication administered
to a resident:
a. Is administered in
compliance with an order, and
b. Is
documented in the resident's medical record; and
4. If a psychotropic medication is
administered to a resident, the psychotropic medication:
a. Is only administered to a resident for a
diagnosed medical condition; and
b.
Unless clinically contraindicated or otherwise ordered by an attending
physician or the attending physician's des-ignee, is gradually reduced in
dosage while the resident is simultaneously provided with interventions such as
behavior and environment modification in an effort to discontinue the
psychotropic medication, unless a dose reduction is attempted and the resident
displays behavior justifying the need for the psychotropic medication, and the
attending physician documents the necessity for the continued use and
dosage.
C. An
administrator shall ensure that:
1. A current
drug reference guide is available for use by personnel members; and
2. If pharmaceutical services are provided:
a. The pharmaceutical services are provided
under the direction of a pharmacist;
b. The pharmaceutical services comply with
ARS Title 36, Chapter 27; A.R.S. Title 32, Chapter 18; and 4 A.A.C. 23;
and
c. A copy of the pharmacy
license is provided to the Department upon request.
D. When medication is stored at a
nursing care institution, an administrator shall ensure that:
3.
2.
Medication is stored according to the instructions on the medication container;
and
4.
3. Policies and procedures are established,
documented, and implemented to protect the health and safety of a resident for:
1. Medication is stored in a separate locked
room, closet, or self-contained unit used only for medication storage ;
2.
If medication is stored in a room or closet, a
locked cabinet is used for medication storage;
a. Receiving, storing, inventorying,
tracking, dispensing, and discarding medication including expired
medication;
b. Discarding or
returning prepackaged and sample medication to the manufacturer if the
manufacturer requests the discard or return of the medication;
c. A medication recall and notification of
residents who received recalled medication; and
d. Storing, inventorying, and dispensing
controlled substances.
E. An administrator shall ensure that a
personnel member immediately reports a medication error or a resident's adverse
reaction to a medication to the medical practitioner who ordered the medication
and the nursing care institution's director of nursing.
Notes
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