Cal. Code Regs. Tit. 22, § 76403 - Pharmaceutical Services-Labeling and Storage of Drugs

(a) Containers which are cracked, soiled or without secure closures shall not be used. Drug labels hall be legible.

(b) All drugs obtained by prescription shall be labeled in compliance with state and federal laws governing prescription dispensing. No person other than the pharmacist shall change any prescription label.

(c) Nonlegend drugs shall be labeled in conformance with state and federal food and drug laws.

(d) Test reagents, germicides, disinfectants and other household substances shall be stored separately from drugs and shall not be accessible to clients unless so specified in the client's individual program plan.

(e) External use drugs in liquid, tablet, capsule or powder form shall be stored separately from drugs for internal use.

(f) Drugs required to be stored at room temperature shall be stored at a temperature between 15°C (59°F) and 30°C (86°F). Drugs requiring refrigeration shall be stored in a refrigerator between 2°C (36°F) and 8°C (46°F). When drugs are stored in the same refrigerator with food, the drugs shall be kept in a closed container clearly labeled "drugs" or "medications."

(g) Drugs shall be stored in an orderly manner in cabinets, drawers or carts of a size to prevent crowding.

(h) Dose preparation and administration areas shall be well lighted. If medication carts are utilized, a light shall be available on the cart.

(i) Drugs, hypodermic syringes and needles shall be accessible only to the administrator, pharmacist,physicians, licensed registered nurses, licensed vocational nurses and psychiatric technicians except as provided in Section 76403(n) and (o). Such access shall be designated in writing by the facility.

(j) Drugs shall not be kept in stock after the expiration date on the label and no contaminated or deteriorated drugs shall be available for use.

(k) The drugs of each client shall be kept and stored in their originally received containers. No drug shall be transferred between containers.

(l) Discontinued drug containers shall be marked to indicate that the drug has been discontinued.

(m) Facilities shall dispose of irrigating solutions in accordance with manufacturer's instruction or pharmacy label. Facilities shall establish policies to prevent contamination of irrigating solutions whose labels do not include expiration dates or instructions for storage or disposal of remaining contents after initial use.

(n) Prescription medications of an emergency nature may be stored at a client's bedside under the following conditions:

(1) On the specific order of a person lawfully authorized to prescribe, when the order specifies the manner and frequency of administration by the client, and

(2) The medication is of an emergency nature which is to be administered sublingually or by inhalation, and

(3) The facility has established written procedures by which the use of an emergency bedside medication is recorded in the client's health record.

(4) Such drugs shall be stored in a closed drawer or cupboard or be in the client's possession.

(o) Nonprescription or over-the-counter medications may be stored at a client's bedside under the following conditions:

(1) Medications may be stored at the bedside unless contraindicated by the attending physician. The attending physician shall be informed of all such storage. Facilities may adopt more restrictive policies regarding bedside storage of medications.

(2) In all facilities the following conditions shall apply:

(A) The client health record must reflect the availability of drugs by name at the bedside. Such information must also be included in the client's individual program plan.

(B) The facility shall record bedside medication use daily, based on observation or information supplied by the client.

(C) The facility shall maintain a record of drugs obtained for bedside use, including date of receipt, client name and quantity.

(D) Marked increase in the use of self-administered drugs that indicates a significant change in the condition of the client shall be reported to the physician.

(E) Such medications shall be secured against access by the other clients.

Notes

Cal. Code Regs. Tit. 22, § 76403

Note: Authority cited: Section 208(a), Health and Safety Code. Reference: Section 1276, Health and Safety Code.