049-3 Wyo. Code R. §§ 3-16 - Medication
(a) Supervision and
Administration of Medication. The organization shall develop, adopt, follow and
maintain on file written policies and procedures governing the supervision, the
administration and monitoring of medication to children.
(i) These policies shall include prescription
medications, nonprescription medications and vitamins;
(ii) Prescription medication shall only be
administered under the order of a physician, a nurse practitioner, physician's
assistant or dentist;
(iii) All
medications shall be administered by the appropriately trained personnel in the
facility;
(iv) A medication consent
form must be completed by the child's parent or legal guardian for all
medications given within agreed upon dosage range;
(v) Before the recommended dosage for over
the counter medication is exceeded, written permission must be given to the
facility by the parent(s) or legal guardian and a health care
professional;
(vi) The effects of
medication must be documented in the child's health record and the prescribing
physician should regularly review the child's response to medication;
(vii) If prescribed medications are used,
daily monitoring and documentation is required; and
(viii) There shall be written policy,
procedures and controls governing the destruction of out-of-date medication,
unused medication or medication prescribed for former children and disposal of
syringes and medical waste in accordance with state and local law.
(b) Storage of Medications. The
organization shall develop, adopt, follow and maintain on file written policies
and procedures ensuring that all medications (over-the-counter and prescribed)
are stored in a locked area that is inaccessible to children.
(c) Labeling of Medications. The organization
shall develop, adopt, follow and maintain on file written policies and
procedures ensuring that all medications are accurately labeled.
(i) Medications must bear their original
prescription label or a manufacturer's label; and
(ii) Any deviation from the recommend dosage
on the label must be accompanied by a physician's written
instructions.
(d)
Repackaging of Medication. If medication repackaging (e.g., the placing of a
limited supply of medication in a separate container for use during an
absence/excursion from the facility) is to occur, it must be done in accordance
with the following guidelines:
(i) The
individual having the responsibility of repackaging the medication must have
training and experience in all aspects of medication administration;
(ii) All medication that is repackaged must
be labeled with the following information:
(A)
Patient's name;
(B) Medication
name;
(C) Correct dosage
instructions;
(D) Name of
physician;
(E) Prescription number;
and
(F) Date of
repackaging.
(iii)
Repackaging may occur as often as needed; and
(iv) If there is medication left over from
repackaging:
(A) It shall be documented in the
child's record. Said documentation shall state why there was medication left
over and a description of what the medication is for; and
(B) Medication left over from repackaging
shall not be returned to the original bottle/container due to changes in
potency and contamination.
(e) Medication Logs. The organization shall
develop, adopt, follow and maintain on file written policies and procedures
ensuring that medication logs are maintained for each child. The organization
shall maintain a cumulative record of all medication dispensed to children, a
copy of which shall be placed in the child's case record. This record shall
include:
(i) Child's name;
(ii) Name of physician prescribing
medication;
(iii) The name of the
medication;
(iv) Date and time the
medication was administered;
(v)
Amount of medication given;
(vi)
Signature/initial of person monitoring medication and time administered
documented at the time of administration of the medication;
(vii) Any medication errors and reason for
the errors; and
(viii) A statement
must be signed and documented by the staff member who witnessed medication
refusal.
(f) Medication
Errors. Documentation of medication errors shall be kept in the medication log.
(i) Medication errors may include:
(A) The failure to administer
medication;
(B) Administering the
incorrect medication;
(C)
Administering the correct medication in an incorrect dosage;
(D) Administering the correct medication at
the incorrect time; or
(E) The
failure to refill a medication.
(ii) After each medication error:
(A) Medical personnel (e.g., physician,
registered nurse, nurse practitioner, licensed practical nurse, physician's
assistant) shall be contacted as soon as possible for instructions;
(B) Immediate actions shall be taken to
prevent future medication errors and actions shall be documented; and
(C) An incident report shall be submitted to
the DFS Caseworker and the DFS Certifying Authority within two (2) working
days.
(g)
Adverse Reactions. The organization shall develop, adopt, follow and maintain
on file written policies and procedures ensuring that all staff members are
aware of the side effects of medication prescribed for the child.
(h) Medication Administration Training. The
organization shall develop, adopt, follow and maintain on file written policies
and procedures ensuring that medication administration training has been
provided.
(i) Psychotropic
Medication
(i) The organization shall develop,
adopt, follow and maintain on file written policies and procedures ensuring
that psychotropic medications shall be prescribed and administered only as a
component of a comprehensive treatment plan;
(ii) If psychotropic medications are used,
the organization must have a written policy governing the use of such
medications that shall include the following:
(A) Criteria for the use and review of
psychotropic medications as a part of the ITPC and/or ISPC;
(B) Procedures for monitoring and reviewing
use of psychotropic medication by a physician, nurse practitioner, or
physician's assistant; and
(C)
Procedures for reporting the suspected presence of side effects.
(iii) Special training shall be
given to all staff and foster parents to enable them to recognize changes in a
child's appearance or behavior that may be related to the use of the
psychotropic medication.
(j) Revocation of consent. If a parent or
guardian revokes consent for the use of medication, the organization has the
option of continuing to provide services to the child without the use of
medications. The organization also has the option of not continuing to serve
the child and DFS shall be notified immediately if the child is in DFS custody.
In addition, the organization shall immediately file a statement describing the
circumstances under which consent has been revoked.
(i) This statement shall be provided to all
organization staff;
(ii) The
child's prescriber shall be notified; and
(iii) The child's DFS caseworker shall be
notified.
(k) Incident
reporting. Any unscheduled use of medications, including any PRN orders, used
to target psychiatric symptoms or behaviors shall be reported to the DFS
Caseworker and the DFS Certifying Authority within two (2) working
days.
Notes
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