Section He-P 811.17 - Medication(a) All medications and treatments shall be administered in accordance with the orders of the licensed practitioner.(b) The licensee shall have a written policy and system in place instructing how to: (1) Obtain any medication ordered for immediate use at the ESRDDC;(2) Reorder medications for use at the ESRDDC; and (3) Receive and record new medication orders.(c) For each prescription medication being taken by a client at the ESRDDC, the licensee shall maintain in the client's record, the original or a copy of, the written or electronic order, signed by a licensed practitioner or other professional with prescriptive powers.(d) Each medication order shall legibly display the following information unless it is an emergency medication as allowed by (aa) below: (2) The medication name, strength, prescribed dose, and route, if different then by mouth;(3) The frequency of administration;(4) The indications for usage for all medications that are used PRN; (5) The dated signature of the licensed practitioner; and(6) For pro re nata (PRN) medications the licensed practitioner shall indicate, in writing, the indications for use and any special precautions or limitations for use of the medication, including the maximum allowed dose in a 24-hour period.(e) Medications shall be kept in locked storage.(f) Except as allowed by (d) (6) above, each prescription medication shall legibly display the following information: (2) The medication name, strength, the prescribed dose, and route of administration;(3) The frequency of administration;(4) The indications for usage of all PRN medications;(6) The name of the prescribing licensed practitioner; and(7) The expiration date of the medication(s) .(g) Any change or discontinuation of medications taken at the ESRDDC shall be pursuant to a written order from a licensed practitioner.(h) Telephone orders for medications shall only be taken by a licensed person such as a nurse and shall be counter-signed by the authorized prescriber within 30 days.(i) There shall be a medication storage area for all medications kept at the ESRDDC, which shall be: (1) Locked and accessible only to authorized personnel;(2) Clean, organized in a fashion to ensure correct identification of each client's medication(s), and have lighting adequate to read all medication labels; and(3) Equipped to maintain medication at the proper temperature.(j) Except as allowed by (q) below, all medication at the ESRDDC shall be kept in the original containers as dispensed by the pharmacy and properly closed after each use.(k) Controlled drugs, as defined by RSA 318-B:1, are stored in a central storage area in the ESRDDC, they shall be kept in a separately locked compartment within the locked medication storage area and accessible only to authorized personnel.(l) The licensee shall develop and implement written policies and procedures regarding a system for maintaining counts of controlled drugs.(m) Topical liquids, ointments, patches, creams, or powder forms of products shall be stored in such a manner that cross contamination with oral, optic, ophthalmic, and parenteral products shall not occur.(n) Except as allowed by (o) below, any contaminated, expired, or discontinued medication shall be destroyed within 30 days of the expiration date, the end date of a licensed practitioner's orders, or the medication becoming contaminated, whichever occurs first.(o) Controlled drugs shall be destroyed only in accordance with state law.(p) If medication(s) are to be returned to pharmacies, the medication(s) shall be returned to pharmacies for credit only as allowed by the law. (q) Medication administered by individuals authorized by law to administer medications shall be prepared, identified, and administered by the same person in compliance with RSA 318-B and RSA 326-B. (r) Personnel shall remain with the client until the client has taken the medication.(s) If a nurse delegates the task of medication administration to a patient care technician, the nurse shall follow the requirements of the nurse practice act.(t) The licensee shall maintain a written record for each medication taken by the client at the ESRDDC which contains the following information: (1) Any allergies or allergic reactions to medications;(2) The medication name, strength, dose, frequency, and route of administration;(3) The date and the time the medication was taken;(4) The signature, identifiable initials, and job title of the person who administers, supervises or assists the client taking medication;(5) For PRN medications, the reason the client required the medication and the effect of the PRN medication; and(6) Documented reason for any medication refusal or omission.(u) Each ESRDDC which permits patient care technicians to administer heparin or its derivatives shall: (1) Require patient care technicians to be under the direction of a registered nurse as required by the nurse practice act for nurse delegation of medications;(2) Require the delegating licensed nurse to document that patient care technicians have received the required initial competency verificationand annual competency evaluations as required by the nurse practice act; and(3) Have a copy of the client assessment documented in the client record, verifying the client is stable and is an acceptable candidate to receive heparin via nurse delegation, as required by the nurse practice act.(v) The licensee shall develop and implement a system for reporting within 24 hours any observed adverse reactions to medication and side effects, or medication errors such as incorrect medications.(w) The written documentation of any reports in (v) above shall be maintained in the client's record.N.H. Admin. Code § He-P 811.17
Amended by Volume XXXIX Number 32, Filed August 8, 2019, Proposed by #12827, Effective 7/20/2019, Expires 1/16/2020.Amended by Volume XL Number 7, Filed February 13, 2020, Proposed by # 12985, Effective 1/29/2020, Expires 1/29/2030.