Haw. Code R. § 11-94.2-46 - Pharmaceutical services
(a) Each facility
shall employ a licensed pharmacist or shall have a written contractual
arrangement with a licensed pharmacist, to provide consultation on methods and
procedures for ordering, storing, administering, disposing, and recordkeeping
of drugs and biologicals, and provisions for emergency service.
(b) A facility shall have a current pharmacy
policy manual consistent with current pharmaceutical practices developed and
approved by the pharmacist, medical director/medical advisor, and director of
nursing that:
(1) Includes policies and
procedures, and defines the functions and responsibilities relating to pharmacy
services, including the safe administration and handling of all drugs and
self-administration of drugs. Policies and procedures shall include pharmacy
functions and responsibilities, formulary, storage, administration,
documentation, verbal and telephone orders, authorized personnel,
recordkeeping, and disposal of drugs;
(2) Is reviewed at least every two years and
revised as necessary to keep abreast of current developments in overall drug
usage; and
(3) Has a drug recall
procedure that can be readily implemented.
(c) As authorized by facility policy and
state law, a physician, physician assistant, or APRN shall order medications,
either in writing or verbally, to be administered to a resident.
(d) A physician's, physician assistant's, or
APRN's verbal orders for prescription drugs shall be given only to a licensed
nurse, pharmacist, or another physician.
(e) All verbal or telephone orders for
medication shall be recorded and signed by the licensed person receiving them
and shall be authenticated by the prescribing physician according to the
policies and procedures of the facility.
(f) The physician, physician assistant, or
APRN shall review all orders at the time of the visit to the
resident.
(g) Each drug shall be
rechecked and identified immediately prior to administration.
(h) Prescription medication shall not be used
for any resident other than the resident for whom it was issued. Stock supply
items may be administered per facility protocol.
(i) Appropriately licensed and trained staff
shall be responsible for the entire act of medication administration, which
entails removing an individual dose from a container properly labeled by a
pharmacist or manufacturer (unit dose included), verifying the dosage with the
physician's orders, giving the specified dose to the proper resident, and
promptly recording the time, route, and dose given to the resident, and signing
the record- Only a licensed nurse, physician, or other individual to whom the
licensed professional has delegated the responsibility pursuant to chapter
16-89, subchapter
15, may administer
medications.
(j) Medication errors
and drug reactions shall be recorded in the resident's chart and reported
immediately to the physician, physician assistant, or APRN who ordered the
drug, and a medication error report shall be prepared and given to the
administrator of the facility or director of nursing for review and appropriate
action, according to facility policy.
(k) Drugs shall be stored under proper
conditions of sanitation, temperature, light, moisture, ventilation,
segregation, and security.
(l) All
drugs, including drugs that are stored in a refrigerator, shall be kept under
lock and key, except when authorized personnel are in attendance. The facility
shall be in compliance with all security requirements of federal and state laws
as they relate to storerooms and pharmacies.
(m) Drugs for external and internal use shall
be kept separate and stored in locked, well-marked, separate
cabinets.
(n) Discontinued and
outdated prescriptions and containers with worn, illegible, or missing labels
shall be disposed of according to facility policy.
(o) A pharmacist shall, on a monthly basis,
review the record of all residents receiving medications to determine potential
adverse reactions, interactions, and contraindications. The review and any
concerns identified shall be documented in the resident's record.
(p) When appropriateness of drugs or dosage
of drugs as ordered are questioned by the pharmacist or licensed nurse, the
licensed nurse or the pharmacist shall consult the physician, and a record of
the consultation shall be made available to the administrator of the facility
or director of nursing.
Notes
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No prior version found.