Iowa Admin. Code r. 441-24.40 - Medication-administration, storage and documentation
This rule sets forth medication requirements for 23-hour
crisis observation and holding,
(1)
Performance benchmark.
Policies and procedures ensure prescription and over-the-counter drugs are
administered or self-administered safely and properly in accordance with
federal, state and local laws and regulations. Medication is administered by a
qualified prescriber or an individual following the instructions of a qualified
prescriber . Medication storage is maintained in accordance with the security
requirements of federal, state and local laws. Case records include written
policies and procedures regarding use of medication.
(2)
Performance indicators .
a.
Administration of
medication.
(1) Medication
administration dose schedules and standardization of abbreviations are
documented.
(2) Throughout the CSRS
specific methods for control and accountability of medication products are
established.
(3) Prescription and
over-the-counter drugs are administered or self-administered safely and
properly in accordance with federal, state and local laws and
regulations.
(4) Medications are
prescribed by a qualified prescriber under Iowa law.
(5) Prescription drugs are not administered
or self-administered without a written order signed by a qualified
prescriber .
b.
Staff-administered medication .
(1) Only qualified and authorized staff
administers medication, and a current, accurate list of staff is
maintained.
(2) Qualified
prescribers instruct how medications are administered and documented. The type
and amount of medication, time and date of medication administered, and the
name of staff administering the medication are transcribed in the medication
record.
c.
Self-administered medication .
(1) Policies and procedures document which
staff have completed department -approved training on self-administration of
prescription medication.
(2)
Self-administration of prescription and over-the-counter medications are
permitted only when the medication label is clear and complete.
d.
Medication
storage. Medication storage policies under the care and control of the
administration include:
(1) All medication is
maintained in locked storage, and controlled substances are maintained in a
locked box within locked storage.
(2) Medications requiring refrigeration are
kept in a refrigerator separated from food and other edible items.
(3) Disinfectants and medication for external
use are stored separately from internal and injectable medications.
(4) Each medication is stored in original
containers and labeled with the name.
(5) All potent poisonous or caustic
medications are clearly labeled; stored separately from other medication, in a
specific well-illuminated cabinet, closet, or storeroom; and made accessible
only to authorized staff .
(6)
Medication provided is dispensed from a licensed pharmacy in the state of Iowa
in accordance with the Iowa Code. It can also be provided by a qualified
prescriber from a licensed pharmacy in another state according to the laws of
the state.
(7) Prescription
medications prescribed for one individual are not administered or allowed in
the possession of another.
e.
Medication labeling. All
prescribed medications are clearly labeled with the full name; prescriber's
name; prescription number; name and strength of the medication; dosage;
directions for use; date of issue; and name, address and telephone number of
the pharmacy or prescriber issuing the medication. Medications are packaged and
labeled according to state and federal guidelines.
f.
Monthly inspection. The
staff member in charge of medication provides monthly inspection of all storage
units.
g.
Damaged
labels. Medication containers having soiled, damaged, illegible, or
makeshift labels are returned to the issuing pharmacist, pharmacy, or qualified
prescriber for relabeling or disposal.
h.
Unused medications.
Unused prescription drugs are destroyed by staff with a witness present, when
an individual leaves the crisis service without medication. A notation is
documented in the record. When an individual is discharged or leaves the crisis
service, medications currently being administered are sent in their original
containers with the individual or with a designated person, with the approval
of the qualified prescriber .
i.
Medication brought by individual. If the prescribed and
over-the-counter medication the individual brings to the CSRS is not used, the
medication is packaged, sealed and stored. The sealed packages of medications
are returned to the individual or family at the time of discharge.
j.
Medication documentation.
(1) Written policies and procedures are in
place for the review, approval, and implementation of ethical, safe, human and
efficient behavioral intervention procedures .
(2) Written policies and procedures are in
place to inform the individual and the individual's legal guardian, when
appropriate , about prohibitions on the use of medication as a
restraint .
(3) Documentation is
required in case records on adverse drug reactions when medications are
administered and self-administered.
(4) All medication orders are documented in
the case records and document the name of the medication, dose, route of
administration, frequency of administration, name of the qualified prescriber
prescribing the medication, and name of the staff administering or dispensing
the medication.
(5) Medication
records are documented by authorized staff administering the
medication.
k.
Medication rights and responsibilities.
(1) Medication is not used as a restraint .
The use of psychopharmacological medication in excess of the standard plan of
care is prohibited. Using medication as a restraint includes:
1. Drugs or medications used to control
behavior or restrict freedom of movement.
2. Drugs or medications used in excessive
amounts or in excessive frequency.
3. Neuroleptics, anxiolytics, antihistamines,
and atypical neuroleptics, or other medication used for calming, rather than
for the medication's indicated treatment.
(2) Drugs or medications used for standard
treatment of the individual's medical or psychiatric condition are not
considered to be used as a restraint .
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.