N.J. Admin. Code § 10:161B-14.2 - Standards for drug administration
(a) The facility's policies and procedures shall ensure that medications, in the correct strengths and dosages and at the ordered correct time intervals, are administered to each client through the prescribed route of administration. The facility's policies and procedures shall ensure a method of tracking the line of possession of the medications while in the facility and shall describe the program's plan to ensure the adequate maintenance of supplies, including the following:
1. Methods for procuring medications on a routine basis, in emergencies and in the event of disaster;
2. Acceptable methods for ordering medications, consistent with the following:
i. Orders shall be in writing, and shall specify the name and strength of the medication, dose, frequency and route of administration;
ii. Orders shall be signed and dated by the prescriber;
iii. Verbal orders shall be written on the chart when given and countersigned within 72 hours of the original order and provide the information required in (a)2i and ii above; and
iv. Special requirements for prescribing or dispensing controlled drugs shall be noted on the prescription and in the client's clinical record;
3. Administration of medication, including establishment of the times for administration of medication prescribed;
4. If the program permits it, self-administration of medication, including:
i. A prohibition on self-administration of medication except upon a written order of the prescriber;
ii. Storage and labeling of medications including directions for use and appropriate cautionary and/or warning messages;
iii. Methods for documenting self-administration of medication in the client's clinical record;
iv. Training and education of clients in self-administration and the safe use of medications; and
v. Establishment of precautions against clients sharing their medications with one another;
5. Procedures for documenting and reporting adverse medication reactions, medication errors, and medication defects, subject to the following:
i. Allergies shall be documented in the client's clinical record and on its outside front cover; and
ii. Medication product defects shall be reported in accordance with the United States Pharmacopeia - National Formulary (2007 version USP30-NF 25) published by the US Pharmacopeia Convention, 12601 Twinbrook Parkway, Rockville, MD 20852, http://www.usp.org/, incorporated herein by reference, as amended and supplemented;
6. If the program permits it, use of over the counter floor stock medications approved as set forth on a list maintained at the facility, and the amounts that may be stocked throughout the facility;
7. Discontinuation of medication orders, including:
i. The length of time medication orders may be in effect, for medications that are not specifically limited as to duration of use or number of doses when ordered, including intravenous infusion solutions; and
ii. A process for notifying the prescriber prior to the expiration of a medication order in accordance with the written policy of the program, to ensure that the medication for the specific client is discontinued if no specific renewal is ordered.
8. Standards for the purchase, storage, safeguarding, accountability, use and disposal of medications consistent with New Jersey Board of Pharmacy rules, N.J.A.C. 13:39, accessible at http://www.njconsumeraffairs.gov/phar/Pages/regulations.aspx, and 24:21-1 et seq.;
9. Standards for the procurement, storage, use and disposal of needles and syringes in accordance with the State laws, and a system of accountability which shall not require counting of individual needles and syringes after they are placed in a container for disposal;
10. Standards for the control of medications subject to 24:21-1 et seq., consistent with N.J.A.C. 13:39 and other applicable Federal and State laws, including:
i. Provisions for a verifiable record system for controlled medication;
ii. Procedures to be followed when inventories of controlled medications cannot be verified and medications are lost, contaminated, and/or unintentionally wasted or destroyed, which shall include a written report of the incident signed by the individuals involved and any witnesses; and
iii. Procedures for the intentional wasting of controlled medications, including the disposal of partial doses, which shall include written documentation of the event signed by the individual responsible and the individual assigned to witness the event;
11. Maintenance of a record of each prescriber's Federal Drug Enforcement Administration (DEA) number and New Jersey Controlled Dangerous Substance (CDS) number;
12. Data to be maintained within each program, including:
i. A list of abbreviations, metric conversion charts and chemical symbols, subject to approval by the medication staff;
ii. A current Physician's Desk Reference (PDR), or other current medical reference materials that contains specific information on medications and other drugs, including indications, contraindications, actions, reactions, interactions, cautions, precautions that should be taken, toxicity, and dosages; and
iii. Antidote information and the telephone number of the New Jersey Poison Information and Education System at 1-800-POISON-1;
13. The program shall have access to all current applicable Federal and State laws, regulations and information concerning all medications used in the facility; and
14. In no instance shall the program permit drug or medication samples to be accepted, stocked, distributed or otherwise used for any client or staff unless specifically approved by the Pharmacy and Therapeutics Committee in writing.
i. If the program utilizes drugs marked "samples," the Pharmacy and Therapeutics Committee shall develop a mechanism for the control and limitations of these drugs in accordance with New Jersey State Board of Medical Examiners rule 13:35-6.6 , accessible at http://www.njconsumeraffairs.gov/bme/Pages/regulations.aspx.
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