La. Admin. Code tit. 48 § I-6271

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-6271 - Medications

A. All TGHs that store and/or dispense scheduled narcotics shall have a site-specific Louisiana controlled substance license and a United States Drug Enforcement Administration (DEA) controlled substance registration for the provider in accordance with the Louisiana Uniform Controlled Dangerous Substance Act and title 21 of the United States Code.

B. The TGH shall have written policies and procedures that govern the safe administration and handling of all prescription and nonprescription medications.

C. The TGH shall have a written policy governing the self-administration of all medications. Such policy shall include provisions regarding age limitations for self-administration, multi-disciplinary team recommendations, and parental consent, if applicable. Those clients that have been assessed to be able to safely self-administer medications shall be monitored by licensed or qualified staff to ensure medication is taken as prescribed in the comprehensive treatment plan.

D. The TGH shall ensure that medications are either self-administered or administered by licensed persons according to state law.

E. The TGH shall have a written policy for handling medication taken from the facility by clients on pass.

F. The TGH shall ensure that any medication given to a client for therapeutic and medical purposes is in accordance with the written order of a physician.

1. There shall be no standing orders for prescription medications.

2. There shall be standing orders, signed by the physician, for nonprescription drugs with directions from the physician indicating when he/she is to be contacted. Standing orders shall be updated annually by the physician.

3. Copies of all written orders shall be kept in the client's file.

G. The TGH shall develop and implement procedures for all discontinued and/or expired medications and containers with worn, illegible or missing labels.

H. All medications shall be stored under proper conditions of sanitation, temperature, light, moisture, ventilation, segregation and security.

1. Medications used externally and medications taken internally shall be stored on separate shelves or in separate cabinets.

2. All medications, including those that are refrigerated, shall be kept under lock and key.

I. Any TGH using psychotropic medications shall have written policies and procedures concerning the use of psychotropic medications including:

1. when used, there is medical monitoring to identify specific target symptoms;

2. procedures to ensure that medications are used as ordered by the physician for therapeutic purposes and in accordance with accepted clinical practice;

3. procedures to ensure that medications are used only when there are demonstrable benefits to the client unobtainable through less restrictive measures;

4. procedures to ensure continual physician review of medications and discontinuation of medications when there are no demonstrable benefits to the client;

5. an ongoing program to inform clients, staff, and where appropriate, client's parent(s) or legal guardian(s) on the potential benefits and negative side-effects of medications and to involve clients and, where appropriate, their parent(s) or legal guardian(s) in decisions concerning medication; and

6. training of staff to ensure the recognition of the potential side effects of the medication.

J. Current and accurate records shall be maintained on the receipt and disposition of all scheduled drugs. An annual inventory, at the same time each year, shall be conducted for all Schedule I, II, III, IV and V drugs.

K. Medications are to be administered only upon written orders, electromechanical facsimile, or oral orders from a physician or other legally authorized prescriber, taken by a licensed nurse.

L. All drug containers shall be labeled to show at least the client's full name, the chemical or generic drug's name, strength, quantity and date dispensed unless a unit dose system is utilized. Appropriate accessory and cautionary statements as well as the expiration date shall be included.

M. Medications and biologicals that require refrigeration shall be stored separately from food, beverages, blood, and laboratory specimens.

N. Drug administration errors, adverse drug reactions, and incompatibilities shall be immediately reported to the attending physician. An entry shall be made in the client's record.

O. Abuses and losses of controlled substances shall be reported to the individual responsible for pharmaceutical services, the clinical director, the Louisiana Board of Pharmacy, DHH Controlled Dangerous Substances Program and to the Regional Drug Enforcement Administration (DEA) office, as appropriate.

La. Admin. Code tit. 48, § I-6271

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:419 (February 2012), Amended by the Department of Health, Bureau of Health Services Financing, LR 44780 (4/1/2018).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2009.