SECTION 310:680-13-1. Medications

  Correct medication and pharmacy techniques and principles shall be used when medications are administered or monitored. The home shall comply with the following:

(1)   Storage and Maintenance.

(A)   Medications shall be stored in an area that is locked, is well lighted, and room temperature not to exceed 86° Fahrenheit.

(B)   Medications requiring refrigeration shall be kept in a refrigerator with a temperature range of 36° Fahrenheit (2° C) to 48° Fahrenheit (8° C) and separate from food and other items. A method of locking these medications shall be provided.

(C)   Medications shall not be stored with any other non-drug item.

(D)   Each individual's medications shall be kept separate.

(E)   Externally applied medications shall be stored separately from medications taken internally.

(F)   The medication of each resident shall be kept or stored in the original container.

(G)   The medication area shall have a work counter and shall be kept clean and well organized.

(H)   Hand washing facilities with hot and cold water shall be in close proximity to the medication area.

(I)   Any unusual resident reaction to medication shall be reported to the physician at once and documented in the resident's record.

(J)   No prescribed medication or over-the-counter medication for one (1) resident may be administered to or allowed in the possession of another resident.

(K)   All prescription medication shall be clearly labeled to include the resident's full name, physician's name, prescription number, strength of drug, dosage, directions for use, date of issue, quantity, and name, address, and phone number of pharmacy or physician dispensing the drug.

(L)   Resident's first and last name shall be on all over-the-counter drugs used. The home shall have a written policy to identify resident ownership of over-the-counter medication.

(M)   All drugs shall be kept locked, and documented when taken by the resident.

(N)   Documentation of medication ordered by the physician to be administered as circumstances may require (p.r.n.) shall be done immediately after administration and shall include date, time, dose, drug, route, and person responsible for administration.

(O)   Only the person responsible for administering or monitoring medications shall have possession of the key to the locked medication area.

(P)   Labels on containers shall be legible and firmly affixed.

(Q)   No one shall alter labels on prescription containers. If a medication dosage change is made by the physician, then the container must be flagged at that time showing a label change is to be made.

(R)   An individual inventory record and documentation for accountability shall be maintained for each Schedule II drug prescribed for each resident.

(S)   Schedule II drugs shall be kept in a separate locked box within the locked medication area.

(T)   All new or refilled prescription medication shall be counted upon receipt in the home and documented in each resident's medication record.

(U)   Discontinued medications may be kept up to three (3) months and must be separated from the current medications within the locked medication area.

(V)   The home shall have a written policy for safe disposal of discontinued medications and it shall be an approved method by the State Department of Health. Documentation shall be retained in the individual resident's record. Over-the-counter medications shall be destroyed in the presence of two (2) residential care home staff persons. Documentation shall include the name of the medication, the amount destroyed, the method of destruction, and shall be retained in the individual resident's record.

(W)   When a resident is admitted to a home, or returns to a home from a temporary leave, the medications brought into the home shall be counted and documented by the person admitting the resident and countersigned by the resident or responsible party.

(X)   When a resident is discharged, moves, or goes on a temporary leave from the home, the unused prescription shall be sent with the resident or with the responsible party. The resident record shall contain documentation of quantities of medication sent, as well as the signature of the resident or the responsible party receiving the drugs and of the staff person of the home that counted them.

(Y)   Unused drugs prescribed for residents who have died shall be kept for one (1) month and then shall be destroyed in accordance with Item (V) of this subsection.

(Z)   The R.N. shall do a documented medication review on every resident in the home quarterly.

(AA)   Each residential care home shall have a first-aid kit for emergency use.

(2)   Administration of medications.

(A)   Only persons who meet requirements for administration of medications shall administer medications.

(B)   The person responsible for medication administration must personally prepare the dosage, observe the resident swallowing the medication, and chart the medication.

(C)   The person administering the medication shall maintain an accurate written record of medications administered.

(D)   Charting the administration of medications shall be done within an hour after it is taken and correct procedures followed to assure that medications are not documented by memory.

(E)   All medications shall be administered according to label directions.

(F)   A resident who has been determined by his physician as capable of self-administering medication may retain the medications in a safe location in the resident's room. The facility shall develop and follow policies for accountability. Scheduled medications shall not be authorized for self-administration. A resident who has been declared legally incompetent is not eligible for self-administration of medications.

(3)   Monitoring of medications.

(A)   Only persons who have completed an approved course in medication administration shall monitor medications.

(B)   An accurate written record of medication monitoring shall be made by the individual monitoring the medication. This record must identify the individual responsible for the drug monitoring.

(C)   Charting the monitoring of medication shall be done within an hour after it is taken and correct procedure followed to assure that medications are not documented by memory.

(D)   All medications monitored shall be taken according to label directions.

[Source: Amended at 11 Ok Reg 911, eff 12-17-93 (emergency); Amended at 11 Ok Reg 2649, eff 6-25-94]