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Medication Management: Orders, Medication List, Administration and Medication Incidents

Sets out the Agency's policies and procedures for the safe and effective use of medications under 19 CSR 30-35.010(2)(H): a medication list for every patient, complete orders (name, dose, frequency, route, with a maximum and a reason for variable doses), timely provision and 24-hour emergency medication services, review and teaching, current reference material, who may administer, the nurse's documented evaluation of patient and family administration, and reporting every medication incident to the prescriber, the registered nurse coordinator and the pharmacist (Sky Sample).

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About this policy
Policy number
MO-HSP-MED-01
Version
1.0
Main rule
19 CSR 30-35.010(2)(H)
Library
Missouri hospice · 59 policies
Category
Clinical tasks
Sections
19

In short

  • Keep a current medication list for every patient. It must match what is in the home.
  • Every order needs the drug name, dose, how often and the route. "As needed" orders also need a maximum and the reason.
  • Only people the law allows, the patient or a family member give medications. Aides never give them.
  • The nurse checks and writes down whether the patient or family can give medications safely.
  • Report every medication error or bad reaction to the prescriber at once, and to the nurse coordinator and the pharmacist Sky Sample the same day. Fill in Form MO-HSP-MED-01-A.
  • Never move a patient's medicines to another patient or take them out of the home.

What's inside

19 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (19 CSR 30-35.010(2)(H); 42 CFR §418.106)
  • 5. Which Medications the Agency Provides, and How
  • 6. Orders
  • 7. Medication List, Drug Profile Review and Teaching
  • 8. Who Gives Medications
  • 9. Labeling and Storage in the Home
  • 10. Medication Incidents (19 CSR 30-35.010(2)(H)11)
  • 11. Cannabis and Other Products the Agency Does Not Provide
  • 12. Responsibilities
  • 13. Records and Compliance Monitoring
  • 14. Staff Training
  • 15. References
  • 16. Related Policies and Forms
  • 17. Approval
  • 18. Revision History

An inspector may ask

  • Show me this patient's medication list. Does it match what is in the home?
  • This order says "as needed". Where are the maximum dose or frequency and the reason for giving it?

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