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Controlled Substances in the Home: Management and Disposal

Sets out how the Agency manages controlled drugs in patients' homes: what the patient and family are given and told when a controlled drug is first ordered, how the drugs are kept safe, the governing body's decision on disposal by Agency staff under federal law, when and how disposal is done and recorded, and what happens if loss or diversion is suspected.

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About this policy
Policy number
PA-HSP-MED-02
Version
1.0
Main rule
42 CFR §418.106(e)(2)
Library
Pennsylvania hospice · 60 policies
Category
Clinical tasks
Sections
20

In short

  • When the first controlled drug is ordered, give the family Form PA-HSP-MED-02-A, talk it through in their language, and record that you did.
  • Count controlled drugs at nurse visits and report any count that does not match the same day.
  • Dispose only after a death or when a drug has expired, only in the home, with a witness aged 18 or older, and only if the family agreed.
  • If the doctor stops a drug while the patient is alive, do not dispose of it yourself. Teach the family how to dispose of it.
  • Record every disposal on Form PA-HSP-MED-02-B. If the family stops you, do not argue; record it.
  • Never take a patient's drugs out of the home.

What's inside

20 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 and Governing Body Decision (42 CFR §418.106(e)(2))
  • 5. When a Controlled Drug Is First Ordered
  • 6. Keeping Controlled Drugs Safe in the Home
  • 7. When Disposal Is Allowed
  • 8. How Disposal Is Done
  • 9. When Disposal Is Prevented or Declined
  • 10. Patients in Facilities
  • 11. Suspected Loss, Misuse or Diversion
  • 12. Disposal Training
  • 13. Responsibilities
  • 14. Records and Compliance Monitoring
  • 15. Staff Training
  • 16. References
  • 17. Related Policies and Forms
  • 18. Approval
  • 19. Revision History

An inspector may ask

  • Show me where you gave and discussed your controlled drug policy when the first controlled drug was ordered for this patient.
  • Does your Agency dispose of patients' controlled drugs? Where is that decision written, and who may do it?

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