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Controlled Substances in the Home: Management and Disposal

Sets out how the Agency manages controlled substance prescription drugs in patients’ homes: what the patient and family are given and told when a controlled substance is first ordered, how the drugs are kept safe, the governing body’s decision that Agency nurses will dispose of unused controlled substances, when and how disposal is done and recorded, and what happens if diversion is suspected.

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About this policy
Policy number
TX-HSP-MED-02
Version
1.0
Main rule
26 TAC §558.861
Library
Texas hospice · 59 policies
Category
Clinical tasks
Sections
20

In short

  • When the first controlled drug is ordered, give the family Form TX-HSP-MED-02-A, talk it through in their language and record it.
  • 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, only with a witness aged 18 or older, and only if the agreement is on file.
  • If the doctor stops a drug while the patient is alive, do not take or dispose of it yourself. Teach the family to dispose of it.
  • Record every disposal on Form TX-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 (26 TAC §558.861(i)-(t); 42 CFR §418.106(e)(2))
  • 5. When a Controlled Substance Is First Ordered
  • 6. Keeping Controlled Substances 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

  • Does your agency dispose of patients’ unused controlled substances? Where is that decision written?
  • Show me where you gave and discussed your controlled substance policy when the first controlled drug was ordered for this patient.

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