Controlled Substances in the Home: Management and Disposal
Sets the Agency’s written procedures for managing and disposing of controlled drugs in the patient’s home: what staff give and explain to the patient, representative and family when a controlled drug is first ordered, how controlled drugs are kept safe at home, when hospice employees may dispose of them under 21 U.S.C. §822(g)(5) (after death, when expired, or by a registered hospice physician when the plan of care changes), how disposal is done and recorded, what happens when a family declines, patients in facilities, and suspected loss or diversion.
- Policy number
- DC-HSP-MED-02
- Version
- 1.0
- Main rule
- 42 CFR §418.106(e)(2)
- Library
- Washington, DC hospice · 60 policies
- Category
- Clinical tasks
- Sections
- 20
In short
- When the first controlled drug is ordered, give the family Form DC-HSP-MED-02-A, explain it and record that you did.
- Teach the family to keep controlled drugs out of reach and never share them.
- Nurses may dispose of controlled drugs only after death or when they are expired. Never take drugs out of the home.
- Dispose on site with a witness and record drug, dose, route, amount, time, date and method.
- If the family says no, do not insist. Explain safe options and record it.
- Aides and homemakers never handle controlled drugs. Report any missing drugs to the nurse.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.106(e)(2)(i))
- 5. When a Controlled Drug Is First Ordered
- 6. Keeping Controlled Drugs Safe in the Home
- 7. When Agency Staff May Dispose of Controlled Drugs
- 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 this record documents that the controlled substance policy was given to and discussed with the family when the first controlled drug was ordered.
- What do your nurses do with the patient’s controlled drugs after a death?
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