North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-03 - Community Services › Chapter 75-03-17 - Psychiatric Residential Treatment Facilities for Children › Section 75-03-17-07 - Medical care

Current through Supplement No. 393, July, 2024
The facility shall institute policies and procedures to
				  address the medical care for each child during placement at the facility,
				  including:
1.
Medical
				examination.
Each child must have a medical examination within thirty
				days prior to admission or within seventy-two hours of admission.
2.
Immunizations.
Each child
				must have current immunizations as required by North Dakota Century Code
				section 23-07-17.1.
3.
Medical care arrangements.
A facility shall make arrangements with
				a physician for medical care of each child.
4.
Annual medical examination.
Each child shall have a medical examination at least annually.
5.
Employee instruction.
The
				facility shall train employees what medical care, including first aid, may be
				given by employees without specific orders from a physician. The facility shall
				instruct employees how to obtain further medical care and how to handle
				emergency cases.
6.
Hospital
				admission.
Each facility shall institute policies and procedures
				regarding transfers and discharges from an admission to the hospital. A
				facility's policies and procedures must include arrangements made with a
				hospital for the admission of children from the facility in the event of
				serious illness or an emergency.
7.
Hospitalization or death reports.
A facility shall report all
				hospitalizations immediately to an individual who lawfully may act on behalf of
				the involved child. The facility shall report any death immediately to the
				department, an individual who lawfully may act on behalf of the child, a law
				enforcement agency, and the county coroner. The facility shall document these
				contacts in the involved child's case file.
8.
Prescription labels.
The
				facility shall obtain prescribed medications on an individual prescription
				basis and labeled according to state and federal rules.
9.
Administration of
				medications.
a. The facility shall
				institute policies and procedures for guidance in the administration of all
				medications. Medications must be administered by a designated employee who is
				medication-certified. All medications must be labeled and stored in a locked
				cabinet, with the keys for the cabinet kept under the supervision of the
				designated employee assigned to administer the medications. The medication
				cabinet must be equipped with separate cubicles, plainly labeled with each
				child's name.
b. The facility shall
				return medications belonging to a child to the person who lawfully may act on
				behalf of the child upon discharge, or the designated individual in charge of
				medication storage shall dispose of the medications according to the facility's
				policies and procedures for the disposal of medications. The facility's
				policies and procedures for the disposal of medications must be in accordance
				with state and federal requirements for the disposal of medications.
c. The facility may possess a limited
				quantity of nonprescription medications. The medications must be ordered by a
				physician and administered under the supervision of medication-certified
				employee.
d.
(1) The facility shall obtain written
				consent, including via electronic mail, or shall obtain verbal consent
				witnessed by another individual, from a person who lawfully may act on behalf
				of the child prior to administering:
(a) A
				newly prescribed medication to the child except in an emergency
				situation;
(b) A psychotropic
				medication; or
(c) A medication
				dosage or dosage range change.
A person who lawfully may act on behalf of the child who
				  receives medication must be informed of benefits, risks, and the potential side
				  effects of all prescribed medication. The facility shall obtain written consent
				  within fourteen days verifying verbal consent received. The facility shall
				  document and file all consents in the child's case file.
(2) The facility shall institute
				policies and procedures governing the use of psychotropic medications, which
				require documentation in the case file justifying the necessity and therapeutic
				advantages for the child receiving psychotropic medication. Documentation must
				reflect that a trauma screening has been completed and that the symptomology
				that the psychotropic medication is attempting to treat is not more effectively
				treated through therapeutic interventions that specifically address
				symptomology related to trauma.
e. Upon admission, when a new psychotropic
				medication is prescribed, and when a psychotropic medication is discontinued, a
				child's psychotropic medication regime must be reviewed by the attending
				psychiatrist every seven days for the first thirty days and every thirty days
				thereafter. Additionally, the facility's nursing staff shall complete an
				involuntary movement assessment prior to the start of, or a change in the dose
				of, a psychotropic medication. An involuntary movement assessment must be
				repeated every three months, or sooner if determined necessary, following
				completion of the initial involuntary movement assessment to monitor the child
				for side effects of the psychotropic medication.