New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 161B - STANDARDS FOR LICENSURE OF OUTPATIENT SUBSTANCE USE DISORDER TREATMENT FACILITIES › Subchapter 14 - PHARMACEUTICAL SERVICES › Section 10:161B-14.2 - Standards for drug administration

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The facility's
				policies and procedures shall ensure that medications, in the correct strengths
				and dosages and at the ordered correct time intervals, are administered to each
				client through the prescribed route of administration. The facility's policies
				and procedures shall ensure a method of tracking the line of possession of the
				medications while in the facility and shall describe the program's plan to
				ensure the adequate maintenance of supplies, including the following:
1. Methods for procuring medications on a
				routine basis, in emergencies and in the event of disaster;
2. Acceptable methods for ordering
				medications, consistent with the following:
i. Orders shall be in writing, and shall
				specify the name and strength of the medication, dose, frequency and route of
				administration;
ii. Orders shall be
				signed and dated by the prescriber;
iii. Verbal orders shall be written on the
				chart when given and countersigned within 72 hours of the original order and
				provide the information required in (a)2i and ii above; and
iv. Special requirements for prescribing or
				dispensing controlled drugs shall be noted on the prescription and in the
				client's clinical record;
3. Administration of medication, including
				establishment of the times for administration of medication
				prescribed;
4. If the program
				permits it, self-administration of medication, including:
i. A prohibition on self-administration of
				medication except upon a written order of the prescriber;
ii. Storage and labeling of medications
				including directions for use and appropriate cautionary and/or warning
				messages;
iii. Methods for
				documenting self-administration of medication in the client's clinical
				record;
iv. Training and education
				of clients in self-administration and the safe use of medications;
				and
v. Establishment of precautions
				against clients sharing their medications with one another;
5. Procedures for documenting and
				reporting adverse medication reactions, medication errors, and medication
				defects, subject to the following:
i.
				Allergies shall be documented in the client's clinical record and on its
				outside front cover; and
ii.
				Medication product defects shall be reported in accordance with the United
				States Pharmacopeia - National Formulary (2007 version USP30-NF 25) published
				by the US Pharmacopeia Convention, 12601 Twinbrook Parkway, Rockville, MD
				20852,
http://www.usp.org/
,
				incorporated herein by reference, as amended and supplemented;
6. If the program permits it, use
				of over the counter floor stock medications approved as set forth on a list
				maintained at the facility, and the amounts that may be stocked throughout the
				facility;
7. Discontinuation of
				medication orders, including:
i. The length
				of time medication orders may be in effect, for medications that are not
				specifically limited as to duration of use or number of doses when ordered,
				including intravenous infusion solutions; and
ii. A process for notifying the prescriber
				prior to the expiration of a medication order in accordance with the written
				policy of the program, to ensure that the medication for the specific client is
				discontinued if no specific renewal is ordered.
8. Standards for the purchase, storage,
				safeguarding, accountability, use and disposal of medications consistent with
				New Jersey Board of Pharmacy rules,
N.J.A.C. 13:39
, accessible
				at
http://www.njconsumeraffairs.gov/phar/Pages/regulations.aspx
,
				and
24:21-1
et seq.;
9. Standards for the procurement,
				storage, use and disposal of needles and syringes in accordance with the State
				laws, and a system of accountability which shall not require counting of
				individual needles and syringes after they are placed in a container for
				disposal;
10. Standards for the
				control of medications subject to
				24:21-1 et seq., consistent with
				N.J.A.C. 13:39 and other applicable Federal and State laws, including:
i. Provisions for a verifiable record system
				for controlled medication;
ii.
				Procedures to be followed when inventories of controlled medications cannot be
				verified and medications are lost, contaminated, and/or unintentionally wasted
				or destroyed, which shall include a written report of the incident signed by
				the individuals involved and any witnesses; and
iii. Procedures for the intentional wasting
				of controlled medications, including the disposal of partial doses, which shall
				include written documentation of the event signed by the individual responsible
				and the individual assigned to witness the event;
11. Maintenance of a record of each
				prescriber's Federal Drug Enforcement Administration (DEA) number and New
				Jersey Controlled Dangerous Substance (CDS) number;
12. Data to be maintained within each
				program, including:
i. A list of
				abbreviations, metric conversion charts and chemical symbols, subject to
				approval by the medication staff;
ii. A current Physician's Desk Reference
				(PDR), or other current medical reference materials that contains specific
				information on medications and other drugs, including indications,
				contraindications, actions, reactions, interactions, cautions, precautions that
				should be taken, toxicity, and dosages; and
iii. Antidote information and the telephone
				number of the New Jersey Poison Information and Education System at
				1-800-POISON-1;
13. The
				program shall have access to all current applicable Federal and State laws,
				regulations and information concerning all medications used in the facility;
				and
14. In no instance shall the
				program permit drug or medication samples to be accepted, stocked, distributed
				or otherwise used for any client or staff unless specifically approved by the
				Pharmacy and Therapeutics Committee in writing.
i. If the program utilizes drugs marked
				"samples," the Pharmacy and Therapeutics Committee shall develop a mechanism
				for the control and limitations of these drugs in accordance with New Jersey
				State Board of Medical Examiners rule
13:35-6.6
, accessible at
http://www.njconsumeraffairs.gov/bme/Pages/regulations.aspx
.