Oregon Administrative Rules › Chapter 415 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: ADDICTION SERVICES › Division 50 - STANDARDS FOR ALCOHOL DETOXIFICATION CENTERS › Section 415-050-0155 - Management of Medications

Current through Register Vol. 63, No. 7, July 1, 2024
Each Program must have:
(1) A written order signed by a physician, a
			 physician's standing order, or a physician's order received by phone and signed
			 by the physician at the earliest opportunity before any medication is
			 administered or dispensed to or self-administered by any patient.
(2) The program must have a policy that
			 requires, at a minimum, each of the following:
(a) Assurances that medications prescribed
			 for one patient must not be administered to or self-administered by another
			 patient or employee;
(b) All
			 prescription drugs stored in the program must be kept in a locked container.
			 Only those medications requiring refrigeration must be stored in a
			 refrigerator;
(c) Stored not yet
			 prescribed controlled substance including records and maintain inventories in
			 conformance with 21 U.S.C.
			 Section 827;
			 21CF R 1304.02 through 1304.11;
			 1304.21 through 1304.26; 1304.31 through 1304.33; except that a written
			 inventory of all controlled substances must be taken by registrants annually
			 within 365 days of the last written inventory. All such records must be
			 maintained for a period of three years;
(d) In the case where a patient
			 self-administers their own medication, self-administration must be recommended
			 by the Program, approved in writing by the Medical Director, and closely
			 monitored by the medical treatment staff;
(e) No unused, outdated, wasted or recalled
			 medications, confiscated substances or objects used for substance consumption
			 must be kept by the program or in the facility;
(f) All unused, outdated, wasted or recalled
			 medications, and confiscated substances and objects must be disposed of in a
			 manner that assures that they cannot be retrieved within 21 days of identifying
			 need for destruction;
(g) A written
			 record of all disposals of medications, substances and objects must be
			 maintained in the Program and must include:
(A) A description of the drug, medication or
			 substance including the amount;
(B)
			 The patient for whom the medication was prescribed, or from whom the
			 medication, substance or object was confiscated from;
(C) The reason for disposal; and
(D) The method of disposal including:
(i) Medications that are outdated, damaged,
			 deteriorated, misbranded, or adulterated must be quarantined and physically
			 separated from other medications until they are destroyed or returned to their
			 supplier; and
(ii) Controlled
			 substances which are expired, deteriorated or unwanted must be disposed of in
			 conformance with  21 CFR
			 1307.21.
(E) The destruction must be documented and
			 signed by the witnesses and the document retained at the facility for a period
			 of at least three years. Destruction must be jointly witnessed on the premises
			 by any two of the following:
(i) The
			 consultant pharmacist or registered nurse designee;
(ii) The Director of Nursing Services or
			 supervising nurse designee;
(iii)
			 The administrator of the facility or an administrative designee; or
(iv) A Registered Nurse employed by the
			 facility.
(h)
			 Documentation of each prescription medication dispensed, administered to, or
			 self-administered by any patient. This written record must include, at a
			 minimum:
(A) A copy or detailed written
			 description of the signed prescription order, including;
(i) Patient's name;
(ii) The date medications were prescribed,
			 reviewed, or renewed;
(iii)
			 Prescribing physician's name and credential;
(iv) Description of the medication, including
			 the medication name and prescribed dosage; and
(v) Method of administration.
(B) Known allergies to
			 medication(s);
(C) Verification in
			 writing by medical treatment staff that the medication was taken, and the times
			 and dates the medication was dispensed, administered, or
			 self-administered;
(D) Observed
			 side effects including laboratory findings;
(E) Any adverse reactions to the medication;
			 and
(F) Continuing evaluation of
			 the patient's ability to self-administer the medication.