OAR 333-536-0075
Medication Services
(1)
If an agency has been approved to provide non-injectable medication services, the services shall be rendered by persons who meet the requirements of section (10) of this rule. The services shall be provided as requested by the client or client’s representatives in accordance with these rules, accepted standards of medication practice, and the service plan.(2)
If a client representative or family member performs the task of filling secondary non-injectable medication containers from which an agency caregiver is to administer medication, an agency shall:(a)
Obtain a signed agreement from the client representative or family member that identifies their obligation to:(A)
Provide a list of the client’s medication and a physical description of each with any special instructions. The list must be updated when changes to the client’s medication regimen are made;(B)
Keep the original labeled medication containers in the home for verification should the caregiver have questions; and(C)
Use closed non-injectable medication secondary containers designed and manufactured for that purpose that meet the labeling requirements of subsection (7)(d) of this rule.(3)
Agency staff shall obtain written or telephone orders from a physician or other legally recognized practitioner for all medications managed or administered by an agency under this rule and for any changes to those medications.(a)
Written orders shall be signed or confirmed by a physician or practitioner.(b)
Telephone orders shall be immediately recorded, dated, and signed by agency staff, and transmitted within 72 hours to the physician or practitioner for confirmation. The orders that have been signed or confirmed by the physician or practitioner shall be incorporated into the client’s record within 30 days.(4)
An agency owner or administrator shall be responsible for developing and implementing safe and appropriate medication administration delivery systems and policies and procedures that include, but are not limited to:(a)
Provisions to ensure that each client receives the right medication, in the right amount, by the right route, and at the right time;(b)
Provisions to ensure that the caregivers are informed about the potential adverse reactions, side effects, drug-to-drug interactions and food-to-drug interactions, and contraindications associated with each client’s medication regimen;(c)
Provisions to ensure that the caregivers promptly report problems or discrepancies related to each client’s medication regimen to the caregivers’ supervisor, agency administrator or designee;(d)
Provisions to ensure storage of medications at appropriate temperatures based on the manufacturer’s recommendations; and(e)
Provisions to ensure the security and integrity of narcotics and controlled substances.(5)
A client’s service plan must specify the medication tasks to be performed.(6)
Records for medication administration shall include, but are not limited to, the name of each medication, the dosage to be administered, the route of administration, the frequency of administration, client medication allergies and sensitivities, client specific indicators for administration of as needed medications and other special instructions necessary for safe and appropriate administration.(7)
Packaging and labeling:(a)
Prescription medications shall be in the original pharmacy containers and clearly labeled with the pharmacists’ labels.(b)
Samples of medications received from the physician or practitioner shall be in the original containers and have the original manufacturers’ labels.(c)
Over-the-counter medications shall be in the original containers and have the original manufacturers’ labels.(d)
Secondary containers and all removable compartments must be labeled with the client’s name, the specific time the medications in each compartment are to be administered, the date and time the secondary container was filled, and the name of the individual who filled the container.(e)
Liquid and non-pill medications that cannot be put in secondary containers shall be appropriately labeled.(8)
The provision of medication tasks as described in this rule shall be documented by the individuals performing the tasks. The documentation shall include the tasks completed, the date and signature of the individual(s) performing the task(s), and shall be maintained in accordance with agency policies and procedures.(9)
Visits by a registered nurse to evaluate a client’s medication regimen and the provision of medication administration services shall be conducted and documented at least every 90 days for each client receiving medication administration services.(10)
Agency caregivers assigned to provide medication services must be given basic non-injectable medication training before providing the services. The medication training must include successful return demonstrations of non-injectable medications tasks by the caregivers.(a)
The medication training shall include at least the following areas:(A)
Medication abbreviations;(B)
Reading medication orders and directions;(C)
Reading medication labels and packages;(D)
Setting up medication labels and packages;(E)
Administering non-injectable medications:(i)
Pill forms, including identification of pills that cannot be crushed;(ii)
Non-injectable liquid forms, including those administered by syringe or dropper and eye and ear drops;(iii)
Suppository forms; and(iv)
Topical forms.(F)
Identifying and reporting adverse medication reactions, interactions, contraindications and side effects;(G)
Infection control related to medication administration; and(H)
Techniques and methods to ensure safe and accurate medication administration.(b)
Prior to providing medication services, caregivers shall demonstrate appropriate and safe techniques in the provision of medication tasks described in this rule.(c)
The content of the medication training, the dates and length of training, the identity of the qualified individual or qualified entity, evidence of successful return demonstrations, and the instructor’s statement that the caregiver has been evaluated to be competent to provide the medication services described in this rule shall be clearly documented for each caregiver and maintained in the agency’s personnel records.(d)
An individual with a current Oregon State Board of Nursing medication aide (CMA) certification is exempt from the training requirements in this rule.
Source:
Rule 333-536-0075 — Medication Services, https://secure.sos.state.or.us/oard/view.action?ruleNumber=333-536-0075.