Medications Flashcards
What is CSM?
Centrally Stored Medications
How are CSMs to be stored?
- Shall be kept in a safe and locked place
- Not accessible to persons other than employees responsible for the supervision of the CSM
What medication related items shall be inaccessible to residents with dementia?
- Over the counter medication
- Nutritional supplements
- Vitamins
How must all CSMs be maintained?
- CSMs shall be labeled and maintained in compliance with state and federal laws
- No persons other than the dispensing pharmacist shall alter a prescription label
What information is required to be labeled on a CSM?
- Name of resident for whom prescribed
- Name of the prescribing physician
- Drug name, strength and quantity
- Date filled
- Prescription number
- Name of issuing pharmacy
- Expiration date
- Number of refills
When shall CSMs be destroyed?
- Not taken with resident upon termination of services
- Not returned to the issuing pharmacy
- Not retained in the facility as ordered by the resident’s physician and documented in the residents record
- Not disposed of according to the hospices’ established procedures
Who is required to destroy CSM when applicable?
- Facility administrator
- One other adult who is not a resident
How are the destruction of CSMs managed?
- Both persons involved shall sign a record
- Records shall be retained for at least three years
What information is required on CSM destruction records?
- Name of the resident
- Prescription number
- Name of the pharmacy
- Drug name, strength and quantity destroyed
- Date of destruction
What information is required for the CSM record for each resident?
- Name of resident for whom prescribed
- Name of the prescribing physician
- Drug name, strength and quantity
- Date filled
- Prescription number
- Name of issuing pharmacy
- Instructions, if any, regarding control and custody of the medication
Who is responsible for CSM records?
RCFE Administrator Licensee
How long must CSM records be maintained?
1 year
Who shall assist residents with self administered medications?
- RCFE Administrator Licensee
Who may assist residents, with approval of the RCFE Administrator Licensee, with the self administered medications?
- Staff designated by licensee
What are the CSM packaging requirements?
- Each residents medications shall be stored in its originally received container
- No medications shall be transferred between containers
When shall the facility staff be permitted to assist the resident with self administration of his/her PRN (As Needed) medication?
- Resident’s physician has stated in writing the resident is:
- Able to determine and communicate his/her need for a prescription or nonprescription PRN medication
When shall facility staff designated by the licensee be permitted to assist the resident with self-administered medications without restrictions?
- Resident’s physician has stated in writing that the resident is able to determine his/her own need for nonprescription PRN medication can communicate his/her symptoms clearly
What requirements must be met for facility staff to assist a resident with self-administered medications when the resident is unable to determine their need for a PRN but can communicate his/her symptoms clearly?
- Written direction from physician on prescription blank including:
- name of resident
- name of medication
- physicians order including
- specific symptoms which indicate need for use
- exact dosage
- minimum number of hours between doses
- maximum number of doses allowed in each 24-hour period - once ordered by physician the medication is given according to physician’s directions
- Record each dose is maintained in the resident’s record
What is required on PRN medication records for each resident?
- Date and time the PRN medication was taken
- Dosage taken
- Resident’s response
If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication and is unable to communicate his/her symptoms clearly, what is required of the facility staff in order to assist the resident with their PRN medications?
- Facility staff contact the resident’s physician prior to dose:
- relay description of resident’s symptoms
- receive direction to assist the resident in self-administration of dose of medication - Record the following information in the resident’s facility record:
- Date and time of each contact with physician
- Physician’s directions
- Date and time PRN medication was taken
- Dosage taken
- Resident’s response
What does self-administration assistance by the facility staff not include?
- Forcing a resident to take medications
- Hiding or camouflaging medications in other substances without the resident’s knowledge and consent
- Otherwise infringing upon a resident’s right to refuse to take a medication
How must syringes and needles be disposed of?
IAW California Code of Regulations Title 8, Section 5193 concerning blood-borne pathogens
- Shearing or breaking of contaminated needles is prohibited
- Contaminated needles shall not be bent or recapped
- Waste containers shall not be opened or emptied manually
- immediately or as soon as possible after use, contaminated needles shall be placed in appropriate containers that:
- rigid
- puncture resistant
- leak proof
- Portable, if portability is necessary to ensure easy access by the user
- Labeled as BIOHAZARDOUS WASTE or SHARPS WASTE
