An ALA shall ensure that an initial assessment identifies whether a resident:
(1) Is capable of self-administering his or her own medications;
(2) Is capable of self-administering his or her own medication, but requires a reminder to take medications or requires physical assistance with opening and removing medications from the container, or both; or
(3) Requires that medications be administered by a TME or a licensed nurse.
(June 24, 2000, D.C. Law 13-127, § 901, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
Within 30 days prior to admission, the ALR shall consult with the prospective resident's healthcare practitioner regarding:
(1) The prospective resident's current medication profile, including a review of nonprescription drugs;
(2) Possible adverse interactions;
(3) Common expected or unexpected side effects; and
(4) The potential that such medications have to act as chemical restraints.
(June 24, 2000, D.C. Law 13-127, § 902, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
The ALR shall arrange for an on-site review by a registered nurse every 45 days to:
(1) Supervise the administration of medications by Trained Medication Employees;
(2) Assess the resident's response to medication; and
(3) Assess the resident's ability to continue to self-administer his or her medications.
(June 24, 2000, D.C. Law 13-127, § 903, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
(a) The ALA shall provide a secured space for medication storage with access to a sink and cold storage in the same area. Space for necessary medical supplies and equipment shall be provided.
(b) The storage area shall be kept locked when not in use.
(c) The storage area shall be used only for storage of medications and medical supplies.
(d) The key to the storage area shall be kept on the person of the employee on duty who is responsible for administering the medications.
(e)(1) All medications shall be kept in their original packaging and shall be properly labeled and identified.
(2) The label of each resident's prescription medication container shall be permanently affixed and contain the resident's full name, healthcare practitioner's name, prescription number, name and strength of drug, lot number, quantity, date of issue, expiration date, manufacturer's name, if generic, directions for use, and cautionary or accessory information. Required information appearing on individually packaged drugs or within an alternate medication delivery system need not be repeated on the label.
(3) All over-the-counter (OTC) medications repackaged by the pharmacy shall be labeled with an expiration date, name and strength of the drug, lot number, date of issue, manufacturer's name if generic, and cautionary or accessory labels, in accordance with U.S.P. regulations. Original manufacturer's containers shall be labeled with at least the resident's name. The name label shall not obstruct any of the aforementioned information.
(4) In the "unit of use" distribution system, each dose of medication shall be individually packaged in a hermetically sealed, tamper-proof container, and shall carry full manufacturer's disclosure information on each discrete dose. Disclosure information shall include product name, strength, lot number, expiration date, and the manufacturer's distributor's name.
(5) Single use and disposable items shall not be reused.
(6) No stock supply of prescription medications shall be maintained, unless prior approval is obtained from the Mayor.
(7) Discontinued or expired medications shall be destroyed within 30 days in the ALR, or, if unopened and properly labeled, returned to the pharmacy. All medication destroyed in the ALR shall be witnessed and documented by two persons, one of whom shall be the ALA or the ALA designee.
(8) Residents who self-administer may keep and use prescription and nonprescription medications in their units as long as they keep them secured from other residents.
(June 24, 2000, D.C. Law 13-127, § 904, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
(a) Licensed nurses, physicians, physician assistants, and TMEs may administer medications to residents or assist residents with taking their medications.
(b)(1) Each resident shall be identified prior to drug administration.
(2) Drugs prescribed for one resident shall not be administered to another resident.
(3) The TME shall report drug errors to the healthcare practitioner or licensed nurse and shall document the incident in the resident's record.
(June 24, 2000, D.C. Law 13-127, § 905, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
(a) The Mayor shall develop medication management training courses which shall be approved by the Board of Nursing. The medication administration training program shall include instruction in the following areas:
(1) Cuing, coaching, and monitoring residents who self-administer medications with or without assistance;
(2) Pharmacology;
(3) Terminology related to medication;
(4) Procedures and precautions in administering medication;
(5) Types of medication;
(6) Actions, interactions, and effects of medication;
(7) Administration of medication in emergency or life-threatening circumstances;
(8) Recordkeeping, storage, handling, and disposal requirements for medications;
(9) Rights of residents;
(10) Monitoring of vital signs;
(11) Federal and District of Columbia laws governing medication; and
(12) Reference sources related to medication.
(b) The Mayor shall maintain a list of approved medication administration courses for the training of persons to be certified by the District of Columbia as TMEs.
(c) In order to maintain certification, every 2 years a TME shall successfully complete a clinical update or refresher course approved by the Mayor.
(d) The ALA shall document completion of the medication training course in TME's personnel file.
(June 24, 2000, D.C. Law 13-127, § 906, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
(a) Each resident shall be identified prior to drug administration.
(b) Drugs prescribed for one resident shall not be administered to another resident.
(c) Staff shall report drug errors and adverse drug reactions immediately to the ALA or ALA designee who shall report, as appropriate, to the doctor, prescriber, pharmacist, resident, and resident's surrogate and shall document the incident in the resident's record.
(d) A unit drug compliance package (blister or bubble or unit dose package) shall be developed and implemented where feasible.
(e) Medications shall be refrigerated separately from lab specimens and food.
(June 24, 2000, D.C. Law 13-127, § 907, 47 DCR 2647.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 13-127, see notes following § 44-101.01.
