HAR §11-99-22
HAR §11-99-22. Pharmaceutical services
Cite as Haw. Code R. § 11-99-22
(a) The
facility shall employ a licensed pharmacist, or shall
have formal arrangements with a licensed pharmacist to
provide consultation on methods and procedures for
ordering, storage, administration, disposal,
record-keeping of drugs and biologicals, and provision
for emergency service.
(b)
Medications administered to a resident shall
be ordered either in writing or verbally by a physician
so authorized by facility policy.
(1)
All verbal or telephone orders for medication
shall be recorded and signed by the person
receiving them and shall be countersigned by
the attending physician within seventy-two
hours.
(2)
All orders shall be renewed by the physician
at the time of the resident's visit to the
physician or at least every six months.
(c)
Each drug shall be rechecked and identified
immediately prior to administration.
(d)
Medications shall not be used for any resident
other than the one for whom they were issued.
(e)
Only appropriately trained staff shall be
allowed to administer drugs and shall be responsible for
proper recording of the medication, including the route
of administration. Such persons shall have
satisfactorily completed a course of training in the
administration of drugs, which course has been approved
by the department. Medication errors and drug reactions
shall be recorded in the resident's chart and §11-99-22
reported immediately to the physician who ordered the
drug and an incident report shall be prepared. All
incident reports shall be kept available for inspection
by the director.
(f)
Facility staff which makes available
medications for residents shall receive appropriate
instruction in medications.
(g)
Drugs shall be stored under proper conditions
of sanitation, temperature, light, moisture,
ventilation, segregation, and security.
(1)
All drugs shall be kept under lock and key
except when authorized personnel are in
attendance.
(2)
All security requirements of federal and state
laws shall be satisfied as they refer to
storerooms and pharmacies.
(3)
Poisons, drugs used externally, and drugs
taken internally shall be stored in locked,
well marked separate cabinets, at all
locations.
(4)
Medications that are stored in a refrigerator
containing things other than drugs shall be
kept apart and in a locked container.
(5)
If there is a drug storeroom there shall be a
perpetual inventory of receipts and issues of
all drugs in such storerooms.
(6)
Discontinued and outdated drugs and containers
with worn, illegible, or missing labels shall
be returned to the pharmacy or drug room for
proper disposition.
(h)
There shall be written policies and procedures
governing resident self-administration of drugs. These
shall include at least the following:
(1)
Procedures for physician documentation in the
resident's record that a plan of
self-administration should be developed.
(2)
Supervision of resident self-administration by
an appropriately trained staff member.
(3)
Provision for appropriate storage of drugs.
(4)
Documentation in the resident's record of
resident compliance. [Eff. April 29, 1985]
(Auth: HRS §§321-9, 321-10, 321-11, 333-53)
(Imp: HRS §333-53)