Administering In Emergency Rooms

PURPOSE: This rule sets requirements for administering controlled substances in hospital emergency rooms. (1) Controlled substances may be administered to a hospital emergency room patient under a verbal order of a registered practitioner who is not physically present if— (A) The order is for a legitimate medical purpose and the practitioner who orders the administration of a controlled substance is acting in the usual course of his/her medical practice, after sufficient examination and establishment of a practitioner/patient relationship; (B) The practitioner who orders the administration of a controlled substance is a medical staff member of the hospital; (C) The administration of a controlled substance is documented in a formal medical record for the patient; (D) The patient is assessed in the hospital by a practitioner, when available, or a registered nurse. If the patient is not assessed by a practitioner in the hospital, a registered nurse shall assess the patient and confirm and document in the patient’s medical record the existence of a preestablished practitioner/patient relationship with the practitioner who ordered administration of a controlled substance; (E) The order is written in the patient’s medical record and is authenticated by the ordering practitioner within a time frame and manner as defined by the medical staff in cooperation with nursing and administration. This policy shall be included in the hospital’s written policies and procedures. AUTHORITY: section 195.195, RSMo 1994.* Original rule filed April 14, 2000, effective Nov. 30, 2000. *Original authority: 195.195, RSMo 1957, amended 1971, 1989, 1993.