Medication Management and Medical Treatment

Medication Management and Medical Treatment A. Nurses employed by an agency enrolled as an Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver provider must practice within the current guidelines outlined in the Mississippi Nurse Practice Act and applicable state and federal laws and regulations, regardless of the setting. 1. A registered nurse (RN) and/or licensed practical nurse (LPN) must be supervised by appropriately qualified staff through a home health agency or other entity allowed by state and federal laws and regulations. 2. RNs and LPNs must be employed by a Medicaid provider and work under the direction of physician, physician assistant or nurse practitioner. 3. If a participant cannot self-administer medications and the guardian or legal representative is unavailable, only a licensed nurse, nurse practitioner, physician, physician assistant or dentist may administer or oversee administration of medications at ID/DD Waiver program sites in the community or in the home setting. B. The following practices must be in place to protect the health and safety of a participant who requires medications or medical procedures/treatments: 1. Medications must be stored appropriately in their original containers if a licensed nurse is to administer them. 2. Licensed nurses may not prepare medications in a medication planner for a non-licensed provider(s) to dispense in his/her absence. 3. All medications must be documented in the participant’s record by the appropriately licensed medical professional administering them. 4. Documentation must reflect whether the guardian or legal representative administers the participant’s medications or if a participant self-administers his/her medications. 5. RNs must assess the participant for medication side effects and report any suspected side effects or untoward effects to the practitioner who prescribed them. Suspected side effects or potential health issues noted by an LPN must be reported promptly to an RN or appropriately qualified staff. 6. The first-line responsibility for monitoring a participant’s medication regimen lies with the licensed medical professional who prescribes the medication. A licensed medical professional is defined by the Division of Medicaid as a physician, physician assistant, certified nurse practitioner, or licensed dentist who meets the state and federal licensing and/or certification requirements. 7. Second-line monitoring must be provided by the staff in the supervised living setting which focuses on areas of concern identified by the physician and/or pharmacist. C. Supervised Living providers must make arrangements for a licensed nurse to administer medication(s) if a participant who requires medication cannot self-administer while receiving services. With the participant’s permission, the licensed nurse or employing agency may accompany the participant to physician visits and/or communicate with the participant’s physician. After communicating with the physician, the licensed nurse employed by the Supervised Living provider or employing agency, must document the following: 1. Physician visits including the reason for the visit, 2. Physician instructions/orders, 3. New prescriptions including any detailed pharmacy information supplied with the prescription, and 4. Any pertinent information regarding the participant’s medical status. D. All medical treatments prescribed by a physician, physician assistant, or nurse practitioner must be provided or administered by a licensed nurse. 1. Documentation must contain an assessment of the treatment and the name of the healthcare professional, including credentials, who performed the required medical treatment. 2. If the physician, physician assistant, or nurse practitioner orders the participant and/or guardian or legal representative be taught to provide or administer treatments, only an RN may provide this service in accordance with current Mississippi nursing laws, rules and regulations. E. Providers must have policies and procedures for the frequency of monitoring behavior, medication administration, side effects and adverse reactions.