Nursing services

1. The hospice program must provide the services of a registered nurse, licensed pursuant to North Dakota Century Code chapter 43-12.1, to organize, supervise, and coordinate the palliative and supportive care for patients and families provided by the hospice program care team. 2. The nurse supervisor is responsible for the development, maintenance, and revision of nursing care policy and procedure manuals, written job descriptions for each level of personnel, methods of coordination of nursing service with other services, and shall recommend the number and levels of nursing personnel to be employed. 3. The nursing services supervisor shall designate a qualified registered nurse to act in the supervisor's absence. 4. Nursing services must be directed and staffed to assure the nursing needs of patients are met. 5. There must be staff development programs and educational opportunities for nursing personnel which include orientation and inservice education. a. There must be documentation maintained of the staff development program which includes content of program, name of instructor, name of those in attendance, length of program, and date of presentation. b. Records must validate that initial orientation, including appropriate training to the tasks which personnel are expected to perform, and continual training is evident. 6. The hospice program must develop and maintain written policies and procedures for the administration and provision of pharmaceutical services consistent with the drug therapy needs of the patient. Policies and procedures must include, but not be limited to: the administration of treatment modalities, including intravenous procedures, chemotherapy, parenteral feedings, and injections; prescribing, preparing, administering, and recording of all drugs and biologicals; recording and reporting medication errors and adverse drug reactions. a. The hospice program must have a policy for the disposal of controlled drugs maintained in the patient's home when these drugs are no longer needed by the patient. b. Medications administered to patients must be ordered in writing, and the orders shall be authenticated by the person legally authorized to prescribe the medication. c. A verbal medication order may be given to a licensed nurse, physician, or registered pharmacist. The hospice program shall initiate action to obtain the physician's signature for verbal orders within forty-eight hours. d. Drugs and biologicals must be administered by the following: (1) A licensed nurse or physician. (2) The patient, a family member, or other caregiver, as specified in the patient's hospice program service plan.