Pharmaceutical services

The facility shall provide pharmaceutical services to meet resident needs. 1. The facility shall obtain the services of a licensed pharmacist who shall develop policies and procedures for the provision of pharmaceutical services within the facility consistent with chapter 61-03-02, state laws, and federal laws. These policies and procedures must be approved by medical staff or medical director and governing body and must include provisions for: a. The procurement, storage, dispensing, labeling, administration, and disposal of drugs and biologicals. b. Allowing the resident to be totally responsible for the resident's own medication based on request of the resident, assessment of the functional capability of the resident by facility nursing staff, documentation of the assessment and resultant recommendations, and specific approval and order of the licensed health care practitioner. The facility must provide a secure storage area for medications self-administered by the resident. 2. The pharmacist shall review each resident's medications monthly and report any discrepancies to the nurse executive or the resident's licensed health care practitioner. 3. All medications administered to a resident must be ordered in writing by a licensed health care practitioner. Telephone and verbal orders may be given to qualified licensed personnel and must be immediately reduced in writing, signed, and dated by the individual receiving the order, and countersigned or initialed by the licensed health care practitioner. 4. When ordered, medications not specifically limited as to time or number of doses must be automatically stopped in accordance with a written policy. The resident's attending licensed health care practitioner must be notified of stop order policies and contacted promptly for a decision concerning renewal of such orders so continuity of the resident's therapeutic regimen is not inadvertently interrupted. 5. Standing orders for drugs must specify the circumstances for drug dosage, route, duration, and frequency of administration. The order must be reviewed annually and, if necessary, renewed. When a standing order is implemented for a specific resident, it must be entered in the resident's record, dated, and signed by the licensed health care practitioner who prescribed the order. 6. All medications must be administered by individuals authorized to do so in accordance with state laws and regulations governing such acts. Each dose administered must be properly recorded in the resident record. 7. All medications administered by facility staff must be stored in a locked area or locked cart. a. Medications requiring refrigeration must be kept in a separate refrigerator which is locked or in a separate refrigerator in a lockable medication room near the nurses' station. b. Medications for "external use only" must be kept in a locked area and separate from other medications.