Section R9-10-513. Medication Services

A.      An administrator shall ensure that policies and procedures for medication services:

1.        Include:

a.         A process for providing information to a patient about medication prescribed for the patient includ- ing:

i.         The prescribed medication’s anticipated results,

ii.        The prescribed medication’s potential adverse reactions,

iii.      The  prescribed   medication’s  potential  side effects, and

iv.       Potential  adverse  reactions  that  could  result from not taking the medication as prescribed;

b.        Procedures for preventing, responding to, and reporting:

i.         A medication error,

ii.        An adverse reaction to a medication, or

iii.      A medication overdose;

c.         Procedures for documenting medication administra- tion; and

d.        Procedures to ensure that a patient’s medication reg- imen and method of administration is reviewed by a medical practitioner to ensure the medication regi- men meets the patient’s needs; and

2.        Specify a process for review through the quality manage- ment program of:

a.         A medication administration error, and

b.        An adverse reaction to a medication.

B.       An administrator shall ensure that:

1.        Policies and procedures for medication administration:

a.         Are reviewed and approved by a medical practi- tioner;

b.        Specify the individuals who may:

i.         Order medication, and

ii.        Administer medication;

c.         Ensure that medication is administered to a patient only as prescribed; and

d.        Cover the documentation of a patient’s refusal to take prescribed medication is documented in the patient’s medical record;

2.        Verbal  orders  for  medication  services  are  taken  by  a nurse, unless otherwise provided by law;

3.        A medication administered to a patient:

a.         Is administered in compliance with an order, and

b.        Is documented in the patient’s medical record.

C.      An administrator shall ensure that:

1.        A current drug reference guide is available for use by per- sonnel members;

2.        A current toxicology reference guide is available for use by personnel members; and

3.        If pharmaceutical services are provided on the premises:

a.         A committee, composed of at least one physician, one pharmacist, and other personnel members as determined by policies and procedures, is estab- lished to:

i.         Develop a drug formulary,

ii.        Update the drug formulary at least every 12 months,

iii.      Develop medication usage and medication sub- stitution policies and procedures, and

iv.       Specify which medications and medication classifications are required to be stopped auto- matically after a specific time period unless the ordering medical staff member specifically orders otherwise;

b.        The pharmaceutical services are provided under the direction of a pharmacist;

c.         The pharmaceutical services comply with ARS Title 36, Chapter 27; A.R.S. Title 32, Chapter 18; and 4

A.A.C. 23; and

d.        A copy of the pharmacy license is provided to the Department upon request.

D.      When medication is stored at a recovery care center, an admin- istrator shall ensure that:

1.        Medication is stored in a separate locked room, closet, or self-contained unit used only for medication storage;

2.        Medication is stored according to the instructions on the medication container; and

3.        Policies and procedures are established, documented, and implemented to protect the health and safety of a patient for:

a.         Receiving, storing, inventorying, tracking, dispens- ing, and discarding medication, including expired medication;

b.        Discarding or returning prepackaged and sample medication to the manufacturer if the manufacturer requests the discard or return of the medication;

c.         A medication recall and notification of patients who received recalled medication; and

d.        Storing, inventorying, and dispensing controlled substances.

E.       An administrator shall ensure that a personnel member imme- diately reports a medication error or a patient’s adverse reac- tion to a medication to the medical practitioner who ordered the medication and, if applicable, the recovery care center’s director of nursing.

Historical Note

Adopted as an emergency effective October 26, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired. Readopted without change as an emergency effective January 27, 1989, pur- suant to A.R.S. § 41-1026, valid for only 90 days (Supp.

89-1). Emergency expired. Readopted without change as an emergency effective April 27, 1989, pursuant to

A.R.S. § 41-1026, valid for only 90 days (Supp. 89-2).

Emergency expired. Readopted without change as an emergency effective July 31, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-3). Permanent

rules adopted effective October 30, 1989 (Supp. 89-4). Section repealed, new Section adopted effective April 4, 1994 (Supp. 94-2). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective Octo- ber 1, 2013 (Supp. 13-2). Amended by exempt rulemak-

ing at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, §

13; effective July 1, 2014 (Supp. 14-2).