When a request is made by the client and/or the legal guardian, to allow the
client to self-administer medications:
1. The request will be documented and placed in the client's record.
2. The request will be discussed by the client�s service providers.
3. The providers will review the licensing standards for the placement
location of the client and will determine possible safety concerns for the
client or others in the placement. Community Care recognizes a need for a continuum
of least restrictive to most restrictive self-administration of medication
procedures. In most cases, due to the design of Community Care programs, a more
restrictive form of medication self-administration will need to be followed.
For example, an employee and/or contractee will store
all medications and supervise the client while they are self-administering. In
most cases, clients would not be able to store medications in their rooms due
to safety concerns and/or licensing restrictions. The procedures listed below
are to be followed when a client has complete control over their medication
administration. When permission is granted for a client to completely
self-administer medications, the following must be considered and included in
the plan prior to implementation:
a. Location of the medications: Clients that self-administer medications may
be allowed to keep such medications in a locked storage container in their
private living quarters. Providers must decide whether to provide a more secure
location or not.
�b. Security of the medication supply:
The medications must be securely stored. Access to a locking storage container
shall be provided by the Agency if needed. An agency representative will
maintain access to this storage container.�
c. Physician orders and labeling: All medications to be self-administered
must have a corresponding physician's order and a prescription label with the
client's name, prescribing physician's name, medication name, dosage and
frequency, and expiration date.
�d. Education and Supervision: The
Agency will retain a professionally qualified individual to provide education
and supervision when an agency client self-administers medications.
e. Compliance and observation of side effects: Agency employees and contractees will monitor compliance and observe for side
effects.
�f. Documentation: All medication
administration must be documented on an appropriate form and this documentation
must be entered into the client's case record. This process will be documented
on the client's service plan and placed in the client's record.�
g. Plan Review: The team will review this decision minimally every 90 days.
This review may be more often depending on the type of medication being
administered (psychotropic meds must be reviewed every 30 days in residential
programs), and depending on the safety needs of the client and/or other clients
in the same placement.
h. Reporting: All reporting procedures must be maintained in the case of
medication errors or incidents involving medications.
4. When a safety concern is presented that results in the client's request
being denied, providers will document the process and place the documentation
in the client's record. This decision will be reviewed quarterly or more often
if requested.