COLORADO DEPARTMENT OF HUMAN SERVICES DIVISION OF YOUTH CORRECTIONS
POLICY S 12.10A
PAGE NUMBER 1 OF 12
CHAPTER: Medical and Health Care Services SUBJECT:
Use and Management of Pharmaceutical Products NCCHC: Y-D-01, Y-D-02
EFFECTIVE DATE: May 15, 2017
THIS POLICY RELATES TO: State-Operated Treatment Facilities State Owned Privately Operated Secure Treatment Facilities State-Operated Detention Facilities State Owned Privately Operated Secure Detention Regional Offices Central Office
I.
Anders Jacobson, Director
POLICY: All Division of Youth Corrections personnel shall comply with applicable State and Federal regulations governing the control, dispensing, distribution, administration, and disposal of medications. Medications shall be dispensed only by A QUALIFIED HEALTH CARE PROFESSIONAL and shall be administered by either A QUALIFIED HEALTH CARE PROFESSIONAL OR QUALIFIED MEDICATION ADMINISTRATION PERSONNEL (QMAP), in accordance with a PRESCRIBING CLINICIAN’S MEDICATION ORDERS.
II.
KEY TERMS: A.
ACCOUNTING: THE ACT OF RECORDING, SUMMARIZING, ANALYZING, VERIFYING, AND REPORTING MEDICATION USAGE.
B.
ADMINISTERING MEDICATION: PROVIDING A SINGLE DOSE OF A MEDICATION TO AN INDIVIDUAL BY INJECTION, INHALATION, INGESTION, OR OTHER MEANS, UPON THE AUTHORIZATION OF A PHYSICIAN OR DENTIST.
C.
CONTROLLED SUBSTANCES - DRUG ENFORCEMENT AGENCY (DEA): MEDICATIONS THAT COME UNDER THE JURISDICTION OF THE FEDERAL CONTROLLED SUBSTANCES ACT.
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D.
DISPENSING: THE PLACING OF ONE OR MORE DOSES OF A PRESCRIBED MEDICATION INTO CONTAINERS THAT ARE CORRECTLY LABELED TO INDICATE THE NAME OF THE PATIENTS, THE CONTENTS OF THE CONTAINER AND ALL OTHER VITAL INFORMATION.
E.
DISPOSAL OF MEDICATION: THE SAFE REMOVAL DISCARDING OF MEDICATIONS THAT ARE NO LONGER ACTIVELY BEING USED OR HAVE EXPIRED.
F.
DISTRIBUTION: THE PROCESS BY WHICH A MEDICATION IS DELIVERED TO THE CORRECT PLACMENT WHERE THE YOUTH WILL BE RECEIVING THE MEDICATION. THIS MAY BE A MEDICATION CART OR A LOCKED CABINET OR ANOTHER PLAE WHERE SPECIFIC MEDICATIONS ARE KEPT.
G.
DRUG ENFORCEMENT AGENCY (DEA): A FEDERAL LAW ENFORCEMENT AGENCY WITHIN THE U.S. DEPARTMENT OF JUSTICE. THE MAJOR TASK OF THE DEA IS TO COMBAT DRUG SMUGGLING AND ILLICIT USE WITHIN THE UNITED STATES.
H.
ELECTRONIC DATA WAREHOUSE (EDW): A PROGRAM IN TRAILS THAT IS DEVOTED TO SCANNED MEDICAL RECORDS THAT CAN BE REPRODUCED AND PRINTED WHEN NEEDED.
I.
FORMULARY: A WRITTEN LIST OF PRESCRIPTION AND NONPRESCRIPTION MEDICATIONS THAT ARE ORDINARILY AVAILABLE TO AUTHORIZED PRESCRIBERS, INCLUDING CONSULTANTS, WORKING FOR THE FACILITY.
J.
MEDICATION: A SUBSTANCE INTENDED FOR USE IN THE DIAGNOSIS, CURE, MITIGATION, TREATMENT, OR PREVENTION OF DISEASE OR OTHER CONDITIONS
K.
MEDICATION ADMINISTRATION RECORD (MAR): A SYSTEM THAT DOCUMENTS WHEN A MEDICATION IS GIVEN. IT INCLUDES THE TIME, DOSE AND PERSON ADMINISTERING THE MEDICATION. IT CAN BE EITHER ELECTRONIC OR WRITTEN.
L.
MEDICATION ERRORS: “ANY PREVENTABLE EVENT THAT MAY CAUSE OR LEAD TO INAPPROPRIATE MEDICATION USE OR PATIENT HARM WHILE THE MEDICATION IS IN THE CONTROL OF THE HEALTH CARE PROFESSIONAL, PATIENT, OR CONSUMER. SUCH EVENTS MAY BE RELATED TO PROFESSIONAL PRACTICE, HEALTH CARE PRODUCTS, PROCEDURES AND SYSTEMS, INCLUDING PRESCRIBING: ORDER COMMUNICATION; PRODUCT LABELING, PACKAGING, AND NOMENCLATURE; COMPOUNDING; DISPENSING; DISTRIBUTION; ADMINISTRATION; EDUCATION; MONITORING; AND
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USE.” (NATIONAL COORDINATING COUNCIL FOR MEDICATION ERROR REPORTING AND PREVENTION- NCCMERP) M.
OVER THE COUNTER MEDICATION (OTC): MEDICATIONS THAT ARE AVAILABLE TO TREAT COMMON HEALTH PROBLEMS WITHOUT A PRESCRIPTION THAT ARE APPROVED BY THE FOOD AND DRUG ADMINISTRATION (FDA).
N.
PRESCRIBING CLINICIAN: A LICENSED INDIVIDUAL, SUCH AS AN MEDICAL DOCTOR (MD), DOCTOR OF OSTEOPATHIC MEDICINE (DO), NURSE PRACTITIONER (NP), OR PHYSICIAN ASSISTANT (PA), WHO IS AUTHORIZED TO WRITE PRESCRIPTIONS.
O.
PRESCRIPTION MEDICATION: A SUBSTANCE INTENDED FOR USE IN THE DIAGNOSIS, CURE, MITIGATION, TREATMENT, OR PREVENTION OF DISEASE OR OTHER CONDITIONS THAT REQUIRE A LICENSED PHYSICIAN, DENTIST OR ADVANCED PRACTICE PROVIDER’S AUTHORIZATION.
P.
PROCUREMENT: A PROCESS TO ENSURE THE AVAILABILITY OF THE RIGHT MEDICATION AT THE RIGHT TIME IN THE RIGHT AMOUNT OR QUANTITY.
Q.
QUALIFIED HEALTH CARE PROFESSIONAL: PHYSICIANS, PHYSICIAN ASSISTANTS, NURSES, NURSE PRACTITIONERS, DENTISTS, MENTAL HEALTH PROFESSIONALS, AND OTHERS WHO BY VIRTUE OF THEIR EDUCATION, CREDENTIALS, AND EXPERIENCE ARE PERMITTED BY LAW TO EVALUATE AND CARE FOR PATIENTS.
R.
QUALIFIED MEDICATION ADMINISTRATION PERSONNEL (QMAP): INDIVIDUALS WHO HAVE SUCCESSFULLY COMPLETED THE APPROVED TRAINING BY THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT (CDPHE) OR A DESIGNATED APPROVED TRAINING ENTITY AUTHORIZING THEM TO ADMINISTER PRESCRIPTION AND NONPRESCRIPTION MEDICATION.
S.
QUALIFIED MENTAL HEALTH PROFESSIONAL: AN INDIVIDUAL, WHO IS A LICENSED PSYCHIATRIST, LICENSED PSYCHOLOGIST, LICENSED CLINICAL SOCIAL WORKER, A PSYCHOLOGIST CANDIDATE FOR LICENSURE, A LICENSED MARRIAGE AND FAMILY THERAPIST, OR A MASTER’S LEVEL MENTAL HEALTH THERAPIST WHO IS UNDER THE SUPERVISION OF A LICENSED MENTAL HEALTH PROFESSIONAL.
T.
RESPONSIBLE HEALTH AUTHORITY: INDIVIDUAL RESPONSIBLE FOR THE FACILITY’S HEALTH CARE SERVICES, AND ARRANGES FOR ALL LEVELS OF HEALTH CARE AND ASSURES QUALITY, ACCESSIBLE
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AND TIMELY HEALTH SERVICES. THE RHA MAY BE A PHYSICIAN OR THEIR DESIGNEE, HEALTH ADMINISTRATOR, OR CONTRACTED AGENCY. U.
III.
IV.
RESPONSIBLE PHYSICIAN: A DESIGNATED DOCTOR OF MEDICINE (MD) OR DOCTOR OF OSTEOPATHIC MEDICINE (DO) WHO HAS THE FINAL AUTHORITY AT A GIVEN FACILITY REGARDING CLINICAL ISSUES.
ASSOCIATED FORMS: 1.
MEDICATION DIVERSION PROTOCOL
2.
MEDICATION ADMINISTRATION RECORD
3.
MEDICATION COMMUNICATION FORM
4.
MEDICATION REFUSAL FORM
5.
SCHEDULE II INVENTORY FORM
6.
MEDICATION DOCUMENTATION
7.
HAZARDOUS AND NON-HAZARDOUS MEDICAL WASTE
8.
QMAP CERTIFICATES
9.
PRN OTC MAR FORM
10.
JUVENILE TRANSFER MEDICAL ADVISEMENT
PROCEDURES: A.
PHARMACEUTICAL OPERATIONS: 1.
THE RESPONSIBLE PHYSICIAN DETERMINES PRESCRIPTIVE PRACTICE IN THE CLINIC.
2.
The QUALIFIED HEALTH CARE PROFESSIONAL shall ENSURE that all pharmacy procedures and practices REGARDING PRESCRIBING, ADMINISTERING, AND PROCURING PHARMACEUTICALS adhere to applicable State and Federal laws and regulations.
3.
THE CLINIC MAINTAINS A FORMULARY FOR CLINICIANS.
4.
THE CLINIC MAINTAINS PROCEDURES FOR THE TIMELY PROCUREMENT, DISPENSING, DISTRIBUTION, ACCOUNTING, AND DISPOSAL OF PHARMACEUTICALS.
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B.
SUBJECT POLICY Use of Pharmaceutical S 12.10A Products
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5.
THE CLINIC MAINTAINS RECORDS AS NECESSARY TO ENSURE ADEQUATE CONTROL OF AND ACCOUNTABILITY FOR ALL MEDICATIONS. MEDICATIONS ARE KEPT UNDER THE CONTROL OF QUALIFIED HEALTH CARE PROFESIONAL.
6.
SELF-ADMINISTRATED MEDICATION PROGRAMS SHALL BE APPROVED BY THE RESPONSIBLE HEALTH AUTHORITY AND THE RESPONSIBLE PHYSICIAN.
7.
A CONSULTING PHARMACIST SHALL BE USED FOR DOCUMENTED INSPECTIONS AND CONSULTATION ON A QUARTERLY BASIS.
8.
DRUG STORAGE AND MEDICATION AREAS ARE DEVOID OF OUTDATED, DISCONTINUED, OR RECALLED MEDICATIONS.
9.
ALL MEDICATIONS ARE STORED UNDER PROPER CONDITIONS OF SANITATION, TEMPERATURE, LIGHT, MOISTURE, VENTILATION, SEGREGATION, AND SECURITY.
10.
ANTISEPTICS, OTHER MEDICATIONS FOR EXTERNAL USE, AND DISINFECTANTS ARE STORED SEPARATELY FROM INTERNAL AND INJECTABLE MEDICATIONS. MEDICATIONS REQUIRING SPECIAL STORAGE FOR STABILITY ARE SO STORED.
11.
EMERGENCY MEDICATIONS (I.E. EPI-PEN) AND RELATED INFORMATION ARE READILY AVAILABLE TO THE STAFF. THIS INCLUDES A POSTING OF THE POISON CONTROL CENTER TELEPHONE NUMBER.
12.
Where prescriptions are generated by contract or by a consultant, substitutions may be made only when approved by a PRESCRIBING CLINICIAN OR RESPONSIBLE PHYSICIAN.
13.
Non-hazardous pharmaceutical waste and hazardous pharmaceutical waste shall be disposed of in accordance with state regulations. (SEE MEDICAL WASTE DISPOSAL PROTOCOL).
Prescription Practices: 1.
The Division of Youth Corrections and STATE OWNED PRIVATELY OPERATED SECURE FACILITIES SHALL USE professionally recognized and nationally accepted guidelines, protocols, treatment plans and educational tools for the care of juveniles, to include Clinical Care Guidelines for Family Practice by Uphold and Graham (MOST RECENT EDITION), or the equivalent, the American Academy of Child and Adolescent Psychiatry Practice Parameters, the Colorado Division of Youth Corrections’ Parameters for Use of Psychotropic Medications in
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Children and Adolescents, and National Commission on Correctional Health Care. 2.
Prescription medications shall BE PRESCRIBED ONLY upon the authorization of a PRESCRIBING CLINICIAN AND ONLY WHEN CLINICALLY INDICATED.
3.
ALL MEDICATIONS SHALL BE AUTHORIZED BY A PRESCRIBING CLINICIAN AND ADMINISTERED BY A QUALIFIED HEALTH CARE PROFESSIONAL OR QMAP.
4.
THERE SHALL BE AN ADEQUATE METHOD FOR NOTIFYING THE RESPONSIBLE PHYSICIAN OR PRESCRIBING CLINICIAN OF THE IMPENDING EXPIRATION OF A MEDICATION ORDER SO THAT THE PRACTITIONER CAN DETERMINE WHETHER THE MEDICATION ADMINISTRATION IS TO BE CONTINUED OR ALTERED.
5.
JUVENILES ENTERING THE FACILITY TAKING PRESCRIPTION MEDICATION SHALL CONTINUE TO RECEIVE THEIR MEDICATION AS PRESCRIBED AFTER APPROVAL BY A QUALIFIED HEALTHCARE PROFESSIONAL.
6.
MEDICATIONS SHALL NOT BE GIVEN FOR THE FIRST TIME WITHIN A FACILITY TO A JUVENILE UNLESS WRITTEN ORDERS FOR THE MEDICATION ARE GIVEN BY A QUALIFIED PRESCRIBER. JUVENILES WHO URGENTLY REQUIRE MEDICATION AND ARE UNABLE TO BE EXAMINED BY A QUALIFIED MEDICAL PROVIDER IN A TIMELY MANNER SHALL BE SENT TO THE EMERGENCY ROOM OR AVAILABLE MEDICAL CLINIC TO BE EVALUATED BY A QUALIFIED MEDICAL PROFESSIONAL.
7.
CONSENT TO CONTINUE ALL MEDICATIONS BROUGHT INTO A FACILITY SHALL BE OBTAINED FROM THE JUVENILE, OR IN INSTANCES IN WHICH THE JUVENILE IS NOT EMANCIPATED, FROM THE JUVENILE’S PARENTS OR LEGAL GUARDIAN. CONSENT WILL BE DOCUMENTED IN THE JUVENILE’S HEALTH RECORD.
8.
A PRESCRIBING CLINICIAN SHALL BE CONTACTED BY A QUALIFIED HEALTH CARE PROFESSIONAL (NOT QMAP) FOR DIRECTIONS TO RESTART A JUVENILE ON A MEDICATION THAT HAS NOT BEEN TAKEN FOR OVER TWENTY-FOUR (24) HOURS. THIS CONTACT SHALL BE DOCUMENTED IN THE JUVENILE’S HEALTH RECORD.
9.
MEDICATIONS BROUGHT TO THE FACILITY BY A PARENT, LEGAL GUARDIAN, OR A PRIVATE RESIDENTIAL CONTRACT PROGRAM SHALL BE VERIFIED AND COUNTED BY TWO
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PEOPLE, THIS SHALL BE DONE BY THE PERSON DROPPING OFF THE MEDICATION AND THE PERSON RECEIVING THE MEDICATION. THE CLINICIAN SHALL CALL THE CURRENT PHARMACY TO VERIFY THAT THE PRESCRIPTION IS ACTIVE, AND A QUALIFIED HEALTH CARE PROFESSIONAL SHALL INSPECT THE ACTUAL PILLS WITHIN THE CONTAINER AND COMPARE THEM AGAINST AN ONLINE DATABASE OF PILL PHOTOGRAPHS AND DESCRIPTIONS. A MEDICATION COMMUNICATION FORM SHALL BE COMPLETED, A COPY OF WHICH SHALL BE GIVEN TO THE PERSON DELIVERING THE MEDICATIONS. THE ORIGINAL COPY SHALL BECOME PART OF THE JUVENILE’S RECORD. CONSENT FOR MEDICATION SHALL BE OBTAINED BY THE LEGAL GUARDIAN WHEN APPROPRIATE. 10.
MEDICATION SHALL BE ADMINISTERED IN ACCORDANCE WITH THE MEDICATION ADMINISTRATION/DIVERSION PROTOCOL.
11.
The administration of all medications shall be recorded on a form approved by the RESPONSIBLE HEALTH AUTHORITY and RESPONSIBLE PHYSICIAN and shall become part of the juvenile’s medical record. THIS FORM MAY BE ELECTRONIC OR PAPER. Each dose shall be documented with the date and time of administration and shall be signed or initialed by the staff member administering it.
12.
Documentation and execution of prescriber orders must comply with the Operating Procedure Directive entitled “Documentation and Execution of Prescriber Orders” effective September 15, 2014, or as subsequently amended. All medication orders shall be documented in THE JUVENILE’S HEALTH RECORD. Medication orders shall be written by a PRESCRIBING CLINICIAN. Medication orders shall be transcribed and THE PRESCRIPTION TRANSMITTED TO THE PHARMACY within 24 hours FOR PROCUREMENT. An emergency plan for weekends, holidays, and unexpected QUALIFIED HEALTH CARE PROFESSIONAL absences will be identified in EACH FACILITY’S implementing PROCEDURES.
13.
Verbal authorizations for prescriptions shall be WRITTEN OUT IN AN ENCRYPTED EMAIL WITH THE PRESCRIBER’S SIGNATURE AND SENT TO THE FACILITY. THIS ORDER SHALL BE CARRIED OUT BY QUALIFIED HEALTH CARE PROFESSIONALS OR QMAPS. THE ORDER IS TRANSCRIBED ON THE MEDICATION ADMINISTRATION RECORD. THE EMAIL ORDER SHALL BE SCANNED INTO THE JUVENILES’S MEDICAL RECORD WITHIN 7 DAYS.
14.
MEDICATIONS, INCLUDING OVER THE COUNTER MEDICATIONS, SHALL HAVE A WRITTEN ORDER PRIOR TO ADMINISTRATION. WHEN A SUPERVISOR OR DESIGNEE CALLS
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THE ON-CALL PHYSICIAN, HE/SHE WILL SEND AN ENCRYPTED EMAIL TO THE ON-CALL PHYSICAN. THE ON-CALL PHYSICIAN WILL REPLY TO THIS EMAIL WITH A WRITTEN ORDER. THIS EMAIL SHALL BE PRINTED AND PLACED IN THE MARS OF THAT JUVENILE (OR BY THE JUVENILE’S MEDICATIONS). THIS ORDER SHALL BE SCANNED INTO THE JUVENILE’S MEDICAL RECORD WITHIN 7 DAYS. ONLY “RED-DOT” MEDICATIONS NEED TO HAVE IMMEDIATE AUTHORIZATION FROM THE ONCALL PHYSICIAN IF MEDICAL STAFF IS NOT AVAILABLE WITHIN 24 HOURS. 15.
Medications shall be administered in single dosage. Medications that are authorized for patient self-administration may be ADMINISTERED in multiple dosage quantities.
16.
Medications requiring intramuscular or intravenous administration shall be PRESCRIBED ONLY BY A PRESCRIBING CLINICIAN, following an examination of the juvenile.
17.
Prescription medications requiring intramuscular administration ORDERED by a PRESCRIBING CLINICIAN SHALL ONLY BE administered by a QUALIFIED HEALTH CARE PROFESSIONAL. a.
HEALTH STAFF SHALL USE NEEDLE SAFETY DEVICES SUCH AS SELF-SHEATHING NEEDLES OR NEEDLELESS SYSTEMS.
18.
A COURT ORDER SHALL BE OBTAINED WHENEVER IT HAS BEEN DETERMINED BY MEDICAL OR PSYCHIATRIC PERSONNEL THAT MEDICAL OR PSYCHIATRIC CARE IS VITAL AND NECESSARY FOR A JUVENILE'S WELL-BEING AND THE MEDICAL OR PSYCHIATRIC CARE MUST BE RENDERED AGAINST THE JUVENILE'S WILL. THE ORIGINAL COPY OF THE COURT ORDER SHALL BE PERMANENTLY RETAINED IN THE JUVENILE'S MEDICAL FILE. REFER TO DIVISION OF YOUTH CORRECTIONS POLICY “PSYCHOTROPIC EMERGENCY MEDICATIONS” FOR FURTHER INFORMATION.
19.
All medications deemed clinically necessary for the juvenile to receive during a pass shall be ORDERED FROM THE PHARMACY AND provided to the juvenile or his or her parent or guardian prior to releasing the juvenile on pass.
20.
Prior to a juvenile’s discharge A Division of Youth Corrections’ or AUTHORIZED PRESCRIBING CLINICIAN SHALL provide the juvenile WITH a short-term supply of the medication that is dispensed by the pharmacy to the juvenile AND/OR a written prescription that can be filled in the community. THE QUANTITY OF MEDICATION SHALL
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SUPPORT THE JUVENILE UNTIL HE/SHE HAS AN APPOINTMENT IN THE COMMUNITY. THIS SHALL NOT EXCEED A 30 DAY SUPPLY. C.
Security and Storage of Controlled Substances and Other Medications: 1.
THE FACILITY MAINTAINS DOUBLE LOCK SECURITY STORAGE OF, AND ACCOUNTABILITY OF USE, FOR DRUG ENFORCEMENT AGENCY (DEA)-CONTROLLED SUBSTANCES.
2.
All controlled substances, needles, syringes, AND ALL SHARPS shall be stored by QUALIFIED HEALTH CARE PROFESSIONALS in a locked cabinet located in a secure area that is inaccessible to juveniles or unauthorized staff. Access shall be limited to QUALIFIED HEALTH CARE PROFESSIONALS AND staff authorized BY QUALIFIED HEALTH CARE PROFESSIONALS, PURSUANT TO PROTOCOL ISSUED BY THE DIVISION OF YOUTH CORRECTIONS DIRECTOR OF BEHAVIORAL HEALTH AND MEDICAL SERVICES, AND/OR DESIGNEE.
3.
DAILY INVENTORIES ARE MAINTAINED ON ALL SHARPS. Access shall be limited to QUALIFIED HEALTH CARE PROFESSIONALS AND staff authorized by QUALIFIED HEALTH CARE PROFESSIONALS, PURSUANT TO PROTOCOL ISSUED BY THE DIRECTOR OF BEHAVIORAL HEALTH AND MEDICAL SERVICES, AND/OR DESIGNEE.
4.
Controlled substances SHALL be counted by two staff each shift. THE COUNTING SHALL BE DONE BY TWO QUALIFIED HEALTH CARE PROFESSIONALS, TWO QMAPS, A QUALIFIED MANAGER (SUPERVISOR) OR ONE OF EACH. DOCUMENTATION OF THIS COUNT SHALL BE MADE ON THE DEA-CONTROLLED SUBSTANCES SHIFT COUNT FORM.
5.
Any theft or unexplained loss of a DEA-CONTROLLED SUBSTANCE shall be reported immediately to the Director of the facility OR DESIGNEE, the RESPONSIBLE HEALTH AUTHORITY, THE RESPONSIBLE PHYSICIAN, the DIRECTOR OF FACILITY OPERATIONS, and the Director of the Division of Youth Corrections.
6.
Medications that require refrigeration shall be stored BY QUALIFIED HEALTH CARE PROFESSIONALS in a refrigerator. A thermometer shall be KEPT in the DESIGNATED refrigerator to monitor the temperature, AND THE TEMPERATURE READING SHALL BE DOCUMENTED TWICE DAILY IN A TEMPERATURE LOG IN ACCORDANCE WITH FACILITY GUIDELINES.
7.
Medications shall be stored in limited supply in the examination rooms or other appropriate areas, as authorized by A QUALIFIED HEALTH CARE PROFESIONAL.
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8. D.
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A receipt shall be issued and maintained FOR THREE (3) YEARS for all medications received from the pharmacy.
Over the Counter Medications (OTC): 1.
OTCs may be used for the temporary relief of minor health problems, such as headaches, abdominal cramping and indigestion.
2.
All OTCs shall be stored in a locked cabinet in a secure area.
3.
Over the counter medications shall be administered to juveniles by A QUALIFIED HEALTH CARE PROFESSIONAL OR QUALIFIED MEDICATION ADMINISTRATION PERSONNEL (QMAP) ONLY WHEN AUTHORIZED BY A QUALIFIED HEALTH CARE PROFESSIONAL.
4.
THERE SHALL BE A WRITTEN ORDER FOR ALL OVER THE COUNTER (OTC) MEDICATION. THIS DOCUMENT SHALL BE SIGNED AND DATED BY A QUALIFIED HEALTH CARE PROFESSIONAL. A RESPONSIBLE HEALTH AUTHORITY WITH PRESCRIPTIVE AUTHORITY MAY WRITE STANDING ORDERS TO BE USED ONLY FOR PREVENTIVE MEDICINE PRACTICES. STANDING ORDERS SHALL BE INDIVIDUALIZED, SIGNED AND DATED AT THE TIME OF IMPLEMENTATION. THIS DOCUMENTATION SHALL BE SCANNED INTO THE JUVENILE’S HEALTH RECORD WITHIN 7 DAYS.
5.
Administered OTCs shall be documented with the following information: a.
The name of the juvenile, and
b.
The name of the medication, and
c.
The date and time administered, and
d.
The juvenile’s medical REQUEST, and
e.
Name of the QUALIFIED HEALTH CARE PROFESSIONAL OR QUALIFIED MEDICATION ADMINISTRATION PERSONNEL (QMAP) who administered the medication.
6.
QMAP STAFF ADMINISTERING THE OTC MEDICATION SHALL MONITOR THE CONDITION OF THE JUVENILE TO DETERMINE IF ADDITIONAL MEASURES SHOULD BE TAKEN.
7.
QUALIFIED HEALTH CARE PROFESSIONALS shall monitor the use of OTCs by reviewing the MEDICATION ADMINISTRATION RECORD (MAR). THIS SHALL BE DONE MONTHLYAND DOCUMENTED WITH A DATED SIGNATURE ON THE MAR.
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E.
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Medication Self-Administration: 1.
F.
SUBJECT POLICY Use of Pharmaceutical S 12.10A Products
A Division of Youth Corrections’ OR AUTHORIZED RESPONSIBLE PHYSICIAN OR RESPONSIBLE HEALTH AUTHORITY, in collaboration with the Facility Director OR designee, may approve selfadministration programs for juveniles on an individualized basis. The approval shall specify what medications shall be included and any consequences of misuse of the self-administration program. a.
Self-administration programs shall be limited to self-administration of over the counter creams, ointments, and lotions prescribed as needed.
b.
SELF-ADMINISTERED MEDICATIONS SUCH AS INSULIN SHALL BE REVIEWED BY QUALIFIED HEALTH CARE PROFESSIONALS PRIOR TO THE ADMINISTRATION.
c.
A JUVENILE USING A SELF-ADMINISTERED MEDICATION SHALL BE SUPERVISED BY A QMAP OR QUALIFIED HEALTH CARE PROFESSIONAL.
d.
Medications approved for self-administration shall be securely stored in the MEDICATION CART OR REFRIGERATOR and labeled with the juvenile’s name, the PRESCRIBING CLINICIAN’S name, and time for use. YOUTH ARE NOT ALLOWED TO KEEP MEDICATIONS ON THEIR PERSON.
e.
The juvenile shall request the medication from A QUALIFIED HEALTH CARE PROFESSIONALS OR QMAP. QUALIFIED HEALTH CARE PROFESSIONALS AND QMAPS shall document the juvenile’s use of self-administered medication. THIS DOCUMENT SHALL BE SCANNED INTO THE JUVENLE’S HEALTH RECORD AT THE END OF THE MONTH OR UPON RELEASE.
MEDICATION REFUSAL: 1.
A juvenile has the right to refuse any medication other than a medication that is life sustaining. See DIVISION OF YOUTH CORRECTIONS STATE POLICIES “PSYCHOTROPIC EMERGENCY MEDICATIONS” and “INVOLUNTARY MEDICATION ADMINISTRATION” for addressing emergency medications or involuntary medications, respectively.
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a. If a juvenile refuses a prescribed medication, THE QUALIFIED HEALTH CARE PROFESSIONALS shall be notified and the juvenile SHALL sign THE MEDICATION refusal form. b. THE CLINIC HEALTH STAFF, PRESCRIBING CLINICIAN AND BEHAVIORAL HEALTH SPECIALIST SHALL BE NOTIFIED OF CONTINUED MEDICATION REFUSAL. THIS SHALL BE DOCUMENTED IN THE JUVENILE’S HEALTH RECORD. c. If a juvenile refuses to sign the form, the form shall be witnessed by a staff other than the person responsible for administering the medication. d. THIS REFUSAL FORM SHALL BE SCANNED INTO THE JUVENILE’S HEALTH RECORD WITHIN 7 DAYS. G.
Misuse of Medications by Juveniles: 1.
Persistent misuse of a medication by a juvenile after prescribed interventions may result in discontinuation of the medication OR A CHANGE IN MEDICATION DELIVERY unless the medication is necessary to sustain life (e.g., insulin).
2.
Changes in medication delivery shall be made BY THE PRESCRIBING CLINICIAN.
3.
THERE SHALL BE A PLAN CREATED BY QUALIFIED HEALTH CARE PROFESSIONALS AND/OR QUALIFIED MENTAL HEALTH PROFESSIONALS. A COPY OF THIS PLAN SHALL BE SCANNED INTO THE JUVENILE’S HEALTH RECORD WITHIN 7 DAYS.
4.
Juveniles who have misused or been non-compliant with their medications shall be identified when transferred to another facility by using the CRITICAL ADVISEMENT FORM AND THE Juvenile Transfer Medical Advisement.
