NURSING STANDARD 99.1
BY LICENSED STAFF
PURPOSE:
To establish a standard of performance for licensed personnel to ensure the safe and effective administration of medications according to basic concepts of pharmacy and administration techniques as integrated with the nursing process.
APPLICABILITY:
All DMR programs and support services in which licensed nurses are utilized shall adhere to this standard. Private agencies may adopt this or develop a similarly appropriate standard.
DEFINITIONS:
Licensed Nurse: A Registered Nurse (RN), an Advance Practice Registered Nurse (APRN) or a Licensed Practical Nurse (LPN.) working under the direction of a registered nurse, who holds a current license issued by the State of Connecticut under Chapter 378 of the Connecticut General Statutes. See Attachment A: CGS 20- 87a (a), (b), (c).
It is expected that individuals holding such a license shall work within their scope of practice as defined by State statute.
Medication Administration: The process of procuring, administering and documenting medications as related to the nursing practice.
Medication: Medication means any medicinal preparation including controlled substances, Schedules II - V, as defined in Section 21a-240 and regulations adopted pursuant to Section 21a-243 of the CGS. This also includes preparations available without a prescription, (over the counter medications).
PROCEDURES::
1. The individual nurse, by virtue of his or her license, is expected to remain competent in the knowledge of medication administration which includes but is not limited to the following areas:
- purpose of the medication,
- dosages, routes, methods of calculating dosages, etc.,
- expected effects,
- side effects and/or untoward effects,
- effectiveness,
- safe medication administration techniques and documentation,
- systems of distribution, access, control drug processes, etc., and
- appropriate response to medication errors, lack of drug effects, untoward effects and/or other negative outcomes.
2. The individual licensed nurse is expected to have knowledge of and adherence to his or her scope of practice and for working up to and within that scope. See Attachment A, CGS 20-70-87a, (a), (b), (c).
3. The licensed nurse is expected to administer medications using the nursing process of assessment, planning, implementation, evaluation and follow-up.
4. The individual licensed nurse is responsible for knowledge of and adherence to statewide, regional, and facility protocols and procedures for medication administration which shall include, but is not limited to:
- physician and other legally authorized prescriber orders, including methods of obtaining orders, transcribing orders, ordering from the pharmacy and other similar activities,
- methods of safe administration and documentation,
- methods of documentation and response to medication errors, and
- actions, communications and documentation related to evaluation of medication effectiveness, side effects, adverse reactions and other similar outcomes.
5. The individual licensed nurse is responsible for coordinating medication administration (e.g., administration processes, information, addressing concerns, etc.) with members of the interdisciplinary team and other appropriate individuals.
6. The individual licensed nurse is responsible for knowledge and adherence to other federal/state law and regulations pertaining to nursing, physician and pharmacist practices as related to medication administration (e.g. drug control law, pharmacist and pharmacy law, etc.).
Non compliance with the standards defined above shall result in the implementation of the DMR Sanction process for licensed nurses as detailed in Nursing Guidelines 99-1.