"Support, Encouragement, Empowerment"

Employees - Policy 2.4

A. RESPONSIBILITY FOR MEDICATION PROCEDURES
The Service Coordination Team is responsible to assure that Kokua’s medication procedures and staff training are effective and ensure client health and safety. Work Teams are responsible to ensure that proper medication procedures are followed by all team members. Team members who do not follow Kokua’s medication policy and procedures may face disciplinary action.
B. MEDICATION INCIDENTS
A Medication Incident must be completed whenever a medication is missed due to staff error or a medication has been given inappropriately. All Medication Incident Reports will be reviewed by the Client Service Coordinator and the Director of Client Services. Medication Incident Reports must contain written follow-up by the Client Services Coordinator explaining the causative factors and any corrective actions taken.
C. MEDICATION LOG
Medications for each client shall be recorded on a monthly medication log. The log will list each medication, the prescribing physician, the dose, the description of medication and method of administration, times and the possible side effects. All side effects noted will be reported to the physician.
All medications obtained from the pharmacy will be checked against the medication log before administration to assure the correct medications have been received.
Any discontinuation, addition or dosage change will be recorded on the medication log. All entries on the log will be initialed by the staff person administering the medication at the time the medications are given. If a client refuses to take a medication or if a medication is not given for any reason, this must be recorded on the back of the medication log. This should include a description of the circumstances and the signature of the staff making the entry.
The Team Leader will review each client’s medication log weekly to assure that all entries are complete. If any entries are missing or incomplete, the Team Leader will ensure that the appropriate corrections are completed as soon as possible. The Team Leader will document their weekly check process on the bottom of the back side of the Medication Log.
D. MONITORING OF PRN MEDICATIONS
A supply of prescribed PRN medications must be available in the client’s home at all times. When PRN medications are given, the time of administration must always be noted on the back of the medication log. Follow-up charting should be done to report on the efficacy of the PRN medication.
The Team Leader will monitor the use of all PRN medications to be sure they are given appropriately.
E. MEDICATION PROCEDURES
Assistance with self medication must conform to the proper time frames and dosages indicated on the Medication Log, unless directed otherwise by the physician or the Delegating Nurse. Before any medication is given, the staff person must physically compare each medication to the Medication Log to assure he or she has the right client, right medication, right dose, right time and right route.
F. SELF MEDICATION
All clients should participate as much as possible in the taking of their medications. Self-medication should be a goal for all clients. Clients should receive supportive training and any adaptations necessary to help them move toward independence. The process leading to self-medication should be fully documented and all self medication will be supervised until the client is reliably independent. Clients who become self medicating may sign the medication log.
G. STORAGE OF MEDICATIONS
Medications will be stored under proper conditions for safety, sanitation, temperature, moisture and ventilation.
H. DISPOSAL OF UNUSED MEDICATIONS
Outdated, discontinued, contaminated or superseded medications will be stored in a locked storage box while awaiting disposal. When the medications are placed in the storage box, the Team Leader will document the date, the name of medication, the dosage, the prescription number and the amount of medication to be disposed of will be documented on the Medication Disposal form. The Team Leader will then sign the Medication Disposal form.
Medication disposal is the responsibility of the Team Support Specialist for Quality Assurance. On a monthly schedule, the Team Support Specialist will pick up medications needing disposal. The Team Support Specialist will ask a second staff to participate in the disposal process as a witness. At the time of the medications are picked up, the Team Support Specialist will verify that the medications in the storage box match the entries on the team’s Medication Disposal form. The Team Support Specialist will sign the team’s Medication Disposal form and will assume custody of the medications. The medications picked up will be added to the Team Support Specialist’s master medication Disposal list. The Team Support Specialist and the second staff person will transport the medications to Group Health Cooperative for disposal. Both staff persons must sign to affirm that the medications were properly disposed.
I. OVER THE COUNTER MEDICATIONS
All over-the-counter medications present in a client’s home require written approval from the client’s physician. This approval must be renewed yearly.
J. NURSE DELEGATION REQUIREMENTS
Supervision of medications for clients who are not self-medicating will be provided by the contracted delegating nurse. The nurse should be consulted when any questions arise regarding medication administration. The nurse should also be informed of all serious medication incidents.
K.
All Life Skills Instructors, Team Leaders and Client Service Coordinators must complete Nurse Delegation Core Training and must maintain a current Nursing Assistant Registered (N.A.R.) Certification. Kokua will pay the licensure fees for NAR and CNA certificates and certificates will be mailed directly to Kokua.