Medication- Storage, Administration & Prescribing Info

Dawn Farm provides medical monitoring and control, prescribing, and dispensing at their detox and residential facilities. Clients will self-administer their medications at all sites, while staff follow our medication protocol.

Goal- why is this important to us?

Dawn Farm discourages the use of unnecessary medication or treatments. All medications and treatments will be reviewed by Dawn Farm medical staff in cooperation with the clinical staff. For the protection of all clients, all medications must be prescribed by a licensed physician, will be safely stored for clients (clients may not keep any medication on their person without explicit staff and medical authorization) and will be used only in the manner and for the duration specified by the prescription. In general, no mood altering substances will be used at Dawn Farm, although each case will be decided on an individual basis. Medication will not be used as a punishment, for the convenience of staff or as a substitute for appropriate treatment. All records of medication will become part of the permanent clinical record.

Storage of medication-

Medication (in its original container or accompanied by a current prescription) will be stored in a locked closet or cabinet. The keys will either be in the possession of staff or in an occupied or locked office. Each client will have a labeled container, which will hold all his or her medications.

All expired medications and those belonging to clients no longer in treatment will be disposed of (see "Illicit Drug/ Medication Disposal SOP in Health & Safety section).

Administration of medication-

Unless a prescription requires a change in time of administration, medications will be taken at designated medication times for each site.

Steps:

1. At Spera, staff will locate clients when it is time for medications. At Farm and DFD, clients will congregate at the office and be called in one at a time for medications.

2. Staff will follow the Five Rights of Medication Monitoring

• Right Person, Right Medication, Right Dose, Right Time, Right Route

3. Client will dispense and take appropriate medication while supervised by staff.

4. Staff will document date, time, name and amount of medication taken. Staff and client will both initial medication log.

Staff will also ensure that clients perform necessary medical treatment, such as applying prescription ointment or taking insulin, at the scheduled times and note this on the Medication Sheet.

If any error is made (too much, too little, missed dose, late, etc.), an entry will be made on the Medication Error Log. Staff will regularly review the Medication Sheets for accuracy, and record any errors on the Error Log.

If a client appears to be having an adverse reaction to a medication (rash, dizziness, difficulty breathing, wheezing, heart palpitations, etc.) and the reaction appears to be life threatening, staff will immediately call 911. If the reaction is not life threatening, staff or the client will contact the prescribing doctor and/or Dawn Farm medical staff for advice. In such an event an Incident Report will be filled out and the information will be entered on the Progress Note.

Other Important Medication Policies-

Prescribing of Medication

Prescribing staff (Medical Director and Nurse Practitioner) maintain responsibility for procuring written, informed consent of client and explaining the benefits, risks, and alternatives to medication, as well as who to contact if there are any unexpected changes in the client’s condition. Medical staff will use the Medication Consent for Treatment document .

Medication Peer Review

The Medical Director performs a thorough medication peer review (sample size) of the Nurse Practitioner's Medication Reviews and Psychiatric Evaluations two times a year. If adjustments are needed or concerns are expressed, the Medical Director would work with the Nurse Practitioner to make needed improvements.

Personal Medicine

Dawn Farm encourages clients to be active participants in their recovery. Dawn Farm recognizes an area that can often be challenging for clients to take on this active role is in the taking of prescription medication. In response to this, we have adopted *Personal Medicine.

*Personal Medicine is a model of care developed by Pat Deegan to support psychiatric patients in achieving recovery from mental illness. Personal Medicine is what patients do to be well. It empowers patients and staff to play an active role in their recovery from psychiatric issues, rather than passively wait for a medication or psychiatrist to heal them.

2014 Medication Policy Change:

Staff is expected to follow the "Five Rights for Medication Monitoring" when giving medication to clients. The document is attached at the bottom of this page. It will also be posted by the medicine cabinet at both sites. Please follow EACH step every time you give out medication. Take your time and be thorough.

Clients will no longer have a support with them to take medication. This will minimize distractions when monitoring the client and hopefully decrease the amount of time it takes to get the clients through the medication line. If the phone rings during medication time, ask the client to please wait one moment while you put the caller on hold. Finish the medication monitoring before taking the phone call. Finish the phone call before starting medication with a new client. Use the cordless phone during medication time to prevent ever having to leave a client in the medication area unsupervised.

Obtaining medication

For residential treatment, the staff member who has the first contact with either a medication or a prescription is responsible for ensuring that pertinent information is conveyed to either the primary counselor or the site supervisor. In the case of an unfilled prescription, this person will contact Dawn Farm medical staff to evaluate the medication and, if approved, make sure that it is filled and brought back to the facility. Once an approved medication is on site, on-duty staff is responsible for filling out the Medication Sheet completely.

In Detox, on-duty staff is responsible for all duties mentioned above and below. Detox clients must bring a three-day supply of any essential medications. Dawn Farm medical staff must approve any questionable medications.

Dawn Farm will maintain a supply of commonly used over the counter medications. They will be inventoried and disposed of in the same manner as prescribed medications.

Client discharge with medication

When a client is discharged from treatment and leaving with their medication, the medication information should be logged on the med sheet by a staff person. Both the client and staff person must sign and add the date. Any medications that cannot be given to client at time of discharge must be disposed of. See "Illicit Drug/ Medication Disposal SOP in Health & Safety section.

Off site Medication Use

All sites follow the same procedure when preparing medication for off site use. All normal administration procedures should be followed with the addition of two steps:

1) The exact dosage of medication needed is placed and sealed in a small envelope

2) The staff member notes in the Med Log that the medication is being taken off site before the client signs.