Questions and Answers
Who must approve the contents of each emergency medication kit?
What is the maximum number of different controlled substances that can be stocked in a sealed emergency medication kit?
Under what Article of the Public Health Law must a facility be licensed to provide pharmacy services?
Who can administer controlled substances from an emergency medication kit?
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How long must the records of controlled substances in emergency kits be maintained?
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Who is responsible for reviewing the drug regimen of each resident at least once a month?
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What is the maximum number of noninjectable, prepackaged medications that can be included in an emergency medication kit?
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What is the primary purpose of a drug regimen review?
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Where must each emergency medication kit be kept?
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Under what circumstances can psychotropic drugs be administered?
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What is the role of the quality assessment and assurance committee in relation to drug regimen reviews?
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What must be done when a verbal order is given for a medication?
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What happens if a verbal order is not signed by the prescriber or a legally designated alternate practitioner within 48 hours?
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What type of drugs must be accounted for and periodically reconciled?
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What is the responsibility of the facility regarding the provision of pharmaceutical services?
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Who is responsible for determining that drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled?
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What should be included in the labeling of drugs and biologicals?
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How should controlled drugs and other drugs subject to abuse be stored?
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What should be done with medications whose shelf life has expired or which are no longer in use?
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What type of medications can be returned to the vendor pharmacy?
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What is required for drug products repackaged by the pharmacy into unit-dose or multiple-dose 'blister packs' to be returned for redispensing?
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What should be done with partially used 'blister packs'?
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What type of medications cannot be returned to the vendor pharmacy?
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Who should have access to stored drugs and biologicals?
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What should be maintained by the pharmacy in the case of drug products repackaged in advance of immediate needs?
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What should the vendor pharmacy do with returned drug products?
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Study Notes
Pharmacy Services in Nursing Homes
- A nursing home facility must provide pharmaceutical services and develop policies to ensure accurate acquisition, receipt, dispensing, and administration of all drugs and biologicals.
- The facility must be licensed under Article 33 of the Public Health Law and Part 80 of this Title.
Service Consultation
- A registered pharmacist must be employed or contracted to provide consultation on pharmacy services.
- The pharmacist must establish a system of records for controlled drugs and maintain an account of all controlled drugs.
Drug Regimen Review
- A registered pharmacist must review each resident's drug regimen at least once a month.
- The pharmacist must report any irregularities to the attending physician and director of nursing.
- Psychotropic drugs can only be administered on a physician's order and as part of a plan of care.
Labeling of Drugs and Biologicals
- Drugs and biologicals must be labeled according to accepted standards of practice, including accessory and cautionary instructions and expiration dates.
- Labeling must comply with Article 137 of the State Education Law and 8 NYCRR Part 29.
Storage of Drugs and Biologicals
- Drugs and biologicals must be stored in locked compartments under proper temperature controls, with access only to authorized personnel.
- Controlled drugs must be stored in separately locked, permanently affixed compartments, except when using single-unit package drug distribution systems.
Return of Unused Medications
- Unused medications can be returned to the vendor pharmacy for redispensing if sealed, unopened, and within the recommended shelf life.
- Returned medications must meet specific criteria, including being repackaged with clear labeling and not being controlled substances.
Emergency Medications
- Emergency medication kits must be approved by the medical director, pharmacist, and director of nursing.
- Kits can contain up to a 24-hour supply of controlled substances, including injectable drugs, and must be secured within or near the nurses' station.
Medications for Leaves
- Medications can be released to discharged residents or those going on temporary leave, using the facility's medication supply.
Verbal Orders
- Medications must be ordered in writing by a legally authorized practitioner, except in unusual circumstances where a verbal order can be given to a licensed nurse or pharmacist, then immediately reduced to writing and authenticated by the nurse or pharmacist, and countersigned by the prescriber within 48 hours.
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Description
Learn about the pharmaceutical services and policies required in nursing homes, including licensing and pharmacist consultation. Understand the rules and regulations governing pharmacy services in these facilities.
