Controlled Substances Protocol and Safety Measures
Ensuring the accountability and security of countable controlled substances is crucial in healthcare settings. This module covers the reasons for frequent counting, extra documentation, special packaging, and heightened security measures. Learn about the importance of double key locking, staff responsibilities, disposal procedures, and the significance of accurate counting and recording. Stay compliant with laws and regulations to protect individuals and prevent mishandling or misuse of medications.
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Presentation Transcript
Medication Education Module 1 Countable Controlled Substances Company LOGO
Company LOGO Objectives 1. Why count them so often? 2. Why the extra documentation? 3. Why the special packaging? 4. Why the extra security?
Company LOGO Countable Substances Must be double key locked A lock within a lock Keys must be carried by the staff assigned med administration duties for the shift
Company LOGO Countable Substances Higher incidence of abuse or addiction Count requirement Each time keys change hands, 2 Certified staff count together Documentation requiring 2 signatures When beginning a new count sheet Adding a refill onto a count sheet Transferring from bottom of old page/top of new an old count book to a new count book Disposal 1. 2. 3. 4.
Schedules Company LOGO In the Medication Administration Program (MAP) Any prescription meds in Schedules II-V are categorized as Countable Controlled Substances
Schedules Company LOGO Schedule VI All prescription meds which are not required to be counted Examples Penicillin Dilantin
Company LOGO Schedule VI Although not required, DPH strongly recommends adding some specific meds to the count, such as Fioricet Gabapentin (Neurontin)
Company LOGO Why Count and Record? Protect Safety of Individuals Certified staff from being accused of mishandling or misusing
Company LOGO Why Count and Record? Assist Certified staff in adhering to laws, regulations and policies If countable substances or prescriptions are taken by a Certified staff an investigation will follow with possible police involvement
Company LOGO Tamper Resistant Packaging Purpose To minimize the chance that the medication inside is replaced with another
Company LOGO Tamper Resistant Packaging
Company LOGO Liquid Countable Medication
Company LOGO Security Access to the med storage area is limited The Certified staff assigned med administration duties is the only staff allowed access to the med storage area
Company LOGO Security-Inventory The Certified staff assigned to give meds is responsible for the inventory (supply) during their assigned shift Must Count at beginning and end of shift Keep key with Certified staff assigned as long as they are in program
Company LOGO Security-Inventory If there will be no Certified staff home during the day, the keys must be kept locked in the home Realtor type combination locked box Count must be done before placing keys in the locked box and after removing keys from the locked box
Company LOGO Security-Inventory Whenever there are 2 Certified staff available there must always be a 2 person count Conducting a 2 person count once every 24 hours is an exception to MAP policy If there is no one else available a single person count must be done The count signature page must indicate it was a single person count
Company LOGO Security-Inventory Due to staffing patterns The exception becomes the norm when the typical staffing pattern is 1 Certified staff throughout a 24 hour period A Supervisor will ensure that at least once every 24 hours 2 MAP Certified staff are available to conduct a 2 person count together
Company LOGO Security-Inventory Only Certified staff who may be assigned to administer meds should know the locked box code The combination should be changed when a Certified staff is no longer working at a site or staff is no longer Certified (such as did not pass recertification)
Security-Inventory Company LOGO Whenever the Certified staff assignment to give meds changes Keys are passed A count must be done
Company LOGO Security Count must be done Shoulder to shoulder with the off-going Certified staff and the on-coming Certified staff
Company LOGO Security-Inventory On-coming Certified staff has blister packs Off-going Certified staff has count book Leads the count using the index
Company LOGO Security-Inventory During the count process Both staff look at blister pack and count book Full legal signatures on shift count verification page
Company LOGO Count Book Must have a binding an index, count sheets and count signature sheets preprinted page numbers pages that cannot be removed
Company LOGO Index Must be kept accurate and up to date Assigned Certified staff can add a countable substance into the index The Site Supervisor (or designated back up) is responsible for removing a countable substance from the index if/when needed
Company LOGO Security-Inventory When entering a countable substance in the book or transferring to a new page the assigned Certified staff should complete the Heading section of the next available page Do not skip pages
Company LOGO Sample Index Page
Company LOGO Count Sheet Scenario 1 Page 11 Page transfer Page transfer
Company LOGO Count Sheet Scenario 2 Page 11 Page transfer 12/20/yr 7am Math on 12/19/yr 8pm entry is incorrect. Karen Mason, Supervisor 12/20/yr 7am Math on 12/19/yr 8pm entry is incorrect. Karen Mason, Supervisor notified. Correct count is 6 left. notified. Correct count is 6 left. 6 6 Reggie Newton Reggie Newton
Company LOGO Count Sheet Scenario 3 Page 11 Name: Doctor: Pharmacy: Cornerstone Medication & Strength: Ativan 0.5mg Directions: Take 1 tab by mouth every morning Prescription Date: Take 2 tabs by mouth at bedtime Joseph Smith Paula Whiten q Original Entry x Transfer from page 2 from page 10 Prescription Number: D388857 Prescription Date: 11/22/yr Prescription Number: Date Time Amount on Hand Page transfer Amount Used Amount Left Signature Page transfer Karen Mason/Lisa Long 12/19/yr 8:00 AM 9 Karen Mason 12/19/yr 8:10 AM 9 One 8 Karen Mason Karen Mason Lisa Long 12/19/yr 8:00 PM 8 Two 6 12/20/yr 7:45pm Morning dose not subtracted when removed. K. Mason notified. Lisa Long Lisa Long Lisa Long 12/20/yr 8:00 PM 5 Two 3 12/21/yr 6am Late entry On 12/20/yr 8am med was given and not documented at that time. Reggie Newton
Company LOGO Count Sheet Scenario 4 Page 11 Name: Doctor: Pharmacy: Cornerstone Medication & Strength: Ativan 0.5mg Directions: Take 1 tab by mouth every morning Prescription Date: Take 2 tabs by mouth at bedtime Joseph Smith Paula Whiten q Original Entry x Transfer from page 2 from page 10 Prescription Number: D388857 Prescription Date: 11/22/yr Prescription Number: Date Time Amount on Hand Page transfer Amount Used Amount Left Signature Page transfer Karen Mason/Lisa Long 12/19/yr 8:00 AM 9 Karen Mason 12/19/yr 8:10 AM 9 One 8 Karen Mason Karen Mason Lisa Long Reggie Newton Reggie Newton Reggie Newton Reggie Newton 12/19/yr 8:00 PM 8 Two 5 Error LL LL 6 12/19/yr 8:00 AM 6 One 5 Error RN Error RN 12/20/yr 8:00 AM 6 One 5
Company LOGO Count Signature Sheets Date Time 8:19am 4:30pm 11:07pm 8:12am 4:15pm 11:02pm 8:15am 4pm 10:30pm 7:35am 2:10pm Count Correct Staff Coming on duty Linda White Linda White Lisa Long Sarah Tourney Linda White Linda White Lisa Long Sarah Tourney Linda White Linda White Lisa Long Sarah Tourney Linda White Linda White Single Person Count Single Person Count Staff Going off duty Sarah Tourney Linda White Linda White Lisa Long Sarah Tourney Linda White Linda White Lisa Long Sarah Tourney Linda White Linda White Lisa Long Sarah Tourney Linda White Linda White 3/3/yr 3/3/yr 3/3/yr 3/4/yr 3/4/yr 3/4/yr 3/5/yr 3/5/yr 3/5/yr 3/6/yr 3/6/yr Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Company LOGO Questions
Resources Company LOGO MAP Curriculum- Responsibilities in Action www.mass.gov/dph/map https://shriver.umassmed.edu/programs /cdder/webinars/map-training- resources/dds-map-training-resources MAP Policy Manual www.mass.gov/dph/map
