NAC 449.144  Medication. 

     1.  In programs that permit the self-administration of medication, there must be written policies and procedures governing this activity. The policies must require that:

     (a) The decisions to permit self-administration be based on individual needs.

     (b) The reasons for the permission be clearly documented in the client’s case record.

     (c) All medications that are to be self-administered be packaged in a manner complying with the Poison Prevention Packaging Act of 1970, 15 U.S.C. §§ 1471 et seq., and all current regulations stemming from that act.

     (d) The self-administration of prescription medication be observed by a staff member who has been oriented to the program’s policies and procedures on self-administration of prescription medication.

     (e) The self-administration of prescription medication be permitted only when the medication is clearly labeled.

     (f) There be documentation in the client’s record of the name of the medication, dose, route of administration, time and name of the person observing the self-administration or the licensed staff member who administered the medication.

     (g) Clients who receive medication for self-administration be given instructions concerning the safe storage and usage of the drugs and the appropriate emergency procedures to be followed if adverse reactions occur.

     2.  Any unusual reaction to a medication by a client must be documented in the client’s record and reported to the appropriate physician as outlined in the policies of the facility.

     3.  Facilities must provide a locked storage area for prescription medication that is to be self-administered by clients. Such medication must be made available to clients at appropriate times and may be dispensed only from a licensed pharmacy in accordance with all applicable provisions of NRS and NAC.

     4.  Members of the staff may not administer any medication unless licensed to do so.

     5.  All medication must be maintained in locked storage. Controlled substances must be maintained in a locked box within the locked storage. Medications requiring refrigeration must be kept in a locked box inside the refrigerator separated from food and other items. Disinfectants and medication for external use must be stored separately from medications for internal use and from medications that can be injected. All potent, poisonous or caustic drugs must be plainly labeled, stored and made accessible only to authorized persons. All medication storage must be maintained in accordance with the security requirements of federal, state and local laws.

     6.  Narcotic treatment facilities may issue methadone “takeouts” to a client in a facility without listing the strength of the drug if the label shows:

     (a) The client’s name or other identifying code; and

     (b) The 24-hour emergency telephone number for the narcotic treatment facility.

     7.  Medication prescribed for a client must not be allowed to be in the possession of another client.

     8.  Any unused prescription medication left behind at a facility by a client must be destroyed by the administrator or his or her designee in the presence of a witness, and a notation indicating that the medication was destroyed must be made on the client’s record. At the time a client is discharged or leaves the facility, medications that are currently being self-administered must be sent, in the original container, with the client or a responsible agent of the client.