DCF 52.45 HistoryHistory: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (3) (b), (4) (a), (e) and (f) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635. DCF 52.46(1)(a)(a) “General supervision” means regular coordination, direction and inspection of the exercise of delegation of medication administration by a physician or registered nurse of someone who is not licensed to administer medications. DCF 52.46(1)(b)(b) “Staff administration” means proper administration of medication to a resident by center nonmedically nonlicensed staff under a valid medical order from a medically licensed practitioner who specifically designates, trains and supervises center staff administration of medications. DCF 52.46(1)(c)(c) “Staff monitoring of self-administration” means handing the medication to the resident by center staff according to physician and medication label instructions and observing and ensuring the proper ingestion, injection, application or inhalation of the medication by the resident. DCF 52.46(2)(2) Medications administration. Each staff person responsible for administering or monitoring resident use of medications shall receive a copy of the center policies and procedures required under s. DCF 52.41 (1) (c) 9. for medication administration and monitoring and shall be knowledgeable of them. The policies and procedures shall include: DCF 52.46(2)(a)2.2. Having information in each resident’s health record about any health allergies or health-related restrictions. DCF 52.46(2)(a)3.3. Having on file written authorization from a physician or registered nurse for each staff person permitted to administer medications or to monitor self-administration of medications. DCF 52.46(2)(a)4.4. Instructions for center staff concerning administration of medications and monitoring of resident self-administration of medications, secure storage of medications and recording medication administration information as required under sub. (4) (a) in the resident’s health record. DCF 52.46(2)(a)5.5. Immediate notification of the resident’s attending physician in the event of a medication error or adverse drug reaction. DCF 52.46(2)(a)6.6. Medications may only be made available when an individual authorized by the center is present. DCF 52.46(2)(b)1.1. Requiring that a medication be administered by center staff to a resident only when: DCF 52.46(2)(b)1.a.a. The resident’s attending physician or center medical consultant provides center staff with clear written instructions for administering the medication and authorizes specific center staff to administer the medication. DCF 52.46(2)(b)1.b.b. The administration takes place under the general supervision of a physician or registered nurse. DCF 52.46(2)(b)1.c.c. The label on the medication container gives clear instruction for administration of the medication and, if not clear, center staff contact the physician or pharmacy for clarification before administration of the medication. DCF 52.46(2)(b)2.2. Allowing a medication, including a self-injectable medication, to be self-administered by a resident only while the resident is under direct supervision of center staff and if self-administration is authorized in writing from the prescribing physician or center medical consultant under s. DCF 52.41 (1) (c) 4., and that authorization is confirmed by review of the authorization for self-administration by center staff before allowing self-administration by a resident. DCF 52.46(2)(b)3.3. Providing information to a resident and the resident’s resident care workers and resident services case manager about any medication prescribed for the resident and when a physician orders or changes the resident’s medication. Information provided shall include expected benefits and potential adverse side effects which may affect the resident’s overall treatment and, for staff, what to do if the resident refuses medication. DCF 52.46(2)(b)4.4. Instructions for center staff on what to look for in monitoring physical or mental changes to a resident that may occur from a medication, what to do if physical or mental changes are observed and recording them in the resident’s health record. DCF 52.46(2)(b)5.5. Arranging a second medical consultation when a resident or the resident’s parent or guardian or legal custodian, if any, has concerns about any medication received by the resident or the resident’s medication plan. DCF 52.46(2)(b)6.6. Having the resident’s physician or center medical consultant review a resident’s prescription medications when there are noted adverse effects from the medication. Documentation showing the date of review and reviewer’s name shall appear in the resident’s health record. DCF 52.46(2)(b)7.7. Ensuring that any use-as-needed medication is based on an assessment by a physician or registered nurse and is approved by either a physician or registered nurse. DCF 52.46(2)(b)8.8. Arranging for administration of prescribed medications to a resident when the resident is away from the center, for example, at school or on a home visit. A resident may not be given access to medications if there is a possibility that the resident may harm self through abuse or overdose. DCF 52.46(3)(a)(a) A center shall comply with all the following requirements for storage of medications: