Section 116.60 Medication Self-Administration

Section 116

Section 116.60  Medication

Self-Administration

a)

As part of the normalization process, in order for each

individual to attain the highest possible level of independent functioning, all

individuals shall be permitted to participate in their total health care

program

[20 ILCS 1705/15.4(d)].  Every program shall include, but not be

limited to, individual training in promoting wellness, prevention of disease,

and medication self-administration procedures.

1)

Every program shall adopt written policies and procedures

for assisting individuals in obtaining preventative health and medication

self-administration skills in consultation with the registered professional

nurse

[20 ILCS 1705/15.4(d)].

2)         Individuals shall be evaluated to determine their self-administration

of medication capabilities by a Nurse-Trainer through the use of DHS required,

standardized screening and assessment instruments.

3)

When the results of the screening and assessment indicate

an individual not to be

independently

capable to self-administer his or

her own medications, programs shall be developed in consultation with the

Community Support Team

(CST) or Interdisciplinary Team (IDT)

to provide

individuals with

medication self-administration training as identified in

each individual's treatment/service plan [20 ILCS 1705/15.4(d)].

b)         Each individual shall be presumed to be competent to

self-administer medications if he or she has been determined to be:

1)         capable by a registered professional nurse or advanced

practice nurse;

2)         approved to self-administer medication by the individual's CST

or IDT; and

3)         authorized by a written order of a physician

ment/service plan [20 ILCS 1705/15.4(d)].

b)         Each individual shall be presumed to be competent to

self-administer medications if he or she has been determined to be:

1)         capable by a registered professional nurse or advanced

practice nurse;

2)         approved to self-administer medication by the individual's CST

or IDT; and

3)         authorized by a written order of a physician.

c)         Training of individuals to self-administer medication shall

minimally include instruction, for each medication prescribed, in the following

areas:

1)         identification of a medication by any of the following

methods:

A)        name;

B)        purpose;

C)        size;

D)        shape;

E)        color;

or

F)         other

distinguishing feature;

2)         dosage or quantity to be taken;

3)         route of administration;

4)         frequency or times of administration;

5)         purpose of medication, special instructions, common

side-effects and potential consequences of not taking the medication or of not

taking the medication properly; and

6)         when to seek medical assistance.

d)         When requested to do so by an individual, authorized direct

care staff may assist an individual in the self-administration of medications

by taking the medication from the locked area where it is stored and handing it

to the individual.  If the individual is physically unable to open the

container, a staff member may open the container for the individual.  Agency

staff may also assist physically impaired individuals, such as those who have

arthritis, cerebral palsy or Parkinson's disease, in the removal of the

medication from the container and in consuming or applying the medication.

e)         Each individual shall remain under observation by authorized

direct care staff and be assisted by the staff to correct or prevent medication

errors and to safeguard against adverse drug reactions

paired individuals, such as those who have

arthritis, cerebral palsy or Parkinson's disease, in the removal of the

medication from the container and in consuming or applying the medication.

e)         Each individual shall remain under observation by authorized

direct care staff and be assisted by the staff to correct or prevent medication

errors and to safeguard against adverse drug reactions.  Observation frequency

shall be determined by the Nurse-Trainer and the individual's Community Support

or Interdisciplinary Team to maintain an individual's safety when independently

self-administering his or her medication.  All observation and assistance shall

be noted in the individual's file.

f)         Individuals specifically determined to be competent, by a

physician who has issued a written order, to self-administer their own

medications may maintain possession of the key or combination of the lock to

their own medication storage area.  A duplicate key or a copy of the

combination shall be kept in a secure location for emergency use by licensed

personnel or authorized direct care staff, should the individual lose or

misplace the key or forget the combination.

g)         A medication administration record need not be kept for those

individuals for whom the attending physician has given permission to have

access to their own medications and to be fully responsible for taking their

own medications.  However, each agency shall develop and implement a quality

assurance procedure to ensure that self-administered medications are taken in

accordance with prescribed orders.  Documentation must include medication name,

dosage and frequency, and the identity of the prescribing physician or other

person licensed to prescribe medications in Illinois.