(a)

1. (1) No medication or treatment shall be given without the written order of the physician or dentist.
2. (2) Drugs shall be administered in accordance with orders.

3. (3) Venapuncture by licensed practical nurses to obtain blood samples for lab work is permitted after the L.P.N. has been trained by:

   1. (A) The director of nurses; or
   2. (B) An R.N. designated by the director.

4. (4) The director and the L.P.N. trained shall sign a form that states that:

   1. (A) The L.P.N. is qualified; and
   2. (B) Has been trained by a registered nurse.
5. (5) The facility shall have policies and procedures for venapuncture that are available for review by nursing personnel and the Office of Long-Term Care.

(b)

1. (1) If it is necessary to take physician's or dentist's orders over the telephone or verbally, the order shall be immediately:

   1. (A) Written on the physician's order sheet in the medical record; and
   2. (B) Signed by the nurse who took the order.

2. (2)

   1. (A) Documentation shall include the:

(i) Name of the physician or dentist who gave the telephone or verbal order;

1. (ii) Date; and

   1. (iii) Time of the order.

   2. (B) The order shall be countersigned by the attending physician or dentist:

      1. (i) On his or her next regular visit; or
      2. (ii) No more than seven (7) days from the time the telephone or verbal order was given.

   3. (C) There shall be indication made by the nurse that the orders were transcribed (signature and time).

      1. (c)

2. (1) When computerized physician order sheets are utilized, the physician must:

   1. (A) Sign each sheet at the bottom of the sheet; and
   2. (B) Date each sheet.
3. (2) If a physician’s signature is affixed to the sheet other than at the bottom, all orders appearing after the signature shall be invalid.
4. (3) When progress notes or recertification statements are written on the computerized order sheet, the name and date affixed by the physician at the bottom of the sheet will be sufficient.

5. (4) However, if progress notes or recertification statements appear elsewhere in the medical record, each sheet shall be signed and dated where they are written.

   1. (d) Each patient shall be identified prior to administration of medication.

(f)

1. (1) The dose of a drug administered to a patient shall be properly recorded by the person who administered the drug.
2. (2) Recordation shall occur only after the medication has been administered.

(h) Treatment of a lesion or open wound shall be done only by licensed nursing personnel.

1. (i)
2. (1) Medication setups will be prepared one (1) pass at a time.
3. (2) The medication must be administered on the same shift on which they are prepared.
4. (3) Liquids and injectables shall not be set up more than one (1) hour in advance except where approved unit dose systems are used.

(k) The attending physician shall be notified of an automatic stop order prior to the last dose so that the physician may decide if the administration of the medication is to be continued or altered.

1. (l)

2. (1) Self-administration of medication is allowed only under the following conditions: if the physician orders, a patient may keep at the bedside the following nonprescription medications:

   1. (A) Topical agents such as Vicks salve, Mentholatum, etc.;
   2. (B) Eye drops such as Murine, Visine, etc.;
   3. (C) Cough drops, such as Ludens, Vicks, etc.;
   4. (D) Sublingual vasodilating agents such as Nitroglycerine tablets, Isordil Sublingual tablets; and
   5. (E) Metered dose aerosols for asthmatics such as primatene or bronkaid.
3. (2) Personal items such as toilet articles and cosmetic articles may be kept at the bedside.