MEDICATION DISPOSAL

Policy:

Medication disposal should follow federal and state laws for all prescription, controlled, vitamins, minerals, herbal supplements and over-the-counter medications.

Practice:

Medications that are no longer needed by the student, have been discontinued, and are unable to be returned to the pharmacy should be disposed of according to applicable laws and guidelines. The Office of National Drug Control Policy (ONDCP) and the Environmental Protection Agency (EPA) jointly released guidelines for disposal of prescription medications. Controlled Substances must be destroyed so that they are unusable by another person to prevent diversion of the drugs.

d. Two nurses will verify the medications being disposed of and a
documentation of the disposal will be kept in the controlled
substance logbook.

e. Two nurses will then place all medications to be disposed of into a
2-millimeter, zip-lock bag. Hot tap water will then be added and
bag sealed. Let the medications dissolve for 5-15 minutes before
adding Absorb-all. Manipulate the sealed bag and its contents until
all moisture is absorbed.

f. Place the sealed bag and its contents into a garbage container in
the nursing area. Housekeeping can then discard the garbage bag
into the campus dumpster.

9. The 2-millimeter, zip-lock bags should be obtained through the food service supplier (Eastern Bag Company).

10. The Absorb-All should be obtained through the maintenance department supplier (Burnell Auto Parts).

1. Student Vacations/Leaves
Upon notification of an upcoming leave or student vacation, nursing orders a supply of medication from the pharmacy for the length of the leave plus two extra days to cover loss, spillage or extra days added onto the leave. Nursing packs medications and documents all those sent on the Medication Administration Log
All medications and instructions will be reviewed by nursing with staff or parent responsible for transport. Staff will review with parent/guardian upon arrival for visit.
When student travels unaccompanied, one of the three following options will be exercised:
Prescription for vacation medications will be mailed to student’s parent/guardian in time for it to be filled at a local pharmacy. A copy of the student’s insurance card will be sent with the prescription.
In an emergency, and as permitted by state law, physician may call prescription in to local pharmacy.
Medications can be mailed via Federal Express overnight service. Parents should be notified as to when medications are due to arrive.

2. Procedure for Dispensing by Non-Licensed Personnel
Medications cannot be dispensed by unlicensed personnel without their successful completion of the “Medication Certification Program” given by HEC registered nurses.
Staff will supervise medication administration only when an off-campus trip is necessary and student involved is unable to return to campus at medication time or when a nurse is not available.

Procedure for certifying staff is as follows:
1) Staff must have been employed by Hillcrest Educational Centers for at least three months to be considered for certification. He/she must have current certification in First Aid and CPR.
2) The decisions about whom to credential will be made by the head nurse of each campus after having consulted with the Program Director/Manager, supervisors, and others who might be in a position to evaluate the capabilities of that staff member.
3) Only R.N.s may certify staff.
4) Training sessions for certifying staff will include:
a) Review of medication procedure by nurse trainer.
b) Administration of test to staff: Staff must pass test with 100% correct score. If staff fails to pass test, nurse trainer may review missed material and re-administer test one time. If second attempt failed, staff must wait for at least one month and begin procedure again. If, after one month staff fails test again, he/she will no longer be considered eligible for credentialing.
5) When staff successfully passes training, nurse trainer will complete the “Certificate of Credential and Privilege to Supervise Medication Administration. Trainer will keep that record with guidelines in a special file in the nurses’ station. A copy of the certificate, along with guidelines will also be kept in the staff’s personnel file. Training coordinator should be notified of training. Recertification takes place on a yearly basis.

6) In the event that certified staff fails to follow medication procedure, an incident report and Medication error report must be filled out by the staff involved in the incident. Immediate notification of the circumstance must be provided to the supervisor on duty and the nursing department. Depending on the nature of the error and the staff understanding, certification can be withdrawn at any time.

3. Medication Refusal
When a student has failed or refused to take his/her medication, the refusal is documented in the student’s record, including the student’s stated rationale for refusing. When indicated, the nurse notifies the prescribing physician. The neurologist is notified of all refusals involving anti-convulsant medication. In addition, direct care staff is informed of any related safety concerns.