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Proper Use of Emergency Kits Essential in Nursing Homes

MacKenzie Kimball, for HealthLeaders Media, November 9, 2009

Although emergency kits are designed to help nursing facilities provide medication to their residents during emergency situations, they can actually create more problems for facilities if not used properly.

Facilities must follow certain procedures and requirements to ensure their use of emergency kits is in compliance with federal and state law. Noncompliance could attract the attention of the Drug Enforcement Administration (DEA), which recently audited numerous long-term care pharmacies and facilities for noncompliance with Controlled Substances Act (CSA).

Emergency kits contain a small quantity of medications that can be dispensed when pharmacy services are not available. However, a nurse cannot simply remove a medication from the kit and administer it to a resident.

"In theory, if there is an emergency kit full of medications and a nurse gets an order from a physician to give a resident one of these medications, the nurse should be able to take the medication from the box and give it to the resident," says Carla McSpadden, RPh, CGP, assistant director of professional services at the American Society of Consultant Pharmacists. "But it doesn't work that way with controlled substances. When something comes out of that emergency pill box, it is the same as dispensing a drug from the pharmacy and, in order to dispense controlled substance, the pharmacy must have a complete prescription, not a just a chart order."

According to the DEA, a complete prescription for a controlled substance must include the following information:

  • Date of issue
  • Resident's name and address
  • Practitioner's name, address, and DEA registration number
  • Drug name
  • Drug strength
  • Dosage form
  • Quantity prescribed
  • Directions for use
  • Number of refills (if any) authorized
  • Manual signature of prescriber

"An emergency controlled substance prescription can be telephoned into a pharmacy, but the only person who can communicate the information to the pharmacy is the prescriber for class two drugs, and this must be done before a nurse could remove the drug from the emergency kit," McSpadden says. "The prescriber or prescriber's employee can communicate the information to the pharmacy for class three-five drugs."

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