Section 144-113-II-7 - Medications and Treatments7.1 Use of safe and acceptable procedures. The administrator shall ensure that all persons administering medications and treatments (except residents who self-administer) use safe and acceptable methods and procedures for ordering, receiving, storing, administering, documentation, packaging, discontinuing, returning for credit and/or destroying of medications and biologicals. All employees must practice proper hand washing and aseptic techniques. A hand-washing sink shall be available for staff administering medications. [Classes I/II/III]7.1.1 Residents shall receive only the medications ordered by his/her duly authorized licensed practitioner in the correct dose, at the correct time, and by the correct route of administration consistent with pharmaceutical standards. [Classes I/II/III]7.1.2 No injectable medications may be administered by an unlicensed person, with the exception of bee sting kits and insulin.7.1.3 Before using a bee sting kit, unlicensed persons must be trained by a registered professional nurse in regard to safe and proper use. Documentation of training shall be included in the employee record.7.1.4 If a resident has Diabetes, unlicensed persons must be trained by a registered professional nurse in regard to the management of persons with diabetics. The registered professional nurse must provide in-service training and documentation to include: Documentation of training shall be included in the employee record. [Class III]7.1.4.1 Dietary requirements;7.1.4.2 Anti-Diabetic Oral Medications - inclusive of adverse reactions and interventions, hyper and hypo glycemic reactions;7.1.4.3 Insulin mixing including insulin action;7.1.4.5 Injection techniques and site rotation including signs/symptoms;7.1.4.6 Treatment and prevention of insulin reaction;7.1.4.8 Lab testing, urine testing and blood glucose monitoring; and7.1.4.9 Standard Precautions.7.1.5 Urine testing shall not be done around medication or areas where food is stored or prepared. Proper Standard Precautions relative to body fluids shall be implemented. Toilets shall be used for the disposal of urine and test sample waste. Toxic urine testing chemicals (tablets, solutions) shall be stored in a locked area totally apart from oral medications.7.2 Self-administration of medications. Upon admission, each individual's ability to self-administer medications will be determined by an assessment of his/her ability or need for assistance, unless the resident/legal representative elects (in writing) to have the facility administer his/her medications. A final decision will be reached between the resident, his/her legal representative, his/her duly authorized licensed practitioner, and a facility representative.7.3 Medication storage. Residents who self-administer medications and who handle their own medical regime may keep medications in their own room. To ensure the safety of the other residents, the facility will provide a locked area/container, if necessary. [Class III]7.4 Whenever a Registered Nurse teaches or provides in-service training to unlicensed personnel on medical issues, treatments, and/or use of medical equipment not specifically outlined in these Regulations, there must documentation in the employee file.7.5 Whenever employees are in serviced or taught procedures, the use of equipment or anything else which impacts resident care, there must be documentation in the employee file. This in service training could be taught by other professionals including a Physician, Registered Nurse, Practitioner, Dietician, Physical Therapist, Occupation Therapist, Speech Therapist, product company representative, or other experts in their field.10-144 C.M.R. ch. 113, § II-7