Section 0940-01-02-.05 - PROCEDURES FOR ADMINISTRATION OF MEDICATION UNDER RULE 0940-1- 1-06 TO PATIENTS WHO LACK CAPACITY TO GIVE INFORMED CONSENT(1) A clinical professional who determines that a patient lacks capacity shall document the basis for the determination.(2) A physician who determines that medication is a necessary part of a patient's treatment plan for which there is no reasonable alternative shall document the basis for the determination and shall consider, among other relevant criteria, the following: (a) whether the medication is necessary to prevent a substantial deterioration of the patient's mental health,(b) whether the need to prevent violence is greater than the potential harm to the patient,(c) whether there is any appropriate treatment that can be provided without the use of psychotropic medication, and(d) whether the patient's lack of capacity is likely to be transitory and can be remedied by medication.(3) If a physician, who is not a member of the patient's regular treatment team, prescribes medication under rule 0940-1-1-.06, the treatment team shall review such action by the end of the next regular working day.(4) By the end of the next regular working day following the Treatment Team's review, a copy of the documentation prepared under subsections (1) and (2) shall be provided to: (a) the patient's clinical chart,(b) the Medical Director, and(c) the Patient Rights Advisor.(5) Within seventy-two hours of the issuance of the order or, if such period expires on a weekend or a legal holiday, by the end of the next regular working day, the PRA shall interview the patient. The PRA shall document comments or recommendations and shall provide copies of the documentation to:(a) the patient's clinical chart, and(b) the Medical Director.(6) When the patient, the PRA, or the physician requests review, the TRC shall interview the patient within five working days, review the patient's chart, and make recommendations to the Medical Director who shall consider all the information provided during the review process before making the final decision regarding medication. The patient's participation in the TRC process shall be encouraged but is not mandatory. The patient may request the PRA or another hospital staff member to assist or to speak on the patient's behalf in all meetings under this rule. The TRC shall prepare documentation of its recommendation and the Medical Director's final decision and provide copies to: (a) the patient's clinical chart,(b) the Medical Director, and(c) the Patient Rights Advisor.(7) The PRA shall continue to monitor the patient and document the Advisor's comments or recommendations and shall provide a copy to:(a) the patient's clinical chart, and(b) the Medical Director. The PRA may, during the regular working day but no more often than at two week intervals, request that a clinical professional evaluate the patient to determine whether the patient still lacks capacity.
(8) If the Superintendent notifies the PRA of the need for a guardian under rule 0940-1-1-.06, the PRA shall review the patient's case at least every thirty days and may request TRC review based on the Advisor's findings. Such review shall continue until adjudication.Tenn. Comp. R. & Regs. 0940-01-02-.05
(For Administrative History prior to February, 1985 see page 1.001). New rule filed January 9, 1985; effective February 8, 1985.Authority: T.C.A. §§ 33-1-203 through 33-1-205, 33-2-104 and 33-3-105.