Department of Pharmacy Policies & Procedures

Number: 5:04

Effective Date: Oct. 1987

Revisions: 2/93; 11/97; 9/01; 7/02; 9/09

Approval: 11/12/97; P&T

Subject: SELF-ADMINISTRATION OF MEDICATIONS BY INPATIENTS

PURPOSE

Occasionally it is desirable to have the patient self-administer drugs which are supplied by the hospital pharmacy. The primary reason for self-administration is to train the patient and assure that dosing integrity is attained and maintained through instructions and supervision.

A. Policy

All medications kept for use at the UAMS Medical Center shall be secured in locked medication rooms or locked storage out of access to patients and visitors unless specifically needed for patient self-administration on a case by case basis as outlined in the procedures of this policy.

B. Procedure

1. All Hospital Patient Care Areas

a. The physician must write an order in the patient's medical record that self-administration is authorized. In this authorization, the physician is to state the drug(s) to be self-administered, their separate dosage strengths and the frequency of dosing.

b. Nursing personnel will observe that proper dosing is accomplished and that doses are charted on the medication administration record (MAR) and/or Input-Output record as appropriate.

c. Medications will be dispensed by the pharmacy and stored appropriately.

2. Solid Organ Transplant Patients

a. Solid organ transplant patients may be authorized to self-administer their medications. Prime candidates are patients that need extra instruction and observation to assure that proper dosing will continue after that patient is discharged. Such patients are identified by the physicians(s) and/or nurses(s) on the unit. The physician will write the appropriate order in the medical record authorizing self-administration.

b. Procedure

1) Drugs must be dispensed by the hospital pharmacy.

2) No more than a 7 day supply will be kept at the bedside.

3) Drug containers and prescription labels are to simulate the appearance of an out-patient prescription as it might be dispensed by a community pharmacy.

4) The phrase "For In Hospital Use" is to be typed on the label.

5) Self-administered drugs will be limited to oral medications.

6) No controlled substances will be included in medications for self-administration.

7) Drug supplies that are unused by the patient while in the hospital will be returned to the hospital pharmacy at the time of discharge for proper disposition.

3. Pancreatic Enzymes

A supply of pancreatic enzyme tablets/capsules may be dispensed for storage at the patient bedside and self-administration as needed with snacks and meals if ordered by the physician for a patient accustomed to managing these drugs.

4.    Metered Dose Inhalers

Metered dose inhalers used for management of chronic respiratory conditions may be stored at the patient bedside for self-administration as needed if ordered by the physician for a patient accustomed to managing these drugs.