(a)  In a private home, the administration of prescribed medications is the primary responsibility of the patient, family member or caregiver.  Where special skills or knowledge are required, medication shall be administered by a licensed registered nurse, licensed practical nurse with training specified by the North Carolina Board of Nursing, or physician.

(b)  In a licensed hospice residence, medications shall be administered by a licensed nurse.  Exceptions to this requirement are as follows:

(1)           persons who hold statutory authority to administer medications;

(2)           hospice patients, their families or caregivers who provide personal care to individuals whose health care needs are incidental to the personal care required;

(3)           administration of oral nutritional supplements;

(4)           applications of non‑systemic, topical skin preparations which have local effects only provided that ongoing, periodic assessment of any skin lesion present is carried out by a person licensed to make such assessments; and

(5)           administration of commonly used cleansing enema solutions or suppositories with local effects only.

(c)  In a hospice inpatient unit or freestanding hospice inpatient facility, medications shall be administered by a licensed nurse, in accordance with the agency's, policies or in accordance with the contractual agreement between the hospice and the facility.

(d)  The administration of all medications must be documented in the patient's record by the licensed nurse, including those medications administered by the licensed nurse and those administered by the patient family or, caregiver, as ordered by the physician.

(e)  The provision of medications shall be specified in the agency's policies or in accordance with the contractual agreement between the hospice and the facility.

(f)  A hospice agency or facility shall develop and implement written policies and procedures to govern the procurement, storage, administration and disposal of all drugs and biologicals in accordance with federal and state laws.

(g)  Medications used in the home are the property of the patient and family and shall be appropriately stored.  Hospice staff shall encourage disposal of unused or discontinued medications.  Witnessed or reported disposal of medications shall be documented by hospice staff in the patient's record.

(h)  If the agency maintains an emergency drug kit, handling shall be in accordance with the North Carolina Board of Pharmacy 21 NCAC 46 .1400.


History Note:        Authority G.S. 131E‑202;

Eff. November 1, 1984;

Amended Eff. February 1, 1996; June 1, 1991.