Policy Manual sample

MDT Home Health Care Agency, Inc. 48 FIRST DOSE MEDICATION ADMINISTRATION RESPONSIBLE PERSONNEL: RN OBJECTIVE: To assure the safe administration of an initial dose of medication in the home setting, and to respond appropriately to potential allergic reactions. POLICY: 1.0 Whenever possible, patients going home on intravenous, intra muscular (IM), or subcutaneous (sub-q) medications should receive the first dose of the drug in the hospital or physicians office prior to discharge to home care. 2.0 Any patient who has a history of allergic reactions to medications, within the same chemical class as the prescribed medication, shall not be considered an appropriate candidate for first dose of IV, IM or sub-q medications in the home. 3.0 “First dose” shall be defined as any IV, IM, or sub-q drug to be given initially in a home setting which the patient has not received within 72 hours previously . If a patient has received the drug within 72 hours, it shall not be considered a “first dose”. An exception to this shall be those medications which are routinely administered less frequently than every 72 hours, such as a monthly B12 injection or monthly IGIV infusion. Any medication scheduled with a frequency greater than 72 hours shall not be considered “first dose” if it has been administered during the previous 90 days. PROCEDURE: In the event MDT Home Health Care Agency, Inc. receives a request to start a “first dose” medication in the home, the following procedure should be followed: 1) If the patient is still hospitalized, the physician should be called to request the first dose to be given prior to discharge with at least one half-hour of post-dose observation by hospital personnel. 2) For patients already at home, MDT Home Health Care Agency, Inc. personnel should contact the physician and patient and arrange, if possible, for the first dose to be given in the physician’s office or out patient setting. 3) If administering the first dose in the physician's office is not possible, the first dose may be administered in the home ONLY if the patient meets the following criteria: A) Patient/caregiver is knowledgeable concerning the potential side effects of the medication, and agrees to home administration of the first dose. The patient or responsible party shall complete and sign a First Dose Registration Form (see Appendix A). B) Patient and caregiver are available during the initial dose.