(a) A center must adopt and enforce written policies and procedures for the administration of medication to a minor. The policies and procedures must address:
  (1) removing an individual dose from a previously dispensed, properly labeled container;
  (2) verifying the medication with the prescriber's orders;
  (3) verifying the order with the correct minor;
  (4) giving the correct medication dose to a minor;
  (5) giving the medication by the correct route;
  (6) observing that the medication is taken;
  (7) recording the required information, including the method of administration; and
  (8) documenting any medication not administered and the reason.
(b) A center's written policy must ensure compliance with:
  (1) THSC Chapter 248A;
  (2) this chapter;
  (3) state law authorizing a person licensed under the Texas Occupations Code to administer medications;
  (4) rules adopted by the Texas Board of Nursing 22 TAC Chapter 224 (relating to Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments) governing when an RN may delegate the administration of medication to an unlicensed person; and
  (5) any other applicable state and federal regulations relating to the administration of medication to a minor.
(c) If there is a direct conflict between this chapter and other applicable state and federal laws and regulations, a center must comply with the more stringent requirements.
(d) The administration of medication by center staff must be included in a minor's plan of care.
(e) A center must adopt and enforce written policies and procedures for maintaining a current medication list and a current medication administration record.
(f) A center's written policy must require center staff who supervise, assign, or delegate the administration of medication or administer medication to a minor to maintain a current medication list in the minor's medical record.
(g) A center may incorporate a current medication list and medication administration record into one document.
(h) An RN must review the medication list initially after a minor is admitted and update the list when necessary but at least every 90 days.
(i) An RN must report significant findings from a review of the medication list to the minor's prescribing physician.
(j) Review of the medication list includes evaluation of prescription and over-the-counter drugs, medication orders, and the medication list for:
  (1) known allergies;
  (2) rational drug therapy-contraindication;
  (3) reasonable dose and route of administration;
  (4) reasonable directions for use;
  (5) duplication of drug therapy;
  (6) drug-drug interaction;
  (7) drug-food interaction;
  (8) drug-disease interaction;
  (9) adverse drug reaction; and
  (10) proper use, including overuse or under use.
(k) A center must adopt and enforce written policies and procedures on medication errors. The policy must ensure that the nursing director, a minor's prescribing physician and the minor's parent are notified immediately after the discovery of a medication error or an adverse reaction.

Source Note: The provisions of this §550.705 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875