(a) The facility must establish drug administration procedures to ensure that:      
        (1) drugs to be administered are checked against the physician's orders;       
        (2) the resident is identified before the administration of a drug;       
        (3) each resident has an individual medication record, where the dose of drug administered is properly recorded by the person who administered the drug;       
        (4) drugs and biologicals are prepared and administered by the same person, except under unit-of-use package distribution systems and as outlined in §19.418 of this title (relating to Self-Administration of Drugs); and       
        (5) drugs prescribed for one resident must not  be administered to any other person.       
      (b) The facility nursing staff must report drug errors and adverse drug reactions to the resident's physician in a timely manner, as warranted by an assessment of the resident's condition, and record them in the resident's record. An incident report must be completed in accordance with §19.1923 of this title (relating to Incident or Accident Reporting). Medication errors include, but are not limited to, administering the wrong medication, administering at the wrong time, administering the wrong dosage strength, administering by the wrong route, omitting a medication, and/or administering to the wrong resident.     
      (c) Nursing facilities must have current medication reference texts  or sources, including information on pediatric medications, dosages,  sites, routes, techniques of drug administration, desired effects, and possible side effects, if facilities have pediatric residents.     
      (d) A licensed nurse may exercise professional judgment in the crushing of a medication, providing that the medication is not a time-released or enteric coated medication.      
        (1) If there is any question about crushing a medication for a resident, the licensed nurse must check with the treating physician, dispensing pharmacist, or consultant pharmacist.       
        (2) The crushed medication should be administered as soon as feasible once it has been added to another substance.       
     Source Note:        The provisions of this §554.1508 adopted to be effective May 1, 1995, 20 TexReg 2054; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871