NAC449.800. Medical orders.

     1. A complete diagnosis must be included with the medical orders as well as any relevant problems.

     2. Initial medical orders, renewals and changes of orders for skilled nursing and other therapeutic services submitted by telephone must be recorded before they are carried out. All medical orders must bear the signature of the physician who initiated the order within 20 working days after the receipt of the oral order.

     3. Orders must be specific regarding the level of care and the service given.

     4. Medication orders must include:

     (a) The name of the drug.

     (b) The exact dosage in units, milligrams, grams or other measurements.

     (c) Frequency.

     (d) The duration of treatment.

     (e) The method of administration.

     (f) Any special precautions, including requests for doctor’s orders for the use of adrenaline for possible anaphylaxis.

     5. The agency must have an established policy regarding the administration of injectable narcotics and other drugs subject to the drug abuse law. If the policy allows the administration of injectable narcotics and other dangerous drugs subject to drug abuse law, they must be prescribed according to state regulations.

     6. Specific orders must be given for:

     (a) Rehabilitative and restorative care such as physiotherapy;

     (b) Skilled nursing and home health aide care;

     (c) Nutritional needs;

     (d) The degree of activity permitted;

     (e) Dressings and the frequency of change;

     (f) The instruction of a member of the family in technical nursing procedures; and

     (g) Any other items necessary to complete a specific plan of treatment for the patient.

     7. All orders must be renewed in writing by the physician at least every 62 days.

     8. New orders are required when there is a change in diagnosis, a change in orders, a change of physician or following hospitalization.

     [Bd. of Health, Home Health Agencies Part II Chap. III § I, eff. 1-10-74]—(NAC A 11-1-88; 11-13-96)