CMS has issued a revision to its "30-minute" rule on the administration of medication in hospitals, according to a Healthcare Facilities Accreditation Program blog post and a copy of the notification (pdf).
Recognizing that it is no longer the standard of practice in the current hospital environment, CMS is removing reference to the so-called "30-minute rule" in the survey procedures portion of the guidance, which had established a uniform 30-minute window before or after the scheduled time for all scheduled medication administration. Instead, CMS is clarifying that hospitals must adopt medication administration policies and procedures that are based on accepted standards of practice, as required by the regulation at 42 CFR 482.23(c). The updated guidance provides hospitals flexibility to establish policies and procedures for the timing of medication administration that take into account the nature of the prescribed medication, specific clinical applications, and patient needs.
Hospitals are expected to identify those medications which require exact or precise timing of administration, and which are not, therefore, eligible for scheduled dosing times. For medications that are eligible for scheduled dosing times, hospitals are expected to distinguish between those that are time-critical and those that are not, and to establish their policies governing timing of medication administration accordingly. Time-critical scheduled medications are those for which an early or late administration of greater than thirty minutes might cause harm or have significant, negative impact on the intended therapeutic or pharmacological effect. Non-time-critical scheduled medications are those for which a longer or shorter interval of time since the prior dose does not significantly change the medication’s therapeutic effect or otherwise cause harm and therefore the hospital may establish, as appropriate, either a one- or two-hour window for administration.
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