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(1)  A specialty mental health facility must provide 24-hour nursing services and meet the following standards:

(a)  The director of nursing services must be a licensed registered nurse and must:

(i)  determine the types and numbers of nursing personnel and staff necessary to provide nursing care; and

(ii)  schedule adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care as needed.

(b)  A registered nurse must be on duty at least eight hours per day, and the director of nursing or another registered nurse designated as the director's alternate must be on call and available within 20 minutes at all times.

(c)  The nursing service must have a procedure to ensure that all nursing personnel have valid and current Montana nursing licenses.

(d)  The nursing staff must develop and keep current a nursing care plan for each patient when a nursing care plan is required.

(e)  Upon admission of a patient to the facility, a registered nurse must assign the nursing care of that patient to other nursing personnel in accordance with the patient's needs as determined by the admitting psychiatrist and the specialized qualifications and competence of the nursing staff.

(f)  All drugs and biologicals must be administered by, or under the supervision of, nursing or other qualified medical personnel in accordance with federal and state law and rules, including applicable licensing requirements, and in accordance with medical staff policies and procedures which have been approved by the governing body.

(g)  Each order for drugs and biologicals must be consistent with federal and state law and be in writing and signed by the practitioner who is both responsible for the care of the patient and legally authorized to prescribe.

(h)  When an oral or telephonically-transmitted order must be used, it must be:

(i)  accepted only by personnel that are authorized to do so by the medical staff policies and procedures, consistent with federal and state law; and

(ii)  signed or initialed by the prescribing practitioner as soon as possible and in conformity with state and federal law.

(i)  The facility must adopt a procedure for reporting to the attending practitioner adverse drug reactions and errors in administration of drugs.

History: 50-5-103, MCA; IMP, 50-5-103, MCA; NEW, 1991 MAR p. 2454, Eff. 12/13/91; TRANS, from DHES, 2002 MAR p. 185.

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