Guideline No. 322 - Personal Care Homes - Drug Utilization and Review

1. The Medical Director of a personal care home has a responsibility to assure that each resident has provision for appropriate medical services.  This includes the appropriate utilization and review of all therapeutic agents used in the medical management of a resident in a personal care home.
2. The resident's personal physician must ensure that medical records are maintained in relation to all pharmaceutical agents used in the medical management of a resident.
3. The attending physician's attendance upon a resident must be frequent enough to ensure appropriate drug utilization.  A regular three monthly medication review program should be instituted for each resident, and involve the attending physician, pharmacist and nurse in charge.
4. The formulary used in the personal care home must remain appropriately updated.  The Manitoba Personal Care Home Prescribing Guide should be the basis for prescribing in the personal care home.
5. Emergency drugs should be available to the facility and should contain drugs necessary to meet expected emergencies in the facility.  An emergency drug list can be found in Guideline 801 of The College of Physicians and Surgeons of Manitoba.
6. All medications must be ordered by a physician in writing and a progress note, including a diagnosis update, should be written to accompany all new or changed medication orders.
7. Automatic stop orders for medications should be established in each facility by a specific policy.
8. In general, patients must not keep drugs in their possession.  Specific exclusions on the written order of a physician should be included in a facility protocol.
9. The participation of attending physicians in drug utilization review studies is recommended.