Medication Administration - Transdermal Drug Delivery System (Patch) Application Policy

Medication Administration - Transdermal Drug Delivery System (Patch) Application Policy 

Purpose: To ensure the safe and effective administration of transdermal patches to residents, in compliance with CMS guidelines and the State Operations Manual (SOM) for long-term care facilities. 

Procedure: 

I. Preparation: 

• Remove the patch from its package and envelope. Check the package expiration date. 

II. Site Selection and Preparation: 

• Select an appropriate site for application, ensuring to rotate sites for application. 

• Observe the site of the previous application. If a patch remains in place, remove it and cleanse the site with an alcohol wipe. Dispose of the patch in such a way as to render it non-reusable. 

• Consult the package information for acceptable placement sites. Generally, avoid extremities and hairy areas of the body. 

• Adjust the resident’s position or clothing as needed and swab the area for application with an alcohol wipe. Allow the area to dry. 

III. Patch Application: 

• Remove the adhesive backing from the patch and apply it to the selected site. 

IV. Site Documentation: 

• Document the site of administration in the Medication Administration Record (MAR) using the following site key: 

• Left upper arm: LA 

• Right upper arm: RA 

• Left upper thigh: LT 

• Right upper thigh: RT 

• Left chest: LC 

• Right chest: RC 

• Left upper back: LB 

• Right upper back: RB 

For transdermal scopolamine: 

• Behind left ear: LE 

• Behind right ear: RE 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.