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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. 

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