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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 1032 (February 24, 2024).

55 Pa. Code § 2390.196. Medication errors.

§ 2390.196. Medication errors.

 (a)  Medication errors include the following:

   (1)  Failure to administer a medication.

   (2)  Administration of the wrong medication.

   (3)  Administration of the wrong dose of medication.

   (4)  Failure to administer a medication at the prescribed time, which exceeds more than 1 hour before or after the prescribed time.

   (5)  Administration to the wrong person.

   (6)  Administration through the wrong route.

   (7)  Administration while the client is in the wrong position.

   (8)  Improper preparation of the medication.

 (b)  Documentation of medication errors, follow-up action taken and the prescriber’s response, if applicable, shall be kept in the client’s record.

 (c)  A medication error shall be reported as an incident as specified in §  2390.18(b) (relating to incident report and investigation).

 (d)  A medication error shall be reported to the prescriber under any of the following conditions:

   (1)  As directed by the prescriber.

   (2)  If the medication is administered to the wrong person.

   (3)  If there is harm to the client.


   The provisions of this §  2390.196 issued under sections 201(2), 403(b), 403.1(a) and (b), 911 and 1021 of the Human Services Code (62 P.S. § §  201(2), 403(b), 403.1(a) and (b), 911 and 1021); and section 201(2) of the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §  4201(2)).


   The provisions of this §  2390.196 adopted October 4, 2019, effective in 120 days, 49 Pa.B. 5777.

Cross References

   This section cited in 55 Pa. Code §  2390.18 (relating to incident report and investigation).

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