1. Medication Education Module 2
Disposal
Note to the Trainer: In all scenarios, Karen Mason is the name of the Supervisor.
Trainer Preparation
Copies of PowerPoint handout
Print p. 2 “Objectives” to test staff knowledge before & after the training.
(Use as your training documentation.)
Copies of MAP Policy 10-5 and 10-6 [Disposal form]
Corresponding Training Information can be found on Pgs Responsibilities in Action (RIA) Curriculum that can be downloaded at scroll down to "what would you like to do" and select View MAP training resources and curriculum, then select DDS MAP training resources; once there you will see MAP Curriculum and Adjunct Materials

2. Objectives 1. What does med disposal mean?
2. When would I dispose of meds?
3. How are meds disposed of?
What I know about medication disposal before the training: 1. 2. 3. 4.
What I learned about medication disposal after the training:
4. How many staff are needed?

3. Medication Disposal Purpose To make the medication unusable
Meds must be destroyed on site or at Provider main office.
If disposal is done at a main office, a transfer form is needed when transporting to the office and both the transfer form and disposal records are maintained on site.
Medication is never returned to a pharmacy for disposal.

4. Medication Disposal When Dropped Refused Expired Discontinued
Person leaves
These are examples of when medication disposal is required. More examples can be found on Pg. 185 RIA Curriculum

5. Disposal Methods Unless prohibited by local ordinance
Read the med information sheet first to see if there are specific disposal instructions. If not
Take the med out of original container
Crush and/or dissolve in water in a sealable bag
Mix with liquid soap, used coffee grounds or kitty litter
Place sealable bag in non descript container
Place in trash
Following disposal remove all identifying personal information from label
Only flush if the med information sheet provides that as a disposal option
This is what staff are taught in certification training. Information also covered on Pg. 186 RIA Curriculum.

6. Disposal Process If the meds are expired or discontinued
Disposal must be completed with 2 Certified staff present, 1 must be a Supervisor

7. Disposal Process
If a med is refused, accidentally dropped or prepared incorrectly
And a Supervisor is unavailable
Two Certified staff may dispose of the med following acceptable DPH disposal practices
To the Trainer: If your company has a policy that all disposal is to be completed in the presence of a Supervisor make sure your staff know that.

8. Documentation Required
DPH Controlled Substance Disposal Record Form for all prescription medication
Schedule II-VI disposals
May use for over the counter meds
The DPH form is required to be used for countable meds and other prescription meds that are not countable, such as Tegretol and Dilantin.
Let staff know if your company also uses the DPH disposal form for over the counter meds.

9. DPH Disposal Form
Documentation of any prescription med disposal is required on a DPH disposal form.
If the prescription med is countable there must be a corresponding note in the count book indicating why the med was disposed.

10. Disposal Form Scenario 1
Connections
100 North St.
MAP05555
1-yr
12/20/yr
Joseph Smith
11/22/yr
Ativan
0.5mg
one tab
Dropped on floor
D388857 1 11
Cornerstone
Reggie Newton
Lisa Long
Disposal form scenario 1 demonstrates how to completely fill in the first box of a DPH disposal form as if this is the first disposal for the current year. Neither of the 2 staff are supervisors. There must also be corresponding documentation in Count Book 1 on page 11 (that you will see in the next slide).
The ITEM # is a sequential numbering of each box each time a med is disposed of for any individual.
If you wanted, you could document as Item # 1.
In this scenario, the Supervisor chose to include the Item # 1 and the year [Item # ].
At the end of the year 2018 and the beginning of 2019; the renumbering could begin with Item #
Either way is acceptable.
On the bottom of the form there is a space to number each disposal page. 1

11. Count Sheet Scenario 1
Page 11
Scenario 1 demonstrates how to document disposal of a dropped med on the floor in a count book during your shift when there is another MAP certified staff present. This is the corresponding documentation to the disposal form on the previous slide.
Note that the Supervisor was notified but the 2 Certified staff disposing of the dropped tab are not supervisors. Karen Mason is the Supervisor.
12/20/yr 8am dropped on floor and disposed of. Karen Mason, Supervisor notified.
6 one dropped

12. Count Sheet Scenario 1a
Page 11
Scenario 1a demonstrates how to document that a med was dropped on the floor when you are working alone or without another MAP Certified staff. The med waiting for disposal must be kept on count until it is disposed of.
12/20/yr 8am one tab dropped on floor. In cup in locked box waiting for disposal. Karen Mason, Supervisor notified.
12/20/yr 4pm Lisa Long/ Reggie Newton
One tab dropped 12/20 yr 8am/disposed

13. Count Sheet Scenario 2
Page 11
Count sheet Scenario 2 demonstrates how discontinued countable meds must continue to be kept on count until they are disposed of with 2 staff, 1 of which must be a Supervisor. Karen Mason is the Supervisor.
After disposal, Karen would also update the count book index by writing her signature under the column titled “Signature of person responsible for removing medication from count”.
12/19/yr 1:30pm Ativan discontinued at this morning's PCP appointment.
Karen Mason, Supervisor notified that med needs to be disposed of. Reggie Newton
12/20/yr 10am Eight Ativan tabs discontinued 12/19/yr were disposed of. _______________________________________________ zero Karen Mason/Reggie Newton

14. Disposal Form Scenario 2
Connections
100 North St.
MAP05555
1-yr
12/20/yr
Joseph Smith
11/22/yr
Ativan
0.5mg
eight tabs
Discontinued
D388857 1 11
Cornerstone
Reggie Newton
Karen Mason
Disposal form Scenario 2 demonstrates the disposal form of the corresponding documentation in the count book of the previous slide. Karen Mason is the Supervisor. Another example can be found on Pgs RIA Curriculum. 1

15. Disposal Form Scenario 3
Connections
100 North St.
MAP05555
1-yr
12/20/yr
Joseph Smith
11/22/yr
Ativan
0.5mg
eight tabs
Discontinued
D388857 1 11
Cornerstone
Reggie Newton
Karen Mason
2-yr
Dec. 21, yr
Mike Jones
Nov. 30, yr
Acetaminophen
325mg
eighty five tabs
expired
123654
Cornerstone
Reggie Newton
Karen Mason
3-yr
Dec. 30, yr
Mike Jones
July 1, yr
OTCs do not require documentation of disposal per DPH but mention here what your company expects.
Disposal form scenario 3, Item #2 shows the disposal of expired acetaminophen being done with 2 staff, 1 of which is the Supervisor.
OTC meds are not countable, so there is no information that goes in the count book number or page number sections of the form.
Disposal form scenario 3, Item #3 shows the disposal of a dropped Tegretol [a prescription med and although not countable, this form is required] being done with 2 staff, neither of which are supervisors.
Tegretol
100mg
one tab
fell on floor
654321
Cornerstone
Lisa Long
Reggie Newton 1

16. Questions

17. Resources MAP Curriculum- Responsibilities in Action
MAP Policy Manual