WSR 20-02-026
PERMANENT RULES
DEPARTMENT OF HEALTH
(Nursing Care Quality Assurance Commission)
[Filed December 19, 2019, 1:32 p.m., effective January 19, 2020]
Effective Date of Rule: Thirty-one days after filing.
Purpose: WAC 246-840-4651 Patient notification, secure storage, and disposal, the nursing care quality assurance commission (commission) adopted amendments to existing rule to implement the legislative requirement of SSB 5380, section 10 (chapter 314, Laws of 2019) regarding requiring advanced registered nurse practitioners who prescribe opioids to inform patients of their right to refuse an opioid prescription and document patient requests to avoid opioids.
Citation of Rules Affected by this Order: Amending WAC 246-840-4651.
Statutory Authority for Adoption: RCW 18.79.110 and 18.79.800, and 34.05.353.
Adopted under notice filed as WSR 19-18-040 on August 29, 2019.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: November 20, 2019.
Paula R. Meyer, MSN, RN, FRE
Executive Director
AMENDATORY SECTION(Amending WSR 18-20-086, filed 10/1/18, effective 11/1/18)
WAC 246-840-4651Patient notification, secure storage, and disposal.
(1) The practitioner shall provide information to the patient educating them of:
(a) Risks associated with the use of opioids as appropriate to the medical condition, the type of patient, and the phase of treatment;
(b) The safe and secure storage of opioid prescriptions; ((and))
(c) The proper disposal of unused opioid medications including, but not limited to, the availability of recognized drug take-back programs; and
(d) The patient's right to refuse an opioid prescription or order for any reason.
(2) The practitioner shall document such notification in the patient record. If the patient refuses an opioid prescription or order, the practitioner must document the patient's request and avoid prescribing or ordering opioids, unless the request is revoked by the patient.
(3) Patient notification must occur, at a minimum, at the following points of treatment:
(a) The first issuance of a prescription for an opioid; and
(b) The transition between phases of treatment, as follows:
(i) Acute nonoperative pain or acute perioperative pain to subacute pain; and
(ii) Subacute pain to chronic pain.