By: Todd Duncan, Law Enforcement & Safety Specialist
Medication administration is one of the highest-risk responsibilities in a jail. Delayed, missed, or incorrect medications can quickly become medical emergencies and lead to significant liability.
The National Commission on Correctional Health Care is a nonprofit organization that develops widely respected standards aimed at guiding health service delivery in correctional facilities. The NCCHC standard relevant to this topic broadly provides: “Medication services are clinically appropriate and provided in a timely, safe, and sufficient manner.”
Jail policies and procedures should provide that all medications brought into the jail must be approved by the facility administrator or a qualified medical authority before use.
Furthermore, Nebraska Jail Standards[1] specifically require that:
- Prescription medications must be administered strictly according to the prescribing provider’s orders.
- Records of medication administration by jail staff are maintained and audited monthly (including date, time, name of inmate receiving, and name of staff distributing it).
- Staff must observe inmates taking prescribed medications to reduce diversion and misuse.
- Non-prescription medications must also be dispensed with great care.
- Medications must be securely stored, properly labeled, and administered under established written procedures.
It is highly recommended that only authorized and trained personnel administer inmate medications. Medication Aide Certification for such personnel is strongly recommended.
Medication errors can lead to serious injury, death, withdrawal, worsening mental illness, seizures, diabetic emergencies, or cardiac events. They also increase the risk of medication diversion, overdose, and constitutional claims alleging deliberate indifference to an inmate’s serious medical needs.
Reduce medication-related risk by:
- Verifying medications promptly upon intake with the pharmacy or prescribing provider.
- Continuing clinically necessary medications without unnecessary delay.
- Following physician orders exactly; never change or discontinue medications without medical authorization.
- Watching every inmate swallow prescribed medications and visually checking their mouth afterwards.
- Storing medications securely and documenting every dose, refusal, omission, and delay.
- Training staff and promptly consulting medical personnel whenever questions or concerns arise.
- Ensuring that medications are properly transferred to the inmate upon their release.
Remember the Five Rights of Inmate Medication Administration:
- Right Inmate – Verify the inmate’s identity before administering medication.
- Right Medication – Confirm the correct medication is being given.
- Right Dose – Administer the exact prescribed dosage.
- Right Time – Give the medication at the prescribed time or within approved time parameters.
- Right Route – Ensure the medication is administered by the correct route (oral, topical, injection, inhalation, etc.).
Bottom Line
A safe medication program depends on verification, continuity of care, the Five Rights, direct observation, secure storage, accurate documentation, and well-trained staff. These practices protect inmate health while significantly reducing jail liability.
[1] Title 77, Chapt. 9, Sections 002.07A through 0002.07E
