Maryland law (MD SB394 STOP Act of 2022) was signed into law in May of 2022. Part of the law requires that hospitals are to dispense Naloxone free of charge to patient under certain circumstances. All of our hospitals are following this law.  

To ensure that patients have the medication at discharge, the provider orders the medication prior to discharge. The medication is reviewed and profiled by pharmacy and appears on the MAR as Naloxone 4mg nasal spray (Take Home Kit) with the indication of Opiate reversal.  The discharging RN must provide the medication to the patient with instructions for when to use at the appropriate time after discharge. The RN signs the MAR signifying that the medication was provided to the patient for use post their discharge; it is not administered during the patient's encounter. Profiling the medication and having the nurse sign off the MAR is required for record keeping and state requirements. 

In review of our HH-ORAE reports, all of these instances are being reflected with the report outcome of Numerator. This greatly skews our reporting data as we have much fewer instances of naloxone being administered during a patients encounter, outside of the OR, to reverse the effects of an opioid administered. 

We must comply with MD state law and will need to provide accurate HH-ORAE metrics in the future. Can the specifications be reviewed and updated to provide an avenue for hospitals that are required by law to provide the naloxone at discharge and still be able to report on the original intent of the measure?