Kan. Admin. Regs. § 68-7-11 - Medical care facility pharmacy
The scope of pharmaceutical services within a medical care facility pharmacy shall meet the following requirements:
(a) The pharmacist-in-charge shall be
responsible for developing programs and supervising all personnel in the
distribution and control of drugs and all pharmaceutical services in the
medical care facility.
(b) The
pharmacist-in-charge shall develop a policy and procedure manual governing the
storage, control, and distribution of drugs within the medical care facility.
The pharmacist-in-charge shall submit the policy and procedure manual for
approval to the pharmacy and therapeutics committee or an equivalent committee
governing the security, control, and distribution of drugs within the
facility.
(c) The
pharmacist-in-charge shall be responsible for the maintenance of all emergency
medication kits.
(d) The
pharmacist-in-charge shall be responsible for developing procedures for the
distribution and control of drugs within the medical care facility when a
pharmacist is not on the premises. These procedures shall be consistent with
the following requirements:
(1) Drugs may be
obtained upon a prescriber's medication order for administration to the
inpatient by a physician's assistant, designated registered professional nurse,
or nurses with approval and supervision of the pharmacist-in-charge. Adequate
records of these withdrawals shall be maintained.
(2)
(A) An
interim supply of prepackaged drugs shall be supplied to an outpatient on an
emergency basis only by a designated registered professional nurse or nurses
pursuant to a prescriber's medication order when a pharmacist is not on the
premises and a prescription cannot be filled. The interim supply shall be
labeled in accordance with
K.A.R.
68-7-14.
(B) The interim supply shall be limited in
quantity to an amount sufficient to supply the outpatient's needs until a
prescription can be filled. Adequate records of the distribution of the interim
supply shall be maintained and shall include the following information:
(i) The original or a copy of the
prescriber's order or, if an oral order, a written record prepared by a
designated registered professional nurse or nurses that reduces the oral order
to writing. The written record shall be signed by the designated registered
professional nurse or nurses and the prescriber; and
(ii) the name of the patient; the date
supplied; the drug or device, strength, and quantity distributed; directions
for use; the prescriber's name; and, if appropriate, the DEA
number.
(3) The
designated registered professional nurse or physician's assistant may enter the
medical care facility pharmacy and remove properly labeled pharmacy stock
containers, commercially labeled packages, or properly labeled prepackaged
units of drugs. The registered professional nurse or physician's assistant
shall not transfer a drug from one container to another for future use, but may
transfer a single dose from a stock container for immediate administration to
the ultimate user.
(e)
The pharmacist-in-charge of the medical care facility pharmacy shall maintain
documentation of at least quarterly checks of drug records and conditions of
drug storage, in all locations within the facility, including nursing stations,
emergency rooms, outpatient departments, and operating suites.
(f) The pharmacist-in-charge shall
participate with the pharmacy and therapeutics committee or an equivalent
committee in formulating broad professional policies regarding the evaluation,
appraisal, selection, procurement, storage, distribution, use, and safety
procedures for drugs within the medical care facility.
(g) The pharmacist-in-charge shall be
responsible for establishing policies and procedures for the mixing or
preparation of parenteral admixtures. Whenever drugs are added to intravenous
solutions, distinctive supplemental labels shall be affixed that indicate the
name and amount of the drug added, the date and the time of addition, the
beyond-use date, storage instructions, and the name or initials of the person
who prepared the admixture. The pharmacist-in-charge shall comply with all
requirements of article 13 of the board's regulations. Before the parenteral
admixture is released from the pharmacy, the pharmacist shall verify the
accuracy of all parenteral admixtures prepared by pharmacy
technicians.
(h) The pharmacist
shall interpret the prescriber's original order, or a direct copy of it, before
the drug is distributed and shall verify that the medication order is filled in
strict conformity with the direction of the prescriber. This requirement shall
not preclude orders transmitted by the prescriber through electronic
transmission. Variations in this procedure with "after-the-fact" review of the
prescriber's original order shall be consistent with medical care facility
procedures established by the pharmacist-in-charge. Each medication order shall
be reviewed by a pharmacist within three days of the date it was
written.
(i)
(1) When a pharmacist is on the premises but
not in the pharmacy, a pharmacy technician may be in the pharmacy. A pharmacy
technician shall not distribute any drug or device out of the pharmacy when a
pharmacist is not physically in the pharmacy unless authorized by the
pharmacist.
(2) When a pharmacist
is not on the premises, no one shall be permitted in the pharmacy except the
designated registered professional nurse or nurses or a physician's
assistant.
(j) Except
with regard to drugs that have not been checked for accuracy by a pharmacist
after having been repackaged, prepackaged, or compounded in a medical care
facility pharmacy, a pharmacy technician in a medical care facility may check
the work of another pharmacy technician in filled floor stock, a crash cart
tray, a unit-dose cart, or an automated dispensing machine if the checking
pharmacy technician meets each of the following requirements:
(1) Has passed a certification examination
approved by the board;
(2) has
either of the following experience levels:
(A) One year of experience working as a
pharmacy technician plus at least six months of experience working as a
pharmacy technician in the medical care facility at which the checking will be
performed; or
(B) one year of
experience working as a pharmacy technician in the medical care facility at
which the checking will be performed; and
(3) has successfully completed a written
training program and related examination designed by the pharmacist-in-charge
of the medical care facility pharmacy to demonstrate competency in accurately
checking whether floor stock, a crash cart tray, and an automated dispensing
machine have been properly filled.
Notes
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