059-12 Wyo. Code R. §§ 12-12 - Absence of Pharmacist

(a) General. During such times as institutional pharmacy services are not available on-site, arrangements shall be made in advance by the PIC for provision of drugs by use of floor stock, ADD, and/or access to the institutional pharmacy.

(b) If floor stock is used, the following shall prevail:

(i) In the absence of a registered pharmacist, medication for inpatients shall be obtained from a locked cabinet or other enclosure located outside the institutional pharmacy to which only authorized nurses may have access.

(ii) The PIC shall develop inventory listings of those drugs to be included in such floor stock, and shall ensure that:

(A) Such drugs are available, properly labeled;

(B) Such drugs are prepackaged in appropriately small amounts, unless commercially prepared packages, (e.g. ophthalmics, otics, topicals, etc.)

(C) All drugs shall be checked and replenished as needed;

(D) A record shall be maintained, and shall include:

(I) The date and time of removal of a drug;

(II) The patient's name and location;

(III) The name, strength, dosage form, and quantity of drug removed; and

(IV) The printed name and signature of the nurse removing the drug.

(E) Written policies and procedures are established.

(c) Access to the institutional pharmacy. Whenever any drug is not available from floor stock, only supervisory or charge nurses may have access to the institutional pharmacy and may remove drugs.

(i) Removal of any drug from the institutional pharmacy by an authorized nurse must be recorded showing:

(A) The date and time of the removal of the drug;

(B) The patient's name and location;

(C) The name, strength, dosage form, and quantity of drug removed; and

(D) The printed name and signature of the nurse.

(ii) The nurse removing the drug shall leave a copy of the physician's order for the new drug with the above record.

(iii) The quantity of drug removed shall not exceed the amount of medication needed until the institutional pharmacy reopens. Drugs that are usually dispensed as a unit of use package, such as inhalers, otics, topicals, insulin, and ophthalmics, are excluded.

(iv) A procedure shall be established to allow verification by the pharmacist of the drug removed (such as by leaving the identifying container or unit-dose sample of the drug with the records).

(d) If off-site pharmaceutical care is provided whenever an institutional pharmacy is closed, then the following requirements must be met:

(i) The institutional pharmacy shall have a pharmacist on duty at the institutional facility the minimum number of hours required in this chapter.

(ii) Any pharmacist providing off-site pharmaceutical care under this section shall be licensed to practice pharmacy in Wyoming.

(iii) The Board shall be notified in writing by the institutional pharmacy of any arrangement whereby pharmaceutical care is provided off-site. This notification shall include the following:

(A) The name, address, and Wyoming license number of each pharmacist who will be providing this service.

(B) The name, address, and Wyoming license number of each pharmacy exchanging information with the institutional facility.

(C) Description of the communication link that will be utilized to exchange information between the institutional facility and the off-site pharmacist.

(D) Description of the scope of work of any pharmacist who provides off-site pharmaceutical care.

(E) Description of patient information that is to be shared between the institutional facility and the off-site pharmacist. At minimum, the off-site pharmacist shall have access to the patient's medical record.

(iv) A pharmacist providing off-site pharmaceutical care may perform remote order processing, if the pharmacist has access to appropriate patient information, including laboratory results.

(v) A pharmacist providing off-site pharmaceutical care shall provide the following services as a minimum:

(A) Review of any new medication order or change in existing medication order prior to administration by the nursing staff at the institutional facility.

(B) Communication with the institutional pharmacy staff on a daily basis or whenever the institutional pharmacy is open for business.

Notes

059-12 Wyo. Code R. §§ 12-12