(b) Obtaining the prescriber's original medication order, a direct carbonized copy,
an electromechanical facsimile, or other electronic order transmission. Security measures
must be in place to ensure that system access by unauthorized individuals is not allowed.
Interpreting and reviewing the prescriber's medication orders and
communicating problems with these orders to the prescriber before administration of first
doses. If the interpretation and review will cause a medically unacceptable delay, then a
limited number of medications may be stocked at the patient care areas for the
administration of first doses. Medications must be provided in a manner that ensures
security and immediate availability, such as sealed or secured medication kits, carts, or
treatment trays. A pharmacist shall routinely inspect the medications and, after use, shall
verify the contents and replace the medications as necessary.
(d) Delegating the stocking of an automated device. Technologies must be in place
and utilized to ensure that the correct drugs are stocked in their appropriate assignment
utilizing bar-coding or another board-approved error prevention technology that complies
with R 338.3154.
(e) Monitoring medication therapy to promote positive patient outcomes while
evaluating clinically significant chemical and therapeutic incompatibilities.
(f) Establishing the specifications for the procurement of all pharmaceuticals and
related biologicals and chemicals approved for use in the medical institution.
(g) Inspecting all areas in the medical institution where medications are stored to
verify compliance with the standards for the safe use and storage of the medications, not
less than once every 6 months.
(h) Maintaining proper security for all medications stored or kept within the
(i) Providing educational programs regarding medications and their safe use.
(j) Providing a method by which medications can be obtained during the absence of
a pharmacist in a medical institution where a pharmacist is not available 24 hours a day.
The method shall minimize the potential for medication error. During the absence of a
pharmacist, the services of a pharmacist must be available on an on-call basis. Only a
limited number of medications that are packaged in units of use must be available. The
medications must be approved and reviewed periodically as deemed necessary, but not
less than once a year, by an appropriate interdisciplinary practitioner committee of the
medical institution. The medication must be kept in a securely locked, substantially
constructed cabinet or its equivalent in an area of limited access in a centralized area
outside the pharmacy. Each medication must be labeled to include the name of the
medication, the strength, the expiration date, if dated, and the lot number. A written
order and a proof of removal and use document must be obtained for each medication
unit removed. The order and document shall be reviewed by the pharmacist within 48
hours of removing medication from the cabinet or its equivalent. The pharmacist who
directs pharmacy services in the medical institution shall designate the practitioners who
are permitted to remove the medication. A pharmacist shall audit the storage locations as
often as needed to guarantee control, but not less than once every 30 days.
(5) Upon recommendation of an interdisciplinary practitioners’ committee, the
pharmacist who directs pharmacy services in the medical institution shall adopt written
policies and procedures to promote safe medication practices, to conduct medication
utilization review, to approve medications for the medical institution's formulary or