Transcript Chapter 17: Institutional Pharmacy

Chapter 17: Institutional
Pharmacy
Jeffery D. Evans, Pharm.D.
Associate Professor of Pharmacy
Practice
Objectives
• At the end of this presentation, the student
will be able to
Chapter 17
• Purpose
– To regulate the use and storage of
medications outside of ‘traditional’ pharmacies
• Impact on Pharmacy Practice
– The chapter sets out rules dealing with the
interactions between pharmacies
(pharmacists) and institutions
What does the board consider an
institution? (1703)
•
•
•
•
•
•
Nursing Home
Rehabilitation center
Drug Abuse treatment center
Family planning clinic
Penal Institution
Athletic facilty
What is an institutional pharmacy
(1703)
• Basically
– The location of drugs, devices, and other stuff
– Must be dedicated space
– Not allowed to do other things (must be
focused on institutional patients)
Are there special rules for an
institutional pharmacy permit?
• Basically, everything that is in chapter 11
applies here.
What is a drug cabinet? (1707)
• These are medication storage areas usually
outside of a pharmacy
– Emergency use
• Should only be used when the pharmacy is closed
– Security
• Must be locked when outside of a pharmacy
• Limited access
– Inventory
• PIC decides what goes in
• Only quantities needed for acute issues should be there
– Accountability and inspection
• A valid medical order must be provided for every medication
• Must be inspected at least every 30 days by the ‘pharmacy’
Are there special labeling requirements for
medications in a drug cabinet? (1707)
• Not really, but the following must appear
on the label
– Drug name
– Dosage form
– Strength
– Name and manufacturer
– Manufacturers lot or batch number
– Pharmacist’s initials (not name)
– Expiration date
What is an emergency drug kit
(EDK?) (1709)
• A kit that contains emergency drugs in
LTCFs (not hospitals?) that meet an
immediate need of a patient
• Emergency medications?
– Medications used to reduce risk to a patient
on an emergent basis
– Delayed access to these medications could
cause issues
Do I need an EDK permit?
• No if you are a
– Hospital or
– Have an institutional pharmacy permit
• Yes if you
– Are not a hospital
– Or do not have an institutional pharmacy
permit
How do I apply for an EDK permit?
(1711)
• This is odd
– The provider pharmacy must apply
– EDK permits are for specific institutions (not
transferable)
– One pharmacy may have an unlimited
number of EDK permits
– The pharmacist in charge is responsible for
all EDKs
Is there anything special about
EDKs? (1713)
• Security
– Must have a tamper evident ability
– Must be in a secure enclosure
• Labeling
– Externally – Clearly labeled as an EDK
– Medications need name, dosage form, strength,
manufacturer’s name and lot, expiration date
• Storage
– Must meet storage requirements of any drugs
– May be stored outside of EDK if needed
What about accountability of the
EDKs? (1713)
• There must be a way to ensure all
medications taken from the EDK have a
valid medical order
– Including who prescribed and administered
the medication, resident name, drug
information, time and date of administration
• Inspection
– Must be inspected by pharmacy every 30
days (+/- 5 days)
– Must be available for the board to inspect
What is a Drug Abuse Treatment
Center Pharmacy? (1715 – 1719)
• A place where drugs are dispensed and
pharmacy primary care is provided in a
drug abuse treatment center
• A DATC is an inpatient or outpatient clinic
where patients are treated for abuse
issues
Are there permits and special security rules
for an DATCP? (1721 – 1723)
• Permit required
– Process outlined in chapter 11
• Special security
– Sort of
• Persons enrolled in a drug abuse treatment center
shall wait for their prescriptions in an area
physically separated from the CDS storage and
dispensing area.
What are the requirements for records
and reports at a DATCP? (1725)
• Not really
• They are required to maintain a perpetual
inventory
– And they must keep the record of it
Can I donate medications to the
penal system? (1727)
• Yes
– PIC of prison pharmacy must
• Verify integrity of product
• Expiration date on package is the expiration date
• May not be redispensed
– No controlled substances
• These medications may not be transferred
to another location
What information must be gathered
at the time of donation? (1727)
• Patient consent must be provided
• Patient’s name, rx number must be
obliterated from the bottle
• Drug name, strength, and expiration date
must remain
• An inventory list of medications donated
must be created
• Expired drugs are not acceptable
Questions