Health Care Facilities & Instituitional Pharmacies Flashcards
An institutional pharmacy filling prescriptions for outpatient use shall…
comply with all retail pharmacy requirements of this chapter
“Drug administration” means…
a procedure in which a prescribed drug is given to a patient by an authorized person in accordance with all laws and rules governing such procedures.
“Formulary” means…
a continually revised compilation of pharmaceuticals available in the pharmacy for use in the facility developed by the P&T Committee.
“Health care facility” means…
a facility or institution licensed by the Department of Health pursuant to N.J.S.A. 26:2H-1 et seq.
“Health care system” means…
one or more health care facilities that are owned or controlled by the same legal entity.
“Institutional pharmacy” means…
the area in a health care facility or a health care system licensed by the Board as a pharmacy that maintains an institutional permit.
“Institutional pharmacy” includes any areas of the health care facility or the health care system where…
pharmaceuticals are stored, compounded or dispensed.
“Medication order” means…
a written request for medication originated by a practitioner and intended for patient use in the health care facility, and not for use of the institution’s employees or their dependents or outpatients of the facility’s clinics
A valid medication order contains the…
date ordered, the patient’s name and location within the facility, the name, dose, route, and frequency of administration of the medication, and any additional instructions
Computerized signatures or passwords will be accepted provided that the facility has adequate safeguards which assure the…
confidentiality of each electronic signature or password and which prohibit their improper or unauthorized use.
“Pharmacy and Therapeutics Committee” means the…
active standing committee of the institution or health care facility which is the organizational line of communication and liaison between the medical service and pharmacists and which acts to review and promote rational drug therapy and utilization in the facility.
“Unit dose packaging” means a…
a single unit use non-parenteral medication provided in packaging which contains the following information for each unit in the package:
1) Product name;
2) Strength and/or quantity and/or volume, where appropriate;
3) Lot number;
4) The phrase “use by” followed by the product’s use by date.
i) For purposes of this paragraph, “use by date” means the earlier of one year from the date of packaging or the expiration date on the manufacturer’s container;
c) Manufacturer or repackager; and
d) If there is more than one product in the single unit, a physical description of each medication in the single unit.
Any institutional pharmacy as defined under N.J.A.C. 13:39-9.2 shall be…
registered with and possess an institutional permit issued by the Board. The permit shall be conspicuously displayed in the facility’s pharmacy. The institutional pharmacy is subject to and shall be conducted in accordance with all existing State and Federal rules and regulations.
An institutional permit is required…
for any area within an institution serviced by an outside vendor that performs on-site pharmaceutical services as defined in N.J.A.C. 13:39-1.2.
The pharmacist-in-charge, or designee, shall be…
an actively participating member on any committees of the facility that may be concerned with drugs and their utilization.
In all health care facilities providing pharmaceutical services to patients, an active standing committee of the institution entitled the Pharmacy and Therapeutics Committee or another appropriate name shall be…
established if required pursuant to Department of
Health rules. A Pharmacy and Therapeutics Committee shall be multidisciplinary and include a pharmacist.
In all health care facilities providing pharmaceutical services to patients that are not required to maintain a Pharmacy and Therapeutics Committee pursuant to Department of Health rules, the pharmacist-in-charge of the provider pharmacy, in cooperation with the
health care facility, shall…
create policies and procedures as needed to provide
pharmaceutical services to the health care facility. Copies of the policies and procedures shall be made available to the Board upon request.
The pharmaceutical services of the health care facility shall be…
the responsibility of and under the control, supervision, and direction of the pharmacist-in-charge of the provider pharmacy
If a health care facility does not have an institutional pharmacy on its premises or chooses to utilize the services of a pharmacy outside the health care system, it may…
enter into an agreement with a retail pharmacy licensed by the Board. The PIC of the retail pharmacy shall direct, control, supervise and be responsible for the pharmaceutical services provided to the facility.
The PIC of the provider pharmacy, with the cooperation of the Pharmacy and Therapeutics Committee, shall…
develop written policies and procedures as
needed to provide pharmaceutical services to the facility. The written policies and procedures shall be available to the Board.
The PIC shall be…
responsible for determining the specifications for
drugs and pharmaceutical preparations used in the treatment of patients of the facility as to quality, quantity and source of supply. An authorized purchasing agent and/or materials manager and/or pharmacy buyer of the facility may perform the actual
procurement. All purchases shall be reviewed by the PIC or his or her designee, who shall be a pharmacist.
Written policies and procedures for the maintenance, content, control and accountability of drugs supplied and located throughout the facility shall be…
developed by the PIC and approved by the P&T Committee
Written policies and procedures for the control, use and accountability of controlled dangerous substances shall be…
developed by the PIC and the P&T Committee. Controlled dangerous substances shall be purchased, received, stored, dispensed, administered, recorded and controlled in accordance with State and Federal laws and regulations
The pharmacist shall…
review the practitioner’s original order or a copy of the original order generated by any media that facilitates the reproduction of the original order before any initial dose of medication is dispensed, except as provided for in N.J.A.C. 13:39- 9.13.
Drugs not specifically limited as to time or number of doses when ordered shall be…
controlled by the automatic stop order procedure or other methods in accordance with written policies of the facility
The Pharmacy and Therapeutics Committee shall…
develop a list of unapproved or unacceptable abbreviations and symbols that shall not be used in the facility. Orders involving symbols or abbreviations shall only be dispensed consistent with this list.
When appropriate, the pharmacist shall…
make necessary entries into the patient medical
record relative to drug use in accordance with health care facility policies and, where applicable, pursuant to regulations of the Department of Health and/or Centers for Medicare and Medicaid Services
A pharmacist shall…
receive oral orders only from an authorized practitioner. Such orders shall be immediately recorded and signed by the person receiving the order on the medication order sheet or into the electronic data processing system.
Oral orders for Schedule II controlled substances shall be…
permitted only in the case of a bona fide emergency situation.
Oral orders received consistent with the requirements of (b) and (c) above shall be…
countersigned by the practitioner.
The pharmacist may release to the patient at discharge any remaining medication in a multiple-dose container (for example, inhalers, multiple-dose injectable medications, such as insulin, topical preparation, drops, ointments and topical irrigation solutions), and a limited supply of other medications provided that the pharmacist:
1) Labels the medications for out-patient use pursuant to labeling requirements set forth
in N.J.A.C. 13:39-7.12;
2) Counsels the patient prior to discharge from the hospital or medical facility pursuant
to N.J.A.C. 13:39-7.21; and
3) Ensures that discharge orders contain the attending physician’s authorizations to dispense the remaining doses of the prescription or the limited supply of other
medications to the patient or guardian.
The pharmacist shall be responsible for monitoring drug therapy of patients in the facility. This shall include, but is not limited to:
maintaining and reviewing the patient medication
profile prior to the dispensing of medications.
In instances involving the issuance and administration of STAT orders (orders requiring immediate attention) these drugs shall be:
be documented on the patient’s medication profile
immediately after dispensing.
When the pharmacy is closed, drugs for STAT orders shall be:
documented on the patient’s medication profile immediately after the pharmacy is reopened.
The pharmacist shall be responsible for:
providing medication in a form that requires little or
no further alterations, preparation, reconstitution, dilution or labeling by other licensed personnel. The pharmacist shall provide adequate instructions for those products that are not dispensed in finished form.
Labeling of medications, other than intravenous solutions, shall be:
conformance with written policies and procedures controlling the drug distribution system in use within the facility and in accord with current acceptable standards of pharmaceutical practice. Labeling of
intravenous solutions shall be consistent with the labeling requirements set forth in N.J.A.C. 13:39-11.
No drugs shall be administered to a patient except those:
provided through the pharmacy or as provided by written policies and procedures developed by the PIC or, where applicable, the director of pharmaceutical services and approved by the P&T Committee.
Although the use of patient’s own medications may be warranted in certain situations, it should be discouraged as a general or routine practice. If a patient’s previously acquired medication is to be used:
a written order to this effect shall be signed and dated by the patient’s physician. Such medications shall be identified by the pharmacist as to contents
and dispensing origin. Also, these medications shall be documented as part of the pharmacy’s patient profile record system.
Where the use of a drug-dispensing device is approved as an integral part of the drug distribution system by the facility, the PIC and the P&T Committee, the device may be used when:
the pharmacist is not on duty (absent during either the day or night), provided that any absence of the pharmacist does not exceed 24 hours, or when the pharmacist is on duty, provided that proper review of
the use of the drug-dispensing device can be ascertained. The supervision of any drug
dispensing device so utilized shall be the responsibility of the PIC servicing the health care facility.
Packaging and labeling of medication for drug-dispensing devices, when done by the pharmacy, shall be:
performed under the immediate personal supervision of a pharmacist in the employ of or under contract to the facility.