1. Institutions, excluding hospitals, that
desire to maintain a stock of prescription drugs provided by a supplying
pharmacy for emergency use by patients who are confined to the institution,
shall obtain an Institutional Emergency Medication Kit (IEMK) permit from the
Mississippi Board of Pharmacy. Emergency use is the procurement of non-patient
assigned medications from a stock supply for the purpose of initiating
medication therapy or supplying non-routine medications to provide for optimal
patient care. Emergency kits as described in this article are not crash carts
that are maintained by the institution for resuscitative care
A. Permit. The IEMK permit shall be
classified as either a Manual IEMK or an Automated IEMK. The manual IEMK permit
is required if the dispensing method is such that the release of each
individual dose is not electronically integrated to the documentation required
for each such release. An Automated IEMK permit shall be required if the
dispensing method is such that the release of each individual dose is
electronically integrated to the documentation required for each such releases.
Only one (1) type of permit, either Manual or Automated, shall be issued per
facility.
B. Application for an
IEMK permit shall be on a form supplied by the Board. The Application for a
Manual IEMK permit shall be accompanied by a fee of One Hundred Dollars
($100.00) and the Application for an Automated IEMK permit shall be accompanied
by a fee of Three Hundred Dollars ($300.00). A separate permit shall be
required for each IEMK and shall be renewed biennially. The Administrator (if a
nursing home or other long-term care facility) or business manager of the
institution shall make application for the IEMK permit. In the event of a
change of the administrator or business manager, a new permit must be obtained.
Any IEMK permit renewal application postmarked after December 31 of the renewal
period shall be returned and a Fifty Dollar ($50.00) late renewal fee shall be
assessed prior to renewal.
C. IEMK
Inventory and Accountability
(1) The contents
of the IEMK are supplied by a pharmacy permitted by the Board. Only one
supplying pharmacy may be utilized per facility;
(2) The contents of the IEMK are jointly
determined by the consultant pharmacist, medical director, director of nurses
and the pharmacist supplying the IEMK;
(3) The IEMK shall have a "par value" for
each prepackaged product that is stored in the IEMK;
(4) A copy of the inventory of the IEMK is on
file in the institution and at the provider pharmacy and a physical inventory
shall be taken at least annually;
(5) A Manual IEMK permit authorizes an
inventory up to sixty (60) medication items with a limit on the quantity (or
par value) to no more than fifteen (15) units each of the sixty (60) medication
items. A facility may choose to increase six (6) of the medication items to a
maximum of thirty (30) units for those six (6) items. A maximum of ten (10)
medication items may be controlled substances with a maximum limit of ten (10)
units each. A facility that requires more than one manual IEMK based on
facility design or divergent patient populations may request consideration for
an additional manual permit. Without multiple permits, manual IEMK's are
globally restricted to the total quantity and drug counts for all kits
combined. An Automated IEMK permit shall not have any limits on the quantity of
the inventory, except controlled substances shall be limited to a maximum of
twenty (20) medication items with a maximum limit of twenty (20) units each;
each automated IEMK location requires an additional permit for the facility.
(6) An IEMK withdrawal log shall be
maintained at the institution and all withdrawals of medications from the IEMK
shall be documented as follows:
(a) name and
room number of resident/patient;
(b) drug name, strength, and number of units
withdrawn;
(c) date and time of
withdrawal; and
(d) name of person
withdrawing the medication.
2. Use. Emergency kit medications shall be
administered to patients only for emergencies and when medications are
otherwise unavailable pursuant to a valid medication order or prescription.
Providing a patient starting dose(s) of a new medication regimen would be
considered a valid emergency. Controlled substances may only be administered by
licensed healthcare professionals.
3. Storage and Security. The IEMK shall be
maintained in a securely locked room or cabinet at the institution. Access to
the contents of the IEMK shall be limited to those licensed personnel
designated by the director of nurses and the provider pharmacist.
4. Controlled Substances. An IEMK that
contains controlled substances as allowed per 45 FR24128 (Schedule II, III, IV
and V) shall be subject to the following:
A.
The institution has been issued a controlled substance registration by the
Mississippi Board of Pharmacy;
B.
Controlled substances are stored in a separate locked container; and
C. The withdrawal of controlled substances
shall comply with the Mississippi Pharmacy Practice Regulations and the Drug
Enforcement Administration Regulations which includes a signed prescription by
the provider.
