Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 661 - Hospice
Subchapter 6 - Hospice Inpatient Service Requirements
Section 310:661-6-5 - Pharmaceutical services

(a) The hospice inpatient facility must provide appropriate methods and procedures for dispensing and administering drugs and biologicals. Whether drugs and biologicals are obtained from community or institutional pharmacies or maintained and stocked by the facility, the facility is responsible for the pharmaceutical services and ensure services are provided in accordance with accepted professional standards of practice in compliance with Federal, State, and local laws.

(b) Each facility must employ or contract with a licensed pharmacist to supervise services and ensure drugs and biologicals are obtained, stored, administered and disposed of as required by Federal and State law.

(c) A physician or licensed independent practitioner must order all medications for each patient. If the physician or practitioner's order is verbal, the physician or practitioner must give the order to a licensed nurse or other individual authorized by State law to receive the order. The individual receiving the order must record and sign the order immediately and have the prescribing physician or practitioner sign as soon as possible in a manner consistent with good medical practice. Another covering or attending physician or practitioner may sign another physician or practitioner's verbal order if the facility allows this practice and specific procedures are approved by the governing body to permit the practice. If a covering or attending physician or practitioner authenticates the ordering physician or practitioner's verbal order, such an authentication indicates that the covering or attending physician or practitioner assumes responsibility for his or her colleague's order and verifies the order is complete, accurate, appropriate, and final.

(d) Drugs and biologicals must be administered only by a physician, licensed nurse, an individual authorized by State law to administer, or the patient if his or her attending physician has approved.

(e) The pharmaceutical service must have procedures for control and accountability of all drugs and biologicals in the facility. Drugs are dispensed in compliance with Federal and State law. Records of receipt and disposition of all controlled drugs are maintained in sufficient detail to enable an accurate reconciliation. The pharmacist must ensure the drug records are in order and that an account of all controlled drugs is maintained and reconciled.

(f) The labeling of drugs and biologicals is based on currently accepted professional principles in compliance with State law, and includes the appropriate accessory and cautionary instructions, as well as the expiration date and lot number when applicable.

(g) All drugs and biologicals must be stored in locked compartments under proper temperature controls. Only authorized personnel must have access. Separately locked compartments must be provided for storage of Schedule II controlled drugs. All stores of Schedule II drugs not individually dispensed to a patient must be accounted for at regular intervals to ensure the drugs are not diverted.

(h) If the facility only maintains drugs and biologicals by individual patient prescription, an emergency medication kit approved by the Medical advisor must also be maintained.

(i) Controlled drugs no longer needed by the patient must be disposed of in compliance with Federal and State requirements. The pharmacist and a facility registered nurse or two (2) facility registered nurses must document disposal and maintain a record.