Current through September 18, 2024
A.
Samples
A practitioner, or his/her authorized agent, may supply
prescription sample medications to his/her patients.
B. Automated Dispensing Systems
1. A practitioner may dispense legend
medications, excluding controlled substances, in accordance with his/her scope
of practice, through the use of an automated dispensing system. The
practitioner shall perform drug utilization review prior to the medication
being dispensed.
2. If a
practitioner utilizes an automated dispensing system for dispensing medications
to his/her patients, the following requirements shall apply:
a. Entering the patient's medication order
into the system shall be done by the practitioner;
b. Labeling of medication containers shall be
in accordance with all applicable State and Federal statutes and
Regulations;
c. Loading medication
into the automated system shall be the responsibility of the
practitioner.
C. Pharmaceutical Assistance Program (PAP)
Medications
1. PAP medications may be
dispensed from stock supplies provided that the following requirements are met:
a. Packaging and labeling of medication
containers shall be in accordance with all applicable State and Federal
statutes and Regulations;
b.
Practitioner performs drug utilization review and dispensing process validation
("final check") prior to the medication being dispensed.
2. Delivery of the PAP medication to the
patient may be delegated by the practitioner.
D. Stock Medications
1. In a hospital, nursing facility, medical
institution, clinic, assisted living residence, or hospice care facility where
the facility or practitioner does not hold an institutional pharmacy license,
administration of stock medications is permitted. The practitioner shall
perform drug utilization review and medication validation ("final check") prior
to the medication being administered. Provided, however, the practitioner may
delegate the medication validation ("final check") to the registered nurse
administering the medication.
2. In
substance abuse facilities, that include detoxification services and
residential treatment services, stock medications shall be administered in
accordance with a protocol approved by the Board.
E. Oral Contraceptives
In entities receiving Title X funding for family planning
services pursuant to 42 C.F.R. Part 59(A) (1001) of the Public Health Services
Act (42 U.S.C. §
300), any practitioner may authorize a
registered nurse to dispense oral and transdermal contraceptives to his/her
patients for the purposes of birth control, pursuant to criteria established by
the Board.
F. Emergency
Dispensing of Pharmaceuticals
1.
Notwithstanding any other provision of this Part to the contrary, any
practitioner authorized to deliver healthcare services at a facility licensed
pursuant to the Rules and Regulations for the Licensing of Organized Ambulatory
Care Facilities, Subchapter 10 Part 3 of this Chapter, may dispense
pharmaceuticals provided by the Director only during a period covered by a
Federal or State emergency declaration. However, all such emergency dispensing
shall only be performed in accordance with specific written protocols provided
by the Director for these pharmaceuticals.
2. Notwithstanding any other provision of
this Part to the contrary, any practitioner in a hospital emergency department
who treats a patient for sexual assault, needle stick or other incident
involving potential exposure to Human Immunodeficiency Virus (HIV) may provide
the patient with up to the entire recommended course of medication for
prophylaxis against potential HIV exposure. Any such dispensing of HIV
prophylaxis medication shall be conducted in accordance with protocols
established by the hospital's institutional pharmacy, and shall include written
instructions to be given to the patient regarding the use of the medication,
which shall contain, as a minimum, the information required by §§
1.9(G)(1)(a) through
(f) of this Part.
G. Distribution of Remaining Doses of
Prescriptions Drugs
1. A practitioner in a
hospital emergency room, hospital clinic or ambulatory surgical center who
administers to a patient a single dose of a medication from a multi-dose unit
of use package may distribute any remaining doses of the prescription drug to
the patient, provided the practitioner gives the patient sufficient
instructions regarding the prescription drug, which instructions may include,
but not be limited to:
a. The name and
description of the drug;
b.
Intended use of the drug and expected action;
c. Special directions and precautions for
preparation, administration, and use by the patient;
d. Common severe side or adverse effects or
interactions and therapeutic contraindications that may be encountered,
including their avoidance, and the action required if they occur;
e. Proper storage; and
f. Action to be taken in the event of a
missed dose.
2. For the
purposes of §
1.9(G) of
this Part, "sufficient instructions" shall include the receipt by the patient
of appropriate written information such as a drug monograph.
3. A label shall be affixed to each dispensed
medication that shall include:
a. The full
name of the patient;
b. The name of
the prescriber;
c. The name of the
drug dispensed;
d. Quantity and
strength of the drug dispensed;
e.
Date of dispensing; and
f.
Directions for use.
4.
Medication dispensing and labeling shall be limited to prescribers only and may
not be delegated to other personnel.
5. In a hospital setting, the
pharmacist/pharmacy shall be responsible to determining which medicines can be
dispensed from the Emergency Department and/or hospital clinic in this
manner.
6. Under no circumstances
shall any drug designated as a controlled substance pursuant to R.I. Gen. Laws
Chapter 21-28, be dispensed to a patient by a practitioner in a hospital
emergency room or ambulatory surgery center.