Iowa Administrative Code › Agency 657 - Pharmacy Board › Chapter 7 - Hospital Pharmacy Practice › Rule 657-7.11 - Outpatient Services

Current through Register Vol. 47, No. 3, July 24, 2024
No prescription drugs shall be dispensed from the hospital
				pharmacy to patients treated in a hospital outpatient setting. If a need is
				established for the dispensing of a prescription drug to an outpatient, a
				prescription shall be issued to be filled at a pharmacy of the patient's
				choice.
(1)
Definitions.
For the purposes of this rule, the following
			 definitions shall apply:
"Emergency department patient"
means a patient
				who is examined and evaluated in the emergency department.
"Outpatient"
means a patient who was examined
				and evaluated by a prescriber who determined the patient's need for the
				administration of a drug or device, when the patient presents to the hospital
				outpatient setting with a prescription or order for administration of a drug or
				device. "Outpatient" does not include an emergency department patient.
"Outpatient medication order"
means an order
				issued by a prescriber pursuant to rules of the board for administration of a
				drug or device. An outpatient medication order may authorize continued or
				periodic administration of a drug or device for a period of time and frequency
				determined by the prescriber or by hospital policy, not to exceed legal limits
				for the refilling of a prescription drug order.
(2)
Administration in the outpatient
			 setting.
Drugs shall be administered only to outpatients who have been
			 examined and evaluated by a prescriber who determined the patient's need for
			 the drug therapy ordered.
a.
Accountability.
Established policies and procedures shall
			 include a system of drug control and accountability in the outpatient setting.
			 The system shall ensure accountability of drugs incidental to outpatient
			 nonemergency therapy or treatment. Drugs shall be administered only in
			 accordance with the system.
b.
Controlled substances.
Controlled substances maintained in the
			 outpatient setting are kept for use by or at the direction of prescribers for
			 the nonemergency therapy or treatment of outpatients. In order to have a
			 controlled substance administered, a patient shall be examined in the
			 outpatient setting or in an alternate practice setting or office by a
			 prescriber who shall determine the patient's need for the drug. If the patient
			 is examined in a setting other than the outpatient setting, the prescriber
			 shall issue a prescription or order for administration of the drug in the
			 hospital outpatient setting.
c.
Outpatient medication orders. A
prescriber may authorize, by
			 outpatient medication order, the periodic administration of a drug to an
			 outpatient.
(1) Schedule II controlled
			 substance. An outpatient medication order for administration of a Schedule II
			 controlled substance shall be issued pursuant to federal regulation and board
			 rules and, except as provided in rule
			 657-10.29 (124) regarding the
			 issuance of multiple Schedule II prescriptions, may authorize the
			 administration of an appropriate amount of the prescribed substance for a
			 period not to exceed 90 days from the date ordered.
(2) Schedule III, IV, or V controlled
			 substance. An outpatient medication order for administration of a Schedule III,
			 IV, or V controlled substance shall be issued pursuant to federal regulation
			 and board rules and may be authorized for a period not to exceed six months
			 from the date ordered.
(3)
			 Noncontrolled substance. An outpatient medication order for administration of a
			 noncontrolled prescription drug may be authorized for a period not to exceed 18
			 months from the date ordered.