Iowa Administrative Code › Agency 657 - Pharmacy Board › Chapter 7 - Hospital Pharmacy Practice › Rule 657-7.12 - Drugs in the Emergency Department

Current through Register Vol. 47, No. 3, July 24, 2024
Drugs maintained in the emergency department are kept for use
				by or at the direction of prescribers in the emergency department. Drugs shall
				be administered or dispensed only to emergency department patients. For the
				purposes of this rule, "emergency department patient" means a patient who is
				examined and evaluated in the emergency department and includes the partner or
				partners of a patient treated pursuant to Iowa Code section
				139A.41.
(1)
Accountability.
Established policies and procedures shall include a system of drug control and
			 accountability in the emergency department. The system shall identify drugs of
			 the nature and type to meet the emergency needs of patients. Drugs shall be
			 administered or dispensed only in accordance with the system.
(2)
Controlled substances.
Controlled substances maintained in the emergency department are kept for use
			 by or at the direction of prescribers in the emergency department.
a. In order to receive a controlled
			 substance, a patient shall be examined in the emergency department by a
			 prescriber who shall determine the need for the drug. It is not permissible
			 under state and federal regulations for a prescriber to see a patient outside
			 the emergency department setting, or talk to the patient on the telephone, and
			 then proceed to call the emergency department and order the administration of a
			 stocked controlled substance upon the patient's arrival at the emergency
			 department except as provided in paragraph 7.12(2)
"c"
or
"d."
b. A
			 prescriber may authorize, without again examining the patient, the
			 administration of additional doses of a previously authorized drug to a patient
			 presenting to the emergency department within 24 hours of the patient's
			 examination and treatment in the emergency department.
c. In an emergency situation when a health
			 care practitioner authorized to prescribe controlled substances is not
			 available on site, and regardless of the provisions of paragraph 7.12(2)"a,"
			 the emergency department nurse may examine the patient in the emergency
			 department and contact the on-call prescriber. The on-call prescriber may then
			 authorize the nurse to administer a controlled substance to the patient pending
			 the arrival of the prescriber at the emergency department. As soon as possible,
			 the prescriber shall examine the patient in the emergency department and
			 determine the patient's further treatment needs.
d. In an emergency situation when a health
			 care practitioner authorized to prescribe controlled substances examines a
			 patient in the prescriber's office and determines a need for the administration
			 of a controlled substance, and regardless of the provisions of paragraph
			 7.12(2)
"a,"
the prescriber may direct the patient to present
			 to the emergency department for the administration of a controlled substance
			 for which the prescriber has issued a prescription in compliance with federal
			 regulation and board rules. As soon as possible, the prescriber shall examine
			 the patient in the emergency department and determine the patient's further
			 treatment needs.