Section 657.15.8. Drug distribution and dispensing controls.

Prescription drugs shall be distributed or dispensed only from the original or a properly verified prescription drug order. There shall be no transcribing of prescription drug orders by nursing staff or clerical staff except for their own records.

         15.8(1) Required information. Prescription drug orders written in patient health records shall include the following information:

            a.               Patient name, identification number, and correctional facility location;

            b.               Drug name, strength, dosage form, and quantity or duration;

            c.               Directions for use of the drug;

            d.               Date the prescription drug order is authorized;

            e.               Prescriber’s name, signature, and office address;

            f.                Prescriber’s DEA number for controlled substances.

         15.8(2) Original maintained. The original prescription drug order and the medication administration record shall be maintained for a minimum of two years in the patient’s health record.

         15.8(3) Effect upon transfer of patient. Current prescription drug orders remain in effect when a patient is transferred to another correctional facility.

         15.8(4) Unit dose dispensing. Drugs dispensed in a unit dose dispensing system for subsequent administration by nurses or other qualified individuals shall be packaged and labeled by pharmacy staff in compliance with the provisions of rule 657—22.1(155A). Policies and procedures shall be implemented that include, but are not limited to, the following:

            a.               Return and reuse of drugs;

            b.               Expiration dating;

            c.               Record keeping.

         15.8(5) Med-pak dispensing. Drugs may be dispensed in med-pak dispensing systems for subsequent administration by nurses or other qualified individuals. Policies and procedures shall be implemented that are in accordance with rule 657—22.5(155A) and include, but are not limited to, the following:

            a.               Return and reuse of containers;

            b.               Expiration dating;

            c.               Record keeping.

         15.8(6) Drug administration. Only a licensed health care professional authorized to administer drugs or a qualified individual shall administer to a patient prepackaged drugs from the supply distributed by the pharmacy. Documentation of administration shall be recorded in the medication administration record. The single unit, unit dose, or med-pak packaging shall remain intact to the point of administration.

         15.8(7) Dispensing for patient self-administration. Drugs dispensed for self-administration by a patient shall be packaged and labeled in accordance with rule 657—6.10(126,155A).

         15.8(8) Labeling of drugs under special circumstances.

            a.                Insulin, ophthalmics, otic preparations, inhalers, nasal sprays, topicals, and other similarly packaged drugs. A label shall be affixed to the immediate container showing at least the patient’s name and ID number. A label that complies with 657—subrule 6.10(1) shall be affixed to the outer container.

            b.                Leave and release drugs.  Labeling of prescription drugs for patients leaving the correctional facility for temporary absences in excess of 24 hours, such as court appearances, and for patients being released from custody shall comply with 657—subrule 6.10(1) before the drug is removed from the facility. The dispensing pharmacy shall be responsible for packaging and labeling leave and release drugs in compliance with this paragraph.

         15.8(9) Drug product selection. Correctional pharmacies shall be exempt from the patient notification requirements of Iowa Code section 155A.32 when exercising drug product selection.

         15.8(10) Emergency/first dose drug supply. An emergency/first dose drug supply of prescription drugs may be supplied to a correctional facility for use by authorized personnel pursuant to rule 657—22.7(124,155A). Only pharmacists, pharmacist-interns, and pharmacy technicians may restock, replace, or return drugs to the emergency/first dose drug supply. A drug shall be removed from the emergency/first dose drug supply only pursuant to a valid prescription drug order. The pharmacy shall be notified of the removal and administration of a drug from the emergency/first dose drug supply. The pharmacist shall perform drug use review prior to the administration of a second dose. All drugs removed from the emergency/first dose drug supply that are not administered, including any wastage, shall be returned to the pharmacy. A written or electronic record shall be made of all removals from the emergency/first dose drug supply. The record shall include the following information:

            a.               Patient’s name and identification number;

            b.               Prescriber;

            c.               Name, strength, dosage form, and quantity of the drug removed;

            d.               Signature, unique identification, or initials of the authorized person removing the drug;

            e.               Date and time the drug was removed;

            f.                Returns of unused drugs to the pharmacy.

[ARC 8670B, IAB 4/7/10, effective 5/12/10]