No. 28312 (Amendment): R432-100-24. Pharmacy Services

DAR File No.: 28312
Filed: 10/31/2005, 04:26
Received by: NL

 

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rulemaking is necessary to update the hospital rule in the area of automated medication dispensing to keep up with evolving technology. The state rule does not presently address automated medication dispensing and needs to be updated to clarify medication audit requirements.

 

Summary of the rule or change:

There will be rule amendments to the pharmacy section of the rule to update medication audit requirements. With the introduction of automated medication dispensing machines in hospitals, hand counts would no longer be required. The rule change will exempt the hospital from performing hand counts of medications if automated dispensing is used, and if the audit functions of the machinery are readily retrievable. The Division of Occupational and Professional Licensing requires licensed pharmacists to oversee these machines, and has specific guidelines to monitor their use.

 

State statutory or constitutional authorization for this rule:

Title 26, Chapter 21

 

Anticipated cost or savings to:

the state budget:

There is one hospital owned and operated by the state. If the hospital chooses to use automated medication dispensing machines, then they would see a moderate savings in staff time. Nursing staff would not need to perform hand counts of medications at each shift change. This could save the hospital a couple of hours a day in professional staff time.

 

local governments:

There are seven hospitals that are owned by local governments. It they chose to use automated medication dispensing machines, this rule amendment could save them $210 per day or up to $76,650 per year in staff time in the aggregate. This figure is based on each hospital using one machine with two shift changes in nursing personnel.

 

other persons:

There are 46 private hospitals that could be affected by this rule amendment if they choose to use the automated dispensing machines. If each hospital used one machine to save staff time for two shift changes, it is estimated that these hospitals would save $1,380 per day or up to $503,700 per year in the aggregate.

 

Compliance costs for affected persons:

There are no anticipated compliance costs for health facilities. This rule amendment will decrease the requirements for medication audits if the providers choose to use this technology, and will end up as a cost savings. If hospitals choose to use the automated medication dispensers, then they will only save money by not having to use staff time to perform medication counts.

 

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule will give regulated hospitals the option of using automated medication dispensing machines. This should be a cost savings for these facilities. David N. Sundwall, MD, Executive Director

 

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Systems Improvement, Licensing
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

 

Direct questions regarding this rule to:

Joel Hoffman at the above address, by phone at 801-538-6165, by FAX at 801-538-6163, or by Internet E-mail at [e-mail]

 

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/15/2005

 

This rule may become effective on:

12/16/2005

 

Authorized by:

David N. Sundwall, Executive Director

 

 

RULE TEXT

R432. Health, Health Systems Improvement, Licensing.

R432-100. General Hospital Standards.

R432-100-24. Pharmacy Services.

(1) The pharmacy of a hospital currently accredited and conforming to the standards of JCAHO shall be determined to be in compliance with these rules.

(a) If a hospital is not accredited by JCAHO, then the pharmacy of such hospital shall comply with rules in this section.

(b) The pharmacy department and service shall be directed by a licensed pharmacist.

(i) Competent personnel shall be employed in keeping with the size and activity of the department and service. If the hospital uses only a drug room and the size of the hospital does not warrant a full-time pharmacist, a consultant pharmacist may be employed.

(ii) The pharmacist shall be responsible for developing, supervising, and coordinating all the activities of the pharmacy.

(iii) Provision shall be made for access to emergency pharmaceutical services.

(iv) The pharmacist shall be trained in the specific functions and scope of the hospital pharmacy.

(2) Facilities shall be provided for the safe storage, preparation, safeguarding, and dispensing of drugs.

(a) All floor-stocks shall be kept in secure areas in the patient care units.

(b) Double-locked storage shall be provided for controlled substances. Electronically controlled storage of narcotics may be permitted if automated dispensing technology is utilized by the hospital.

(c) Medications stored at room temperatures shall be maintained within 59 and 80 degrees F.

(d) Refrigerated medications shall be maintained within 36 and 46 degrees F.

(e) A current toxicology reference, and other references as needed for effective pharmacy operation and professional information shall be available.

(3) Records shall be kept of the transactions of the pharmacy and medication storage unit and coordinated with other hospital records.

(a) There shall be a recorded and signed floor-stock controlled substance count once per shift or the facility must use automated dispensing technology in accordance with R156-17b-619.

(b) Hospitals that utilize automated dispensing technology must implement a system for accounting of controlled substances dispensed by the automated dispensing system.

(c) The record shall list the name of the patient receiving the controlled substance, the date, type of substance, dosage, and signature of the person administering the substance.

(4) Written policies and procedures that pertain to the intra-hospital drug distribution system and the safe administration of drugs shall be developed by the director of the pharmaceutical department or service in concert with the medical staff.

(a) Drugs that are provided to floor units shall be administered in accordance with hospital policies and procedures.

(b) The medical staff in conjunction with the pharmacist shall establish standard stop orders for all medications not specifically prescribed as to time or number of doses.

(c) The pharmacist shall have full responsibility for dispensing of all drugs.

(d) There shall be a policy stating who may have access to the pharmacy or drug room when the pharmacist is not available.

(e) There shall be a documentation system for the accounting and replacement of drugs, including narcotics, to the emergency department.

(f) Medication errors and adverse drug reactions shall be reported immediately in accordance with written procedures including notification of the practitioner who ordered the drug.

 

KEY: health facilities

[November 10, 2004]2005

Notice of Continuation October 16, 2002

26-21-5

26-21-2.1

26-21-20