Ariz. Admin. Code § 4-23-672

Current through Register Vol. 30, No. 50, December 13, 2024

Section R4-23-672 - Limited-service Correctional Pharmacy

A. The limited-service pharmacy permittee shall ensure that the limited-service correctional pharmacy complies with the standards for area, personnel, security, sanitation, equipment, drug distribution and control, administration of drugs, drug source, quality assurance, investigational drugs, and inspections as set forth in R4-23-608, R4-23-609(A) through (D) and (F) through (H), R4-23-610(A), R4-23-611, R4-23-612, R4-23-653(E), R4-23-658(B) through (E), R4-23-659, and R4-23-660.

B. The pharmacist-in-charge of a limited-service correctional pharmacy shall authorize only pharmacists, interns, pharmacy technicians, pharmacy technician trainees, compliance officers, drug inspectors, peace officers, and correctional officers acting in their official capacities, other persons authorized by law, support personnel, and other designated personnel to be in the limited-service correctional pharmacy.

C. When no pharmacist will be on duty in the correctional facility, the pharmacist-in-charge shall arrange, before there is no pharmacist on duty, for the medical staff and other authorized personnel of the correctional facility to have access to drugs in remote drug storage areas or, if a drug is not available in a remote drug storage area and is required to treat the immediate needs of a patient, in the limited-service correctional pharmacy.

1. The pharmacist-in-charge shall, in consultation with the appropriate committee of the correctional facility, develop and implement procedures to ensure that remote drug storage areas:

a. Contain only properly labeled drugs that might reasonably be needed and can be administered safely during the pharmacist's absence,

b. Contain drugs packaged only in amounts sufficient for immediate therapeutic requirements,

c. Are accessible only with a physician's written order,

d. Provide a written record of each drug withdrawn,

e. Are inventoried at least once each week, and

f. Are audited for compliance with the requirements of this rule at least once each month.

2. The pharmacist-in-charge shall, in consultation with the appropriate committee of the correctional facility, develop and implement procedures to ensure that access to the limited-service correctional pharmacy when no pharmacist is on duty conforms to the following requirements:

a. Is delegated to only one nurse, who is in a supervisory position;

b. Is communicated in writing to medical staff of the correctional facility;

c. Is delegated only to a nurse who has received training from the pharmacist-in-charge in proper methods of access, removal of drugs, and recordkeeping procedures; and

d. Is delegated by the supervisory nurse to another nurse only in an emergency.

3. When a nurse to whom authority to access the limited-service correctional pharmacy is delegated removes a drug from the limited-service correctional pharmacy, the nurse shall:

a. Record the following information on a form:

i. Patient's name,

ii. Name of the drug and its strength and dosage form,

iii. Dose prescribed,

iv. Amount of drug removed, and

v. Date and time of removal;

b. Sign the form recording the drug removal;

c. Attach the original or a direct copy of a physician's written order for the drug to the form recording the drug removal; and

d. Place the form recording the drug removal conspicuously in the limited-service correctional pharmacy.

4. Within four hours after a pharmacist in the limited-service correctional pharmacy returns to duty following an absence in which the limited-service correctional pharmacy was accessed by a nurse to whom authority had been delegated, the pharmacist shall verify all records of drug removal according to R4-23-402.

D. When no pharmacist will be on duty in the correctional facility, the pharmacist-in-charge shall arrange, before there is no pharmacist on duty, for the medical staff and other authorized personnel of the correctional facility to have telephone access to a pharmacist.

E. The limited-service pharmacy permittee shall ensure that the limited-service correctional pharmacy is not without a pharmacist on duty for more than 96 consecutive hours.

F. In addition to the requirements of R4-23-671, the limited-service pharmacy permittee shall secure the limited-service correctional pharmacy as follows:

1. Permit no one to be in the limited-service correctional pharmacy unless a pharmacist is on duty except:

a. As provided in subsection (C)(3) when a pharmacist is not on duty; or

b. A pharmacy technician or pharmacy technician trainee may remain to perform duties in R4-23-1104(A), when a pharmacist is on duty and available in the correctional facility but temporarily absent from the pharmacy, provided:

i. All controlled substances are secured in a manner that prohibits access by persons other than a pharmacist;

ii. Activities performed by a pharmacy technician or pharmacy technician trainee while the pharmacist is temporarily absent are verified by the pharmacist immediately upon returning to the pharmacy;

iii. Any drug measured, counted, poured, or otherwise prepared and packaged by a pharmacy technician or pharmacy technician trainee while the pharmacist is temporarily absent is verified by the pharmacist immediately upon returning to the pharmacy; and

iv. Any drug that has not been verified by a pharmacist for accuracy is not dispensed, supplied, or distributed while the pharmacist is temporarily absent from the pharmacy; and

2. Provide keyed or programmable locks to all areas of the limited-service correctional pharmacy.

G. The pharmacist-in-charge of a limited-service correctional pharmacy shall ensure that the written policies and procedures for pharmacy operations and drug distribution within the correctional facility include the following:

1. Physicians' orders, prescription orders, or both;

2. Authorized abbreviations;

3. Formulary system;

4. Clinical services and drug utilization management including:

a. Participation in drug selection,

b. Drug utilization reviews,

c. Inventory audits,

d. Patient outcome monitoring,

e. Committee participation,

f. Drug information, and

g. Education of pharmacy and other health professionals;

5. Duties and qualifications of professional and support staff;

6. Products of abuse and contraband medications;

7. Controlled substances;

8. Drug administration;

9. Drug product procurement;

10. Drug compounding, dispensing, and storage;

11. Stop orders;

12. Pass or discharge medications;

13. Investigational drugs and their protocols;

14. Patient profiles;

15. Quality management procedures for:

a. Adverse drug reactions;

b. Drug recalls;

c. Expired and beyond-use-date drugs;

d. Medication or dispensing errors;

e. Drug storage; and

f. Education of professional staff, support staff, and patients;

16. Recordkeeping;

17. Sanitation;

18. Security;

19. Access to remote drug storage areas by non-pharmacists; and

20. Access to limited-service correctional pharmacy by non-pharmacists.

Ariz. Admin. Code § R4-23-672

Adopted effective April 5, 1996 (Supp. 96-2). Amended by final rulemaking at 10 A.A.R. 4453, effective December 4, 2004 (Supp. 04-4).