21 NCAC 46 .1415             MEDICATION IN HEALTH CARE FACILITY EMERGENCY DEPARTMENTS

(a)  In those Health Care Facilities with 24-hour outpatient pharmacy service, all drugs dispensed to outpatients, including emergency department patients, must be dispensed by the permitted pharmacy during times that it is open for outpatient pharmacy service.

(b)  When the permitted pharmacy in the Health Care Facility is closed for outpatient service, drugs may be dispensed for use outside the emergency department by the physician, registered nurse under physician supervision, or a person authorized to prescribe and dispense drugs pursuant to G.S. 90-18.1 or 90-18.2 subject to the following:

(1)           Drugs shall be dispensed only to a patient of the emergency department;

(2)           The pharmacist-manager shall develop and supervise a system of control and accountability of all drugs administered in, or dispensed from, the emergency department;

(3)           The pharmacist-manager shall develop a formulary of prescription drugs that may be dispensed from the emergency department for patients receiving care in that department. This formulary shall consist of drugs of the nature and type to meet the immediate needs of emergency department patients;

(4)           The emergency department staff may dispense no more than a seven-day supply or the smallest quantity prepackaged by the manufacturer for patient dispensing, whichever is greater;

(5)           Drugs shall be prepackaged in safety closure containers and shall be pre-labeled by a pharmacist to comply with Rule .1414(d)(4) of this Section. Prior to dispensing, the following information shall be placed on the label:

(A)          the name, address, and telephone number of the health care facility pharmacy;

(B)          the dispensing date;

(C)          the full name of patient;

(D)          the generic or trade name, or in the absence of a brand name, the established name of the product dispensed;

(E)           directions for use to the patient;

(F)           the name of physician prescribing and dispensing the product; and

(G)          required precautionary or further accessory cautionary information as may be desirable for proper use and safety to the patient;

(6)           A perpetual record of dispensing of all drugs, including drug samples and starter packages, shall be maintained as part of the pharmacy's records for three years. The pharmacist-manager or designee shall verify the accuracy of these records at least once a month. The record shall contain the following:

(A)          the date dispensed;

(B)          the patient's name;

(C)          the physician's name; and

(D)          the name, strength, dosage form, quantity, and dose of the drug dispensed.

(7)           The drug may be dispensed only if there is an order from a prescriber that complies with applicable laws governing such prescriptions.

(c)  The physician, registered nurse under physician supervision, or person who is authorized to prescribe and dispense drugs pursuant to G.S. 90-18.1 or 90-18.2 shall comply with all rules governing the dispensing of medications including patient counseling as defined in 21 NCAC 46 .2504.

History Note:        Authority G.S. 90-18.1; 90-18.2; 90-85.6; 90-85.21; 90-85.32; 90-85.33;

Eff. May 1, 1997;

Amended Eff. March 1, 2013;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. October 3, 2017;

Amended Eff. November 1, 2024.