PURPOSE: This rule establishes procedures for pharmacists to administer drugs and devices pursuant to medical prescription orders.

1. (1) A pharmacist may administer drugs pursuant to a medical prescription order.
2. (2) The pharmacist may not delegate the administration to another person, except to a pharmacist intern who has met qualifications under subsections (3)(B), (C), and (E) and is working under the direct supervision of a pharmacist qualified to administer drugs pursuant to a medical prescription order.

3. (3) Pharmacist Qualifications. A pharmacist who is administering drugs pursuant to a medical prescription order must—

   1. (A) Hold a current, unrestricted license to practice pharmacy in this state;
   2. (B) Hold a current provider level cardiopulmonary resuscitation (CPR) certification issued by the American Heart Association or the American Red Cross or equivalent;
   3. (C) Successfully complete a certificate program in the administration of drugs accredited by the Accreditation Council for Pharmacy Education (ACPE) or a similar health authority or professional body approved by the State Board of Pharmacy. The certificate program must cover all routes of administration the pharmacist utilizes;
   4. (D) Complete a minimum of two (2) hours of continuing education per calendar year related to administration of drugs. A pharmacist may use the continuing education hours required in this subsection as part of the total continuing education hours required for pharmacist license renewal;
   5. (E) Maintain documentation of the above requirements; and
   6. (F) On a yearly basis prior to administering drugs, notify the State Board of Pharmacy of their qualifications to do so. This notification shall include the types of drugs being administered, and a statement that the pharmacist meets the requirements of subsections (A), (B), (C), and (D) of this section.

4. (4) General Requirements.

   1. (A) A pharmacist shall administer drugs in accordance with treatment guidelines established by the Centers for Disease Control and 20 CSR 2220-6

Prevention (CDC) or in accordance with manufacturer’s guidelines.

1. (B) A pharmacist shall comply with all state and federal laws and regulations pertaining to Vaccine Information Statements and informed consent requirements.
2. (C) A pharmacist shall have a written policy and procedure covering all aspects of the administration of drugs, including the disposal of used and contaminated supplies and appropriate handling of acute adverse events. The manual shall be reviewed annually and be available for inspection by the State Board of Pharmacy or authorized representative.

1. (5) Requirements of Medical Prescription Order. The medical prescription order from a licensed prescriber must contain at a minimum the following:

   1. (A) The name of the licensed prescriber issuing the order;
   2. (B) The name of the patient to receive the drug;
   3. (C) The name of the drug and dose to be administered;
   4. (D) The route of administration;
   5. (E) The date of the original order;
   6. (F) The date or schedule, if any, of each subsequent administration; and
   7. (G) A statement that the drug is to be administered by a pharmacist.

2. (6) Record Keeping.

   1. (A) A pharmacist who administers a drug pursuant to a medical prescription order shall maintain the following records regarding each administration. These records must be separate from the prescription files of a pharmacy.

      1. 1. The name, address, and date of birth

of the patient;

1. 2. The date, route, and anatomic site of

the administration;

1. 3. The name, dose, manufacturer, lot

number, and expiration date of the drug;

1. 4. The name and address of the patient’s

primary health care provider, as identified by the patient;

1. 5. The name or identifiable initials of

the administering pharmacist; and

1. 6. The nature of an adverse reaction and

who was notified, if applicable.

1. (B) All records required by this regulation shall be kept by the pharmacist and be available for two (2) years from the date of such record for inspecting and copying by the State Board of Pharmacy and/or its authorized representatives.

1. (7) Notification Requirements.

   1. (A) A pharmacist administering drugs pursuant to a medical prescription order shall FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION

notify the prescriber within seventy-two (72) hours after administration of the following:

1. 1. The identity of the patient;
2. 2. The identity of the drug administered;
3. 3. The route of administration;
4. 4. The anatomic site of the administra-

tion;

1. 5. The dose administered; and
2. 6. The date of administration.
3. (B) In the event of any adverse event or reaction experienced by the patient, the pharmacist shall notify the prescriber within twenty-four (24) hours after learning of the adverse event or reaction.
4. (C) A pharmacist administering drugs pursuant to a medical prescription order shall report the administration to all entities as required by state or federal law.

AUTHORITY: sections 338.140 and 338.280, RSMo 2000 and section 338.010.1, RSMo Supp. 2007.* Emergency rule filed May 1, 2008, effective May 11, 2008, expired Feb. 18, 2009. Original rule filed May 1, 2008, effective Nov. 30, 2008. *Original authority: 338.010, RSMo 1939, amended 1951, 1989, 1990, 2007; 338.140, RSMo 1939, amended 1981, 1989, 1997; and 338.280, RSMo 1951, amended 1971, 1981.