Section 639.4916 - Provision of remote services by pharmacist employed by off-site pharmaceutical service provider1. A registered pharmacist who is employed by or under contract with a pharmacy located within a hospital or correctional institution to provide the remote chart order processing services to the hospital or correctional institution that the pharmacy is required by NAC 639.4915 to provide must: (a) Be trained in the policies and procedures of the hospital or correctional institution regarding all policies and procedures of the hospital or correctional institution with which the registered pharmacist must comply, including, without limitation, the provision of pharmaceutical services, security and confidentiality of patient records; and(b) Be provided with the same computerized system and access to data regarding a patient for whom a chart order has been submitted that would be available to a registered pharmacist employed by the pharmacy located within the hospital or correctional institution, including, without limitation: (1) The height, weight and age of the patient and any allergies that the patient may have;(2) The medical records regarding any medications prescribed to the patient;(3) The results of any relevant laboratory tests;(4) The health history and notes regarding physical examinations, to the extent that the information is available in the computerized system of the hospital or correctional institution;(5) Any notes provided by a physician, nurse or other medical staff of the institution, to the extent that those notes are available in the computerized system of the hospital or correctional institution;(6) A legible copy of the chart order that is available through a scanned image in the computerized system of the hospital or correctional institution or by facsimile machine; and(7) Any other information that is available in the computerized system of the hospital or correctional institution that is relevant or necessary for the registered pharmacist to provide pharmaceutical services.2. Before a registered pharmacist who is employed by or under contract with a pharmacy located within a hospital or correctional institution provides remote chart order processing services to the hospital or correctional institution, the registered pharmacist must review any relevant information regarding the patient for whom a chart order has been submitted. The registered pharmacist must, before approving a chart order to be filled, evaluate:(a) The overutilization or underutilization of a medication;(b) Therapeutic duplication;(c) The appropriateness of the prescribed dosage and route of administration;(d) The appropriateness of the directions for use of the medication;(e) The appropriateness of the duration of the treatment with the prescribed medication;(f) Any contraindications of the medication and a particular disease, ailment or allergy of the patient;(g) Any contraindications or interactions between multiple medications prescribed for the patient; and(h) The potential abuse or misuse of a medication.3. A registered pharmacist who is employed by or under contract with a pharmacy located within a hospital or correctional institution to provide remote chart order processing services to the hospital or correctional institution shall comply with the requirements of section 2 to the same extent as a registered pharmacist engaging in the practice of pharmacy at a location other than the site of a licensed pharmacy pursuant to the provisions of NAC 639.403 or section 3.4. In an emergency, a registered pharmacist who is employed by or under contract with a pharmacy located within a hospital or correctional institution to provide remote chart order processing services to the hospital or correctional institution may render remote chart order processing services without being provided with all of the information required by paragraph (b) of subsection 1 if the registered pharmacist believes, in his or her professional judgment, that he or she has received sufficient information from the staff of the hospital or correctional institution to render the services.5. A registered pharmacist who is employed by or under contract with a pharmacy located within a hospital or correctional institution to provide remote chart order processing services to the hospital or correctional institution may refuse to approve the filling of a chart order if, in the judgment of the registered pharmacist, the chart order is not safe or reasonable for the patient. A registered pharmacist who refuses to approve the filling of a chart order pursuant to this subsection must notify the hospital or correctional institution as soon as practicable that he or she has refused to approve the filling of the chart order.6. Each time that a registered pharmacist who is employed by or under contract with a pharmacy located within a hospital or correctional institution to provide remote chart order processing services to the hospital or correctional institution provides remote chart order processing services pursuant to this section, the registered pharmacist shall make a notation in the computerized system of the hospital or correctional institution that indicates: (a) The name or other identifier of the registered pharmacist;(b) The date and time that the registered pharmacist provided the services and, if applicable, approved the filling of a chart order; and(c) The specific services provided by the registered pharmacist.7. The managing pharmacist of a pharmacy located within a hospital or correctional institution may limit the remote chart order processing services provided pursuant to this section.Nev. Admin. Code § 639.4916
Added to NAC by Bd. of Pharmacy by R015-05, eff. 10-31-2005; A by R164-20A, eff. 12/29/2022NRS 639.070, 639.071, 639.072