Each ambulance service shall adopt a written prescription drug safeguard policy which, as a condition precedent to obtaining prescription drugs for ambulance service purposes, at a minimum, must include the following requirements:
1. All prescription drugs must be obtained from a North Dakota licensed pharmacy, wholesaler, or authorized prescribes at the request of the ambulance service's medical director or designee. The prescription drugs must be the property of the pharmacy or medical director and not the property of the ambulance service.2. The initial inventory of prescription drugs must be obtained by an ambulance service only upon the written authorization of the ambulance service's medical director who must be a "practitioner" as defined by subsection 17 of North Dakota Century Code section 43-15-01.3. The pharmacist-in-charge of the licensed pharmacy, a licensed pharmacist, or the medical director must be responsible for the security and accountability of the prescription drug inventory obtained by an ambulance service.4. Dispensing or administration of all prescription drugs must be pursuant to a standing order, oral instructions, or prescription of a practitioner.5. All medications administered must be promptly documented on a patient care report, reviewed by the ambulance service's medical director on a monthly basis either directly or indirectly through a quality assurance process approved by the medical director.6. Replenishment of prescription drugs must be requested by a responsible individual. If obtained from a pharmacy, the request must be documented on an administration record justifying the order. If obtained by, or on behalf of, the medical director, drugs must be obtained from a North Dakota licensed pharmacy, a wholesaler, or an authorized prescriber.
7. Expired, damaged, or unused prescription drugs must be returned to the licensed pharmacy where obtained or disposed of by the medical director or the medical director's designee, according to a written protocol established for this purpose.8. Lost, stolen, or misused prescription drugs must be reported to the ambulance service's medical director or the pharmacy where they were obtained.9. The licensed ambulance service must have a process, approved by the ambulance service's medical director, or pharmacist-in-charge where the drugs were obtained that accounts for all schedule II, III, and IV controlled substances, at least daily. The daily accounting of schedule II controlled substances must balance and be documented on a daily log.10. Controlled substances must be sealed in a double lock secure system. A record separate from the other prescription drugs is to be kept for schedule II controlled substances. A system approved by the ambulance service's medical director to account for the use and waste of schedule II, III, and IV controlled substances must be used. The system must include:a. Patient's name and address (if available);b. Medication and strength or amount given and amount wasted (if any); e. The signature of the individual administering the controlled substance.11. Any unused portion of a prescription drug must be disposed of in a manner that it cannot be collected or recovered. The disposal of all controlled substances must be witnessed and cosigned by another person legally qualified to administer controlled substances.N.D. Admin Code 61-09-01-01
Effective July 1, 1990; amended effective October 1, 2012.General Authority: NDCC 28-32-02, 43-15-10(12), 43-15-10(14)
Law Implemented: NDCC 28-32-03, 43-15-10 (12), 43-15-10 (14)