1140-04-.05
Distribution And Control Of Drugs
Cite as Tenn. Comp. R. & Regs. 1140-04-.05
The pharmacist in charge or designee, in conjunction with appropriate committees of the facility, shall be
responsible for approving policies for the distribution and control of drugs within the facility. The process
shall be established to provide for the safe and efficient distribution of drugs and for the provision of
pharmaceutical care, and shall include but not be limited to:
(1)
A drug dispensed from the pharmacy for subsequent administration to a patient shall be
appropriately identified with the name and location of the patient and the name and strength
of the drug.
(2)
The pharmacist in charge is responsible for the development and maintenance of an audit
trail on drugs dispensed.
(3)
The prescription order shall be recorded on a patient medication profile that will be
maintained during the patient’s treatment. This profile shall include the date of the
prescription order, the name and dosage form of the drug and the dose and administration
frequency.
INSTITUTIONAL AND ALTERNATE OR ALTERNATIVE
CHAPTER 1140-04
INFUSION PHARMACY PRACTICE SITES
(4)
The facility distribution system may be based on a combination of processes that will ensure
compliance with federal and state guidelines such as emergency kits/crash carts, floorstock
systems, automated dispensing devices, medication carts, and/or after-hours procedures for
pharmacy site access.
(5)
Upon request, the Board may waive selected portions of these requirements so long as any
waiver granted is consistent with the Board’s authority under Tenn. Code Ann. Title 63,
Chapters 1 and 10, and Tenn. Code Ann. Title 4, Chapter 5.