12 AAC 44.447. Advanced nurse practitioner dispensing standards

(a) An advanced nurse practitioner or "ANP" with prescriptive and dispensing authority may dispense a prescription within the ANP's scope of practice only.

(b) An ANP with prescriptive and dispensing authority may dispense a medication prepackaged by a pharmacy or pharmaceutical manufacturer. A prepackaged medication must be dispensed in its original package.

(c) If an ANP dispenses less than the prepackaged quantity of a medication, the ANP shall adjust the label on the container to show the quantity dispensed. The ANP shall also dispose of the excess medication in accordance with established professional standards.

(d) When dispensing a prescription, an ANP with prescriptive and dispensing authority is responsible for

(1) selection of the medication;

(2) proper labeling of the container as required in (c) and (j) of this section;

(3) delivery of the prescription; and

(4) counseling the client, including giving the client information on

(A) the name, dosage, and purpose of the prescribed drug;

(B) the duration of the prescribed drug therapy;

(C) common side or adverse effects or food or drug interactions that may be encountered, how to avoid those effects or interactions, and what actions should be taken if those effects or interactions occur;

(D) the expected outcome of the prescribed drug therapy; and

(E) the plan for follow-up care.

(e) An ANP with prescriptive and dispensing authority shall keep a readily retrievable written record of prepackaged medication prescriptions dispensed, including lot number.

(f) An ANP may delegate the delivery of a prescription to another individual if the

(1) ANP has developed a protocol on drug delivery and reviewed the protocol with the individual delivering the prescription;

(2) ANP has provided orientation and training on drug delivery to the individual delivering the prescription;

(3) ANP supervises the individual delivering the prescription; the supervision may be in person or by telephone; and

(4) individual to whom the ANP has delegated the delivery of a prescription

(A) is 18 years of age or older; and

(B) can read and write the language of the ANP.

(g) An ANP who delegates delivery of a prescription and does not meet the requirements of (f) of this section is subject to disciplinary action by the board.

(h) An ANP with prescriptive and dispensing authority may dispense a prescription packaged from a bulk supply of medication if the prescription was packaged according to the following standards:

(1) an individual licensed or certified in the administration of medications packaged the prescription;

(2) a health care professional with prescriptive authority supervised the packaging of the prescription and initialed the prescription on the same day that it was packaged;

(3) at the time of packaging, the prescription package was labeled with the information required in (j) of this section.

(i) An ANP who dispenses a prescription packaged from a bulk supply of medication shall keep a readily retrievable record of packaging procedures for that prescription, including the

(1) date of packaging;

(2) manufacturer, lot number, and expiration date of the medication;

(3) signature of the individual who packaged the prescription; and

(4) signature of the individual with prescriptive authority who supervised the packaging of the prescription.

(j) The label for a prescription that is to be dispensed by an ANP and that

(1) is a prepackaged medication must include

(A) the dispensing ANP's name and address;

(B) directions to the patient or a blank space for the instructions of the prescriber;

(D) a blank space for the name of the prescriber;

(2) was packaged from a bulk supply of medication must include the information required in (1) of this subsection and

(A) the name, strength, and quantity of the medication in the container;

(B) a blank space for the date of delivery to the patient;

(D) the manufacturer's lot number;

(E) the expiration date;

(F) warning labels appropriate to the specific medication in the container;

(G) the name, address, and phone number of the health care facility at which the prescription was packaged;

(H) the date the prescription was packaged; and

(I) the initials of the health care professional with prescriptive authority who supervised the packaging of the prescription.

(k) For the purposes of this section,

(1) "delivery of a prescription" means completing the blank spaces on the label of the prescription drug container and actually handing the container to the client or an individual who is 18 years of age or older who is designated as the client's representative;

(2) "supervise the packaging of a prescription" means to

(A) be available to assist the individual packaging the prescription; and

(B) examine the prescription when the packaging is completed to verify its accuracy.

History: Eff. 4/9/94, Register 130; am 4/30/94, Register 130; am 6/22/96, Register 138

Authority: AS 08.68.100

AS 08.68.410

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