§ 131E-128.4. Nursing home pharmacy reports; duties of consultant pharmacist. - North Carolina Statutes

§ 131E‑128.4.  Nursing home pharmacy reports;duties of consultant pharmacist.

(a)        The consultant pharmacist for a nursing home shall conduct adrug regimen review for actual and potential drug therapy problems in thenursing home and make remedial or preventive clinical recommendations into themedical record of every patient receiving medication. The consultant pharmacistshall conduct the review at least monthly in accordance with the nursing home'spolicies and procedures.

(b)        The consultant pharmacist shall report and document any drugirregularities and clinical recommendations promptly to the attending physicianor nurse‑in‑charge and the nursing home administrator. The reportsshall include problems identified and recommendations concerning:

(1)        Drug therapy that may be affected by biological agents,laboratory tests, special dietary requirements, and foods used or administeredconcomitantly with other medication to the same recipient.

(2)        Monitoring for potential adverse effects.

(3)        Allergies.

(4)        Drug interactions, including interactions betweenprescription drugs and over‑the‑counter drugs, drugs and disease,and interactions between drugs and nutrients.

(5)        Contraindications and precautions.

(6)        Potential therapeutic duplication.

(7)        Overextended length of treatment of certain drugs typicallyprescribed for a short period of time.

(8)        Beer's listed drugs that are potentially inappropriate foruse by elderly persons.

(9)        Undertreatment or medical conditions that are suboptimallytreated or not treated at all that warrant additional drug therapy to ensurequality of care.

(10)      Other identified problems and recommendations.

(c)        The consultant pharmacist shall report drug product defectsand adverse drug reactions in accordance with the ASHSP‑USP‑FDA DrugProduct Defect Reporting System and the USP Adverse Drug Reaction ReportingSystem. The term "ASHSP‑USP‑FDA" means American Societyof Health System Pharmacists‑United States Pharmacopoeia‑Food andDrug Administration. Information released to the ASHSP‑USP‑FDAretains its confidentiality and is not subject to discovery or use in any civilaction as provided under G.S. 131E‑128.1.

(d)        The consultant pharmacist shall ensure that all knownallergies and adverse effects are documented in plain view in the patient'smedical record, including the medication administration records, andcommunicated to the dispensing pharmacy. The specific medications and the typeof allergy or adverse reaction shall be specified in the documentation.

(e)        The consultant pharmacist shall ensure that drugs that arenot specifically limited as to duration of use or number of doses shall becontrolled by automatic stop orders. The consultant pharmacist shall furtherensure that the prescribing provider is notified of the automatic stop orderprior to the dispensing of the last dose so that the provider may decidewhether to continue to use the drug.

(f)         The consultant pharmacist shall, on a quarterly basis,submit a summary of the reports submitted under subsections (a) and (b) of thissection to the medication management advisory committee established under G.S.131E‑128.1. The summary shall not include any information that wouldidentify a patient, a family member, or an employee of the nursing home. Thepurpose of the summary shall be to facilitate the identification and analysisof weaknesses in the nursing home's pharmaceutical care system that have anadverse impact on patient safety. (2003‑393, s.1.)