§ 90-18.4. Limitations on clinical pharmacist practitioners. - North Carolina Statutes

§ 90‑18.4. Limitations on clinical pharmacist practitioners.

(a)        Any pharmacist who is approved under the provisions of G.S.90‑18(c)(3a) to perform medical acts, tasks, and functions may use thetitle "clinical pharmacist practitioner". Any other person who usesthe title in any form or holds himself or herself out to be a clinicalpharmacist practitioner or to be so licensed shall be deemed to be in violationof this Article.

(b)        Clinical pharmacist practitioners are authorized toimplement predetermined drug therapy, which includes diagnosis and productselection by the patient's physician, modify prescribed drug dosages, dosageforms, and dosage schedules, and to order laboratory tests pursuant to a drugtherapy management agreement that is physician, pharmacist, patient, anddisease specific under the following conditions:

(1)        The North Carolina Medical Board and the North CarolinaBoard of Pharmacy have adopted rules developed by a joint subcommitteegoverning the approval of individual clinical pharmacist practitioners topractice drug therapy management with such limitations that the Boardsdetermine to be in the best interest of patient health and safety.

(2)        The clinical pharmacist practitioner has current approvalfrom both Boards.

(3)        The North Carolina Medical Board has assigned anidentification number to the clinical pharmacist practitioner which is shown onwritten prescriptions written by the clinical pharmacist practitioner.

(4)        The drug therapy management agreement prohibits thesubstitution of a chemically dissimilar drug product by the pharmacist for theproduct prescribed by the physician without the explicit consent of thephysician and includes a policy for periodic review by the physician of thedrugs modified pursuant to the agreement or changed with the consent of thephysician.

(c)        Clinical pharmacist practitioners in hospitals and otherhealth facilities that have an established pharmacy and therapeutics committeeor similar group that determines the prescription drug formulary or other listof drugs to be utilized in the facility and determines procedures to befollowed when considering a drug for inclusion on the formulary and proceduresto acquire a nonformulary drug for a patient may order medications and testsunder the following conditions:

(1)        The North Carolina Medical Board and the North CarolinaBoard of Pharmacy have adopted rules governing the approval of individualclinical pharmacist practitioners to order medications and tests with suchlimitations as the Boards determine to be in the best interest of patienthealth and safety.

(2)        The clinical pharmacist practitioner has current approvalfrom both Boards.

(3)        The supervising physician has provided to the clinicalpharmacist practitioner written instructions for ordering, changing, orsubstituting drugs, or ordering tests with provision for review of the order bythe physician within a reasonable time, as determined by the Boards, after themedication or tests are ordered.

(4)        The hospital or health facility has adopted a writtenpolicy, approved by the medical staff after consultation with nursingadministrators, concerning the ordering of medications and tests, includingprocedures for verification of the clinical pharmacist practitioner's orders bynurses and other facility employees and such other procedures that are in thebest interest of patient health and safety.

(5)        Any drug therapy order written by a clinical pharmacistpractitioner or order for medications or tests shall be deemed to have beenauthorized by the physician approved by the Boards as the supervisor of theclinical pharmacist practitioner and the supervising physician shall beresponsible for authorizing the prescription order.

(d)        Any registered nurse or licensed practical nurse whoreceives a drug therapy order from a clinical pharmacist practitioner formedications or tests is authorized to perform that order in the same manner asif the order was received from a licensed physician. (1999‑290, s. 3.)