49 Pa. Code § 18.6a - Prescribing, dispensing and administering drugs
(a)
No Schedule I controlled
substances. A nurse-midwife may not prescribe or dispense Schedule I
controlled substances as defined by section 4 of The Controlled Substance,
Drug, Device and Cosmetic Act (35 P. S. §
780-104).
(b)
Prescribing, dispensing and
administering drugs. A nurse-midwife who has prescriptive authority
may prescribe, administer and dispense drugs as follows:
(1) A nurse-midwife may prescribe, dispense
or administer Schedule II through V controlled substances and legend drugs in
accordance with the following restrictions:
(i) A nurse-midwife may not prescribe,
dispense, order or administer a controlled substance except for a woman's acute
pain.
(ii) In the case of a
Schedule II controlled substance, the dose must be limited to 72 hours and may
not be extended except with the approval of the collaborating
physician.
(iii) In the case of a
Schedule III or IV controlled substance, the prescription must be limited to 30
days and shall only be refilled with the approval of the collaborating
physician.
(iv) A nurse-midwife may
prescribe, dispense, order or administer psychotropic drugs only after
consulting with the collaborating physician.
(v) A nurse-midwife may only prescribe or
dispense a drug for a patient in accordance with the collaborative
agreement.
(vi) A nurse-midwife may
not delegate prescriptive authority to another health care provider.
(2) A nurse-midwife authorized to
prescribe or dispense, or both, controlled substances, shall register with the
United States Drug Enforcement Administration.
(c)
Prescription blanks. The
requirements for prescription blanks are as follows:
(1) Prescription blanks must bear the license
number of the nurse-midwife and the name and contact information, including
phone number, of the nurse-midwife in a printed format at the heading of the
blank, as well as the initials "C.N.M." or similar designation.
(2) The signature of the nurse-midwife must
be followed by the initials "C.N.M." or similar designation to identify the
signer as a nurse-midwife.
(3) A
nurse-midwife may use a prescription blank generated by a hospital or other
licensed healthcare facility, provided the information in paragraph (1) appears
on the blank.
(4) Prescription
blanks may not be presigned by the nurse-midwife or collaborating
physician.
(d)
Inappropriate prescribing. Any party who identifies an
inappropriate prescription shall immediately advise the nurse-midwife or the
collaborating physician. The nurse-midwife or collaborating physician shall
advise the patient to modify or discontinue use of the drug as medically
appropriate. In the case of a written prescription, the nurse-midwife or the
collaborating physician shall notify the pharmacy of the changes to the
prescription. The order to modify or discontinue the use of the drug or
prescription must be noted in the patient's medical record. The nurse-midwife
shall seek consultation as medically indicated.
(e)
Recordkeeping
requirements. Recordkeeping requirements are as follows:
(1) When prescribing a drug, the
nurse-midwife shall record in the patient's medical record the name, amount,
directions for use and doses of the drug prescribed, the number of refills, the
date of the prescription and the nurse-midwife's name. When utilizing
electronic prescribing, the nurse-midwife shall comply with the requirements of
the State Board of Pharmacy in §
27.201 (relating to electronically
transmitted prescriptions).
(2)
When dispensing a drug, the nurse-midwife shall record in the patient's medical
record the name, amount, directions for use and doses of the medication
dispensed, the date dispensed, and the nurse-midwife's name.
(f)
Compliance with
regulations relating to prescribing, administering, dispensing, packaging and
labeling of drugs. A nurse-midwife shall comply with §§
16.92-16.94 (relating to prescribing,
administering and dispensing controlled substances; packaging; and labeling of
dispensed drugs) and Department of Health regulations in 28 Pa. Code
§§
25.51 -25.58 (relating to
prescriptions) and regulations regarding packaging and labeling dispensed
drugs. See §
16.94 and 28 Pa. Code
§§25.91-25.95 (relating to labeling of drugs, devices and
cosmetics).
Notes
The provisions of these sections 12 and 35 of the Medical Practice Act of 1985 (63 P. S. §§ 422.12 and 422.35), unless otherwise noted.
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