NAC639.2971. Authorization; contents of and deviation from written protocol.

     1. A physician may establish a written protocol authorizing pharmacists to administer immunizations by an intranasal, intramuscular or subcutaneous injection. Except as otherwise limited by the physician pursuant to subsection 4, any pharmacist who is trained and certified in accordance with NAC 639.2973 may subscribe to the written protocol and administer immunizations in compliance with the protocol. Such a protocol must contain:

     (a) The name of the physician who is authorizing the administration of immunizations by a pharmacist;

     (b) The immunizations that may be administered by a pharmacist;

     (c) Detailed policies and procedures that a pharmacist must follow while administering immunizations, including, without limitation, procedures to follow in the case of adverse reactions or emergencies following administration;

     (d) A procedure for the review of the protocol and its operation by the physician at least once annually, and the making and keeping of a record of the review;

     (e) When appropriate, specific instructions related to the age of the patient;

     (f) Except as otherwise provided in subsection 2, a restriction that a pharmacist may not delegate his or her authority to administer an immunization;

     (g) A restriction that a pharmacist may not administer an immunization except at an authorized location, which location may not be the home of the patient, unless the patient resides in a licensed facility for long-term care or in a hospital;

     (h) A requirement that the immunizations will be administered according to all applicable federal, state and local laws; and

     (i) The signature of the physician authorizing the administration of the immunizations and the time period for which the written protocol is effective.

     2. An intern pharmacist may administer immunizations by an intranasal, intramuscular or subcutaneous injection under the direct and immediate supervision of a pharmacist who has subscribed to a written protocol established by a physician.

     3. If a physician orders a deviation from the written protocol for the benefit of a specific patient, the physician shall note the deviations from the written protocol in the record of the patient.

     4. A physician may include restrictions to a written protocol established by the physician pursuant to subsection 1 by limiting the protocol to any of the following:

     (a) A specific pharmacist or pharmacists;

     (b) A specific location or locations;

     (c) The administration of a specific immunization or immunizations; or

     (d) Other limitations as the physician determines necessary.

     (Added to NAC by Bd. of Pharmacy by R009-01, eff. 11-1-2001; A by R142-03, 4-8-2004; R180-05, 12-29-2005; R115-08, 9-18-2008)