NAC639.720. Mechanical devices: Use to furnish drugs and medicines for administration to registered patients in medical facility and to patients receiving treatment in emergency room of hospital.

     1. Except as otherwise provided in subsections 4 and 6, a mechanical device may be used to furnish drugs and medicines for administration to registered patients in a medical facility. The device must conform to all the following provisions:

     (a) All drugs and medicines stocked in the device must be approved for use in the device by a registered pharmacist employed by the:

          (1) Medical facility in which the drug or medicine is administered; or

          (2) Pharmacy that supplies the medical facility in which the drug or medicine is administered.

     (b) Access to the device must be:

          (1) Limited to pharmaceutical technicians, pharmaceutical technicians in training, intern pharmacists, registered pharmacists, licensed practical nurses, registered nurses or other practitioners who are:

               (I) Authorized by law to prescribe or administer controlled substances, poisons, or dangerous drugs and devices; and

               (II) Employed by the medical facility or pharmacy that supplies the medical facility.

          (2) Monitored and controlled by the pharmacy which supplies the medical facility or the registered pharmacist who is employed by the medical facility.

     (c) Each container of a drug or medicine stored in the device must be labeled in a manner which includes the information required pursuant to subsection 2 of NAC 639.476.

     (d) The device must be designed in such a manner that:

          (1) Each time a person obtains access to the device, the device automatically prepares a record which is readily retrievable and which includes:

               (I) The name, strength, quantity and form of dosage of the drug or medicine which is stocked, inventoried or removed for administration to a patient;

               (II) The day and time access to the device is obtained;

               (III) If a drug or medicine is removed for administration to a patient, the name of the patient;

               (IV) An inventory of the drugs and medicines stored in the device; and

               (V) The name of the person who obtained access to the device.

          (2) Access to the device may be obtained only by a person with the use of a code which identifies that person.

     2. A pharmacy which supplies drugs and medicines to a medical facility which are furnished by a mechanical device pursuant to subsection 1 shall maintain a written policy which sets forth:

     (a) The duties of all persons who are authorized to obtain access to the device; and

     (b) The procedure for:

          (1) Maintaining the security of the drugs and medicines stored in the device during the maintenance and repair of the device;

          (2) The preparation of an inventory of the drugs and medicines stored in the device; and

          (3) Stocking the device with drugs and medicines.

     3. A pharmacy which supplies drugs or medicines to a medical facility which uses a mechanical device to furnish drugs or medicines for administration to patients pursuant to subsection 1 shall provide written notice to the Board. The notice must include:

     (a) A description of each mechanical device used by the medical facility to furnish drugs or medicines for administration to patients, including, without limitation, the name of the manufacturer of the device; and

     (b) The address of the medical facility at which the mechanical device is located.

     4. A pharmacy shall not stock a mechanical device with drugs or medicines and a mechanical device must not be used to furnish drugs or medicines for administration to patients until:

     (a) The pharmacy has notified the Board as required by subsection 3; and

     (b) The Board has issued a certificate to the pharmacy that authorizes the use of the mechanical device at the medical facility at which the mechanical device is located.

     5. Each medical facility that uses a mechanical device pursuant to subsection 1 must make and maintain a record of any waste of a controlled substance in the manner provided in NAC 639.486. The record of any waste of a controlled substance may be prepared:

     (a) By the mechanical device if the mechanical device is capable of making and maintaining such a record and documenting the record of the waste being witnessed by another person as provided in paragraph (g) of subsection 1 of NAC 639.486; or

     (b) As a written record.

     6. A mechanical device may be used to furnish drugs and medicines for a patient receiving treatment in the emergency room of a hospital. The device must conform to all the following provisions:

     (a) All drugs and medicines stocked in the device must be approved for use in the device by a registered pharmacist employed by or contracted with the:

          (1) Hospital in which the drug or medicine is furnished; or

          (2) Pharmacy that supplies the hospital in which the drug or medicine is furnished.

     (b) Access to the device for the purposes of stocking, inventory and monitoring must be limited to pharmaceutical technicians, pharmaceutical technicians in training, intern pharmacists or registered pharmacists employed by the hospital or the pharmacy that supplies the hospital.

     (c) Use of the device to furnish a drug or medicine to a patient must be:

          (1) By a practitioner who:

               (I) Is authorized by law to prescribe controlled substances or dangerous drugs;

               (II) Is employed by or who has privileges at the hospital;

               (III) Prescribed the drug or medicine that is furnished to the patient;

               (IV) Personally verifies the correctness of the prescription for the drug or medicine before he or she furnishes it to the patient; and

               (V) Has offered to the patient the choice of being provided a prescription that may be filled at a pharmacy, which offer first must be declined by the patient before the prescription is transmitted to the mechanical device to fill and furnish the prescription; or

          (2) By the patient where:

               (I) The device requires from the patient a unique code known only to the patient to allow the patient to access the device; and

               (II) The patient is notified by the device that he or she may choose not to purchase the drug or medicine from the device at any time before the device furnishes the drug or medicine.

     (d) Each container of a drug or medicine dispensed by the device is labeled pursuant to NRS 639.2801.

     (e) The device must be designed in such a manner that:

          (1) Each time a person obtains access to the device, the device automatically prepares a record which is readily retrievable and which includes:

               (I) The name, strength, quantity and form of dosage of the drug or medicine which is stocked, inventoried or removed for dispensing to a patient;

               (II) The day and time access to the device is obtained;

               (III) If a drug or medicine is removed for dispensing to a patient, the name of the patient;

               (IV) An inventory of the drugs and medicines stored in the device; and

               (V) The name of the person who obtained access to the device.

          (2) Access to the device may be obtained only by a person with the use of a unique code which identifies that person.

     (f) The device must be located in such a place and manner that a person is unable to remove it from the hospital, and that attempts to obtain access to the device without authorization are visible to employees of the hospital.

     (g) Before the device is used to furnish a drug or medicine directly to a patient pursuant to paragraph (c), the manufacturer of the device must appear before the Board for its approval of that use of the device and submit evidence satisfactory to the Board that the device:

          (1) Furnishes drugs and medicines accurately; and

          (2) Otherwise satisfies the provisions of this subsection.

     7. As used in this section, “medical facility” has the meaning ascribed to it in NRS 449.0151.

     [Bd. of Pharmacy, § 639.320, eff. 6-26-80]—(NAC A 12-21-95; 5-20-96; R017-03, 10-21-2003; R043-07, 10-31-2007)