Effective February 1, 2012, all Tidewater EMS providers must obtain signatures from medical practitioners (Physician, Physician Assistant, or Nurse Practitioner) that are pen to paper on all medication boxes exchanges.
Our regional exchange procedures and practices are not compliant with the Virginia Board of Pharmacy regulation 18VAC110-20-500. In this regulation it requires a pen to paper (wet) signature for all controlled medications (schedule II-VI) that EMS administers in the field. During a recent inspection by the Board of Pharmacy, one of our hospitals was cited for accepting EMS run-reports that were missing signatures or were signed electronically.
To comply with this requirement of the Board of Pharmacy, you will need a pen to paper (wet) signature for all Drug (Red) / IV (Orange) medication box exchanges. This can be completed by using an agency-created short form for exchanges or by printing the required page(s) from the Electronic Medical Record (EMR) software that your agency is using and then have the medical practitioner sign the form(s). Whichever process your agency uses, you must include the following information:
• Patient’s name (Hospital’s sticker may be used)
• Your agency name
• Unit number
• Your name
• Date of exchange
• Old and New Box numbers
• Medication used and waste of narcotics with witness information and signature
• Signature of medical practitioner
If the medical practitioner’s signature is not obtained, the pharmacy will not be required to exchange the used medication box(es). If an exchange takes place at a remote location with missing signature(s) or information the pharmacy will notify the Tidewater EMS Council for follow up by filling out the TEMS Drug / IV Box On-line Incident Report that can be found on the Tidewater EMS Council’s website at www.tidewaterems.org/medbox
Tidewater EMS Council will continue to work with the pharmacies, agencies, OEMS and the Board of Pharmacy to have this rule relaxed. We will keep you updated on that progress.