Texas Statutes (Last Updated: January 4, 2014) |
HEALTH AND SAFETY CODE |
Title 2. HEALTH |
Subtitle G. LICENSES |
Chapter 142. HOME AND COMMUNITY SUPPORT SERVICES |
Subchapter A. HOME AND COMMUNITY SUPPORT SERVICES LICENSE |
Sec. 142.0063. POSSESSION OF CERTAIN DANGEROUS DRUGS
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(a) A home and community support services agency in compliance with this section or its employees who are registered nurses or licensed vocational nurses may purchase, store, or transport for the purpose of administering to their home health or hospice patients in accordance with Subsection (c) the following dangerous drugs:
(1) any of the following items in a sealed portable container of a size determined by the dispensing pharmacist:
(A) 1,000 milliliters of 0.9 percent sodium chloride intravenous infusion;
(B) 1,000 milliliters of five percent dextrose in water injection; or
(C) sterile saline; or
(2) not more than five dosage units of any of the following items in an individually sealed, unused portable container:
(A) heparin sodium lock flush in a concentration of 10 units per milliliter or 100 units per milliliter;
(B) epinephrine HCl solution in a concentration of 1 to 1,000;
(C) diphenhydramine HCl solution in a concentration of 50 milligrams per milliliter;
(D) methylprednisolone in a concentration of 125 milligrams per two milliliters;
(E) naloxone in a concentration of one milligram per milliliter in a two-milliliter vial;
(F) promethazine in a concentration of 25 milligrams per milliliter;
(G) glucagon in a concentration of one milligram per milliliter;
(H) furosemide in a concentration of 10 milligrams per milliliter;
(I) lidocaine 2.5 percent and prilocaine 2.5 percent cream in a five-gram tube; or
(J) lidocaine HCl solution in a concentration of one percent in a two-milliliter vial.
(b) A home and community support services agency or the agency's authorized employees may purchase, store, or transport dangerous drugs in a sealed portable container under this section only if the agency has established policies and procedures to ensure that:
(1) the container is handled properly with respect to storage, transportation, and temperature stability;
(2) a drug is removed from the container only on a physician's written or oral order;
(3) the administration of any drug in the container is performed in accordance with a specific treatment protocol; and
(4) the agency maintains a written record of the dates and times the container is in the possession of a registered nurse or licensed vocational nurse.
(c) A home and community support services agency or the agency's authorized employee who administers a drug listed in Subsection (a) may administer the drug only in the patient's residence under physician's orders in connection with the provision of emergency treatment or the adjustment of:
(1) parenteral drug therapy; or
(2) vaccine or tuberculin administration.
(d) If a home and community support services agency or the agency's authorized employee administers a drug listed in Subsection (a) pursuant to a physician's oral order, the physician shall promptly send a signed copy of the order to the agency, and the agency shall:
(1) not later than 24 hours after receipt of the order, reduce the order to written form and send a copy of the form to the dispensing pharmacy by mail or facsimile transmission; and
(2) not later than 20 days after receipt of the order, send a copy of the order as signed by and received from the physician to the dispensing pharmacy.
(e) A pharmacist that dispenses a sealed portable container under this section shall ensure that the container:
(1) is designed to allow access to the contents of the container only if a tamper-proof seal is broken;
(2) bears a label that lists the drugs in the container and provides notice of the container's expiration date, which is the earlier of:
(A) the date that is six months after the date on which the container is dispensed; or
(B) the earliest expiration date of any drug in the container; and
(3) remains in the pharmacy or under the control of a pharmacist, registered nurse, or licensed vocational nurse.
(f) If a home and community support services agency or the agency's authorized employee purchases, stores, or transports a sealed portable container under this section, the agency shall deliver the container to the dispensing pharmacy for verification of drug quality, quantity, integrity, and expiration dates not later than the earlier of:
(1) the seventh day after the date on which the seal on the container is broken; or
(2) the date for which notice is provided on the container label.
(g) A pharmacy that dispenses a sealed portable container under this section shall take reasonable precautionary measures to ensure that the home and community support services agency receiving the container complies with Subsection (f). On receipt of a container under Subsection (f), the pharmacy shall perform an inventory of the drugs used from the container and shall restock and reseal the container before delivering the container to the agency for reuse.