| (IV) the pharmacy keeps permanent records of prescriptions
electronically verified for a period of two years.
(E) All pharmacists, while on duty, shall be responsible
for the legal operation of the pharmacy and for complying with all
state and federal laws or rules governing the practice of pharmacy.
(F) A dispensing pharmacist shall be responsible for
and ensure that the drug is dispensed and delivered safely and accurately
as prescribed, unless the pharmacy's data processing system can record
the identity of each pharmacist involved in a specific portion of
the dispensing processing. If the system can track the identity of
each pharmacist involved in the dispensing process, each pharmacist
involved in the dispensing process shall be responsible for and ensure
that the portion of the process the pharmacist is performing results
in the safe and accurate dispensing and delivery of the drug as prescribed.
The dispensing process shall include, but not be limited to, drug
regimen review and verification of accurate prescription data entry,
including prescriptions placed on hold, packaging, preparation, compounding,
transferring, labeling, and performance of the final check of the
dispensed prescription. An intern has the same responsibilities described
in this subparagraph as a pharmacist but must perform his or her duties
under the supervision of a pharmacist.
(2) Duties. Duties which may only be performed by a
pharmacist are as follows:
(A) receiving oral prescription drug orders for controlled
substances and reducing these orders to writing, either manually or
electronically;
(B) interpreting prescription drug orders;
(C) selecting drug products;
(D) performing the final check of the dispensed prescription
before delivery to the patient to ensure that the prescription has
been dispensed accurately as prescribed;
(E) communicating to the patient or patient's agent
information about the prescription drug or device which in the exercise
of the pharmacist's professional judgment, the pharmacist deems significant,
as specified in §291.33(c) of this title;
(F) communicating to the patient or the patient's agent
on his or her request information concerning any prescription drugs
dispensed to the patient by the pharmacy;
(G) assuring that a reasonable effort is made to obtain,
record, and maintain patient medication records;
(H) interpreting patient medication records and performing
drug regimen reviews;
(I) performing a specific act of drug therapy management
for a patient delegated to a pharmacist by a written protocol from
a physician licensed in this state in compliance with the Medical
Practice Act;
(J) verifying that controlled substances listed on
invoices are received by clearly recording his/her initials and date
of receipt of the controlled substances; and
(K) transferring or receiving a transfer of original
prescription information for a controlled substance on behalf of a
patient.
(3) Special requirements for compounding. All pharmacists
engaged in compounding non-sterile preparations shall meet the training
requirements specified in §291.131 of this title (relating to
Pharmacies Compounding Non-Sterile Preparations).
(d) Pharmacy Technicians and Pharmacy Technician Trainees.
(1) General.
(A) All pharmacy technicians and pharmacy technician
trainees shall meet the training requirements specified in §297.6
of this title (relating to Pharmacy Technician and Pharmacy Technician
Trainee Training).
(B) Special requirements for compounding. All pharmacy
technicians and pharmacy technician trainees engaged in compounding
non-sterile preparations shall meet the training requirements specified
in §291.131 of this title.
(2) Duties.
(A) Pharmacy technicians and pharmacy technician trainees
may not perform any of the duties listed in subsection (c)(2) of this
section.
(B) A pharmacist may delegate to pharmacy technicians
and pharmacy technician trainees any nonjudgmental technical duty
associated with the preparation and distribution of prescription drugs
provided:
(i) unless otherwise provided under §291.33 of
this subchapter, a pharmacist verifies the accuracy of all acts, tasks,
and functions performed by pharmacy technicians and pharmacy technician
trainees;
(ii) pharmacy technicians and pharmacy technician trainees
are under the direct supervision of and responsible to a pharmacist;
and
(iii) only pharmacy technicians and pharmacy technician
trainees who have been properly trained on the use of an automated
pharmacy dispensing system and can demonstrate comprehensive knowledge
of the written policies and procedures for the operation of the system
may be allowed access to the system.
(C) Pharmacy technicians and pharmacy technician trainees
may perform only nonjudgmental technical duties associated with the
preparation and distribution of prescription drugs, as follows:
(i) initiating and receiving refill authorization requests;
(ii) entering prescription data into a data processing
system;
(iii) taking a stock bottle from the shelf for a prescription;
(iv) preparing and packaging prescription drug orders
(i.e., counting tablets/capsules, measuring liquids and placing them
in the prescription container);
(v) affixing prescription labels and auxiliary labels
to the prescription container;
(vi) reconstituting medications;
(vii) prepackaging and labeling prepackaged drugs;
(viii) loading bulk unlabeled drugs into an automated
dispensing system provided a pharmacist verifies that the system is
properly loaded prior to use;
(ix) loading prepackaged containers previously verified
by a pharmacist or manufacturer's unit of use packages into an automated
dispensing system in accordance with §291.33(i)(2)(D)(III) of
this subchapter;
(x) compounding non-sterile prescription drug orders;
and
(xi) compounding bulk non-sterile preparations.
(D) In addition to the duties listed above in subparagraph
(C) of this paragraph, pharmacy technicians may perform the following
nonjudgmental technical duties associated with the preparation and
distribution of prescription drugs:
(i) receiving oral prescription drug orders for dangerous
drugs and reducing these orders to writing, either manually or electronically;
(ii) transferring or receiving a transfer of original
prescription information for a dangerous drug on behalf of a patient;
and
(iii) contacting a prescriber for information regarding
an existing prescription for a dangerous drug.
(3) Ratio of on-site pharmacists to pharmacy technicians
and pharmacy technician trainees.
(A) Except as provided in subparagraph (B) of this
paragraph, the ratio of on-site pharmacists to pharmacy technicians
and pharmacy technician trainees may be 1:6, provided the pharmacist
is on-site and a maximum of three of the six are pharmacy technician
trainees. The ratio of pharmacists to pharmacy technician trainees
may not exceed 1:3.
(B) As specified in §568.006 of the Act, a Class
A pharmacy may have a ratio of on-site pharmacists to pharmacy technicians/pharmacy
technician trainees of 1:5 provided:
(i) the Class A pharmacy:
(I) dispenses no more than 20 different prescription
drugs; and
(II) does not produce sterile preparations including
intravenous or intramuscular drugs on-site; and
(ii) the following conditions are met:
(I) at least four are pharmacy technicians and not
pharmacy technician trainees; and
(II) the pharmacy has written policies and procedures
regarding the supervision of pharmacy technicians and pharmacy technician
trainees, including requirements that the pharmacy technicians and
pharmacy technician trainees included in a 1:5 ratio may be involved
only in one process at a time. For example, a technician/trainee who
is compounding non-sterile preparations or who is involved in the
preparation of prescription drug orders may not also call physicians
for authorization of refills.
(e) Identification of pharmacy personnel. All pharmacy
personnel shall be identified as follows.
(1) Pharmacy technicians. All pharmacy technicians
shall wear an identification tag or badge that bears the person's
name and identifies him or her as a pharmacy technician, or a certified
pharmacy technician, if the technician maintains current certification
with the Pharmacy Technician Certification Board or any other entity
providing an examination approved by the board.
(2) Pharmacy technician trainees. All pharmacy technician
trainees shall wear an identification tag or badge that bears the
person's name and identifies him or her as a pharmacy technician trainee.
(3) Pharmacist interns. All pharmacist interns shall
wear an identification tag or badge that bears the person's name and
identifies him or her as a pharmacist intern.
(4) Pharmacists. All pharmacists shall wear an identification
tag or badge that bears the person's name and identifies him or her
as a pharmacist.
|
| Source Note: The provisions of this §291.32 adopted to be effective September 14, 1988, 13 TexReg 4306; amended to be effective October 27, 1989, 14 TexReg 5494; amended to be effective September 5, 1990, 15 TexReg 4807; amended to be effective January 29, 1992, 17 TexReg 323; amended to be effective January 1, 1993, 17 TexReg 9116; amended to be effective September 30, 1993, 18 TexReg 6460; amended to be effective June 1, 1994, 19 TexReg 3921; amended to be effective March 21, 1996, 21 TexReg 2227; amended to be effective April 7, 1997, 22 TexReg 3106; amended to be effective September 16, 1999, 24 TexReg 7227; amended to be effective March 29, 2000, 25 TexReg 2575; amended to beeffective June 4, 2000, 25 TexReg 4778; amended to be effective August 31, 2000, 25 TexReg 8405; amended to be effective December 27, 2000, 25 TexReg 12690; amended to be effective September 12, 2001, 26 TexReg 6891; amended to be effective September 8, 2002, 27 TexReg 8214; amended to be effective June 23, 2003, 28 TexReg 4637; amended to be effective March 4, 2004, 29 TexReg 1951; amended to be effective June 6, 2004, 29 TexReg 5361; amended to be effective September 18, 2007, 32 TexReg 6319; amended to be effective September 7, 2008, 33 TexReg 7218; amended to be effective September 13, 2009, 34 TexReg 6112; amended to be effective May 30, 2010, 35 TexReg 4165; amended to be effective December 8, 2010, 35 TexReg 10690; amended to be effective September 12, 2011, 36 TexReg 5847; amended to be effective June 7, 2012, 37 TexReg 4046; amended to be effective March 17, 2013, 38 TexReg1682; amended to be effective March 26, 2014, 39 TexReg 2080; amended to be effective September 11, 2014, 39 TexReg 7094; amended to be effective December 6, 2015, 40 TexReg 8766; amended to be effective September 6, 2017, 42 TexReg 4466; amended to be effective September 16, 2018, 43 TexReg 5783; amended to be effective June 20, 2019, 44 TexReg 2946; amended to be effective December 10, 2020, 45 TexReg 8851 |
