WAC Series: Part Two

WAC 246-865 020-050

The requirements for skilled nursing communities in the state of Washington concerning pharmacy services are extensive and detailed. The information for this article comes from the Washington State Legislature’s Administrative Code, otherwise known as WAC. On the legislature’s website you can review the full text of WAC 246-865, outlining the laws specific to pharmacy services for an extended care community. Today we’re going to take a close look at sections 020 through 050 of this WAC and what they mean for your community.

Pharmaceutical Services Committee

Communities are required to have a pharmaceutical services committee, which consists of the following people:A pharmacist (whether on staff or a consultant);A physician;Director of Nursing (or a designee);The administrator (or a designee).This committee oversees policy and procedure surrounding drug therapy in the community, including distribution, control and use as well as recording and reporting medication errors and adverse drug reactions. This includes developing and maintaining these policies and procedures in writing, keeping them current and ensuring adherence throughout the community.

Emergency Kits

In addition to storing all medications according to state and federal laws, communities must make available pharmaceutical services which meet current standards outlined in the Washington Administrative Code.

This WAC allows for all skilled nursing communities in the state to use an emergency kit on their premises. This kit is considered the property of the pharmacy which provides it, no matter how long it remains in the community, and the pharmaceutical services committee must determine its content with consideration to the number of residents and potential need for emergency medications. The purpose of this kit is to provide residents with necessary medications in the event of an emergency that prevents your staff from obtaining medications from your pharmacy.

Be sure to post a list of the kit’s contents near its storage space. Representatives from the board of pharmacy and the department must be able to review this list, the kit itself and any records related to the kit.

The pharmaceutical services committee is accountable for the emergency kit, its storage and its security. This committee must ensure it is locked away and only available to licensed nurses.Whenever you add or remove medications, document the change. Your pharmacy must also keep a detailed record of additions or subtractions.

Supplemental Dose Kits

Licensed communities in Washington may also maintain a supplemental dose kit, a supply of nonemergency medication to be used in case the community is not able to obtain a necessary medication from the pharmacy in time. This kit also remains the property of the supplying pharmacy. The pharmaceutical services committee is responsible for determining how much of each medication should be stored in the kit based on the number of residents and their possible need. This committee and the supplying pharmacy are ultimately responsible for the kit’s storage, security and accountability.