{"id":508,"date":"2023-10-06T13:14:48","date_gmt":"2023-10-06T20:14:48","guid":{"rendered":"https:\/\/www.cdcr.ca.gov\/hcdom\/?post_type=dom&#038;p=508"},"modified":"2024-07-30T12:27:46","modified_gmt":"2024-07-30T19:27:46","slug":"3-3-5-12-pharmaceuticals","status":"publish","type":"dom","link":"https:\/\/www.cdcr.ca.gov\/hcdom\/dom\/chapter-3-health-care-operations\/article-3-dental-care-5-dental-clinic-operations\/3-3-5-12-pharmaceuticals\/","title":{"rendered":"3.3.5.12 Pharmaceuticals"},"content":{"rendered":"\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p><strong>Policy<\/strong><\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p>The California Department of Corrections and Rehabilitation (CDCR), Adult Correctional Dental Care shall ensure that dental pharmaceuticals are prescribed in accordance with all applicable state and federal regulations and that CDCR policies and procedures regarding prescribing, dispensing, administering and procuring pharmaceuticals are followed. CDCR dental clinics shall maintain a supply of prescription medication as dental stock medications for situations where the dentist determines an immediate dose is necessary.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p><strong>Purpose<\/strong><\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p>To establish procedures for providing medications to dental patients in a safe and timely manner.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p><strong>Procedure<\/strong><\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>General Pharmaceutical Procedures<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Each practitioner must have their own Drug Enforcement Administration Controlled Substance Registration Certificate to write prescriptions for medication. (Reference the Health Care Department Operations Manual [HCDOM], Section 3.5.8, Prescription\/Order Requirements and Medication Availability).\u00a0<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Registered Dental Hygienist, (registered) Dental Assistants and dental laboratory technicians shall not administer nor dispense prescribed dental medications to patients unless expressly permitted by the Dental Board of California.\u00a0<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Dentists shall only prescribe medications listed in the CDCR Drug Formulary, unless otherwise provided for by the non-formulary justification process. (Reference the HCDOM, Section 3.5.5, CCHCS Drug Formulary).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Requirements for Prescriptions and Orders<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>All dental prescriptions or orders shall:<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Be placed by a dentist utilizing the Computerized Provider Order Entry (CPOE) method in the Electronic Health Record System (EHRS).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Contain all required elements and conditions outlined in the HCDOM, Section 3.5.8, Prescription\/Order Requirements and Medication Availability.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Be documented in a clinical note in the Electronic Dental Record System (EDRS), in accordance with EDRS Workflow 1-2 and associated Back Office Job Aid, and as outlined in the HCDOM, Section 3.3.6.1(c)(1)(F) through (H) and shall include the fact that applicable education\/counseling regarding the medication(s) was given.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Be managed in accordance with the HCDOM, Section 3.3.6.1(c)(2)(B).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Telephone or verbal orders shall be signed or electronically authorized via CPOE as described in the HCDOM, Section 3.3.5.10(c)(1)(B) and (c)(2). (Reference the HCDOM, Section 3.5.8, Prescription\/Order Requirements and Medication Availability).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Dental Stock Medications<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Only the following prescription medications may be provided by the pharmacy to the licensed correctional clinics to be stored and used for treatment of dental patients with urgent\/emergent conditions:<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Amoxicillin 500 mg #21\u00a0\u00a0\u00a0\u00a0 [Seven day supply].<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Amoxicillin 500 mg #4\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 [One dose pre-med supply].<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Azithromycin 250 mg #6\u00a0\u00a0\u00a0 [Five day supply].<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Azithromycin 250 mg #2\u00a0\u00a0\u00a0 [One dose pre-med supply].<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Ibuprofen 400 mg #30\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 [Ten day supply].<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Acetaminophen 325 mg #30\u00a0\u00a0\u00a0\u00a0\u00a0 [Ten day supply].<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>The SD or dentist designee shall order dental dispensing stock medication specified in Section (c)(3)(A) by placing an order for the medication(s) using the Requisition Tab in PowerChart.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Storage, Inspections and Par Levels<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>The SD or designee shall ensure that all medications stored in the dental clinics are in a secure location and under appropriate storage conditions in accordance with the HCDOM, Section 3.5.16, Medication Inventory Management, Labeling, and Storage. The Pharmacist-in-Charge (PIC) shall ensure that medications stored in dental clinics are inspected monthly.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>The SD and the PIC shall be responsible for determining appropriate par levels of medications issued for use by dentists within the dental clinics.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Reporting Medication Issues from Dental Dispensing<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p>Medication issues related to the function of dispensing dentists shall be reported to the SD at the institution, the appropriate Regional Dental Director, and the Statewide Chief of Pharmacy Services.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>EHRS Downtime Process<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p>If the EHRS is not available when the dentist needs to order and\/or administer a medication, the dentist shall follow the current EHRS downtime process.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Dental Dispensing Requirements<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>A CDCR dentist may act as a dispensing dentist and when doing so shall assume all the requirements and responsibilities of a dispenser of medications in accordance with California Business and Professions Code, Section 4170. When acting as a dispensing dentist, the dentist shall:<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Perform a safety assessment including patient allergy, medication history, and contraindications to confirm that the medication they intend to prescribe is appropriate. The assessment shall be completed by reviewing the patient\u2019s health record and current medication profile.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Place an order for the medication(s) in PowerChart using only the medication orders that have the DENTAL STOCK MED suffix (e.g., Ibuprofen [DENTAL STOCK MED]).\u00a0 DENTAL STOCK MED orders within PowerChart are configured to auto-verify and thereby support administration of medication from dental stock.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Not select another medication order, besides the DENTAL STOCK MED, or the dentist will not be able to chart administration within PowerChart until the medication is verified by the pharmacy.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Ensure that the pharmacy has affixed a label that complies with California Business and Professions Code Section 4076 to the medication package being dispensed to the patient. The dentist or designee shall enter the patient\u2019s name, CDCR number, the date of dispensing, as well as the dentist\u2019s name and clinic designation as the dispensing entity.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Personally dispense required medication(s) in an appropriate package and with a legal label as defined in Section (c)(4)(A)4. Dispensing the medication cannot be delegated to any other dental staff.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Comply with Section (c)(2)(A)3.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>When dispensing dental stock medications to a patient, the dentist shall:<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Chart the administration of the medication within PowerChart via barcode scanning.\u00a0 In cases of barcode equipment failure, the dentist may chart medication administration within PowerChart via the non-scanning process.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Ensure that the medication administered is documented by dental staff on a CDCR 7438, Dental Pharmaceutical Record Log. The SD shall maintain completed Dental Pharmaceutical Record Logs for a period of three years.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Medication Availability (Reference the HCDOM, Section 3.5.8, Prescription\/Order Requirements and Medication Availability).<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Non-urgent new medication orders received by the pharmacy during normal business hours shall be available to the patient no later than three business days later, unless otherwise ordered by the dentist (e.g., the order specifies the medication is to start today).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Dentists shall inform patients that medications ordered today can be picked up at the medication line in three business days unless deemed more urgent by the prescriber. (Reference the HCDOM, Section 3.5.8, Prescription\/Order Requirements and Medication Availability).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>For situations where a patient is housed as an inpatient, is receiving care in the Triage and Treatment Area (TTA), or is in an urgent\/emergent treatment area, dentists shall follow the local institution STAT process to obtain single doses of prescription medication for administration in emergency situations. Dentists shall not order STAT medications in the outpatient clinic setting. (Reference the HCDOM, Section 3.5.8, Prescription\/Order Requirements and Medication Availability).<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>In situations where the dentist determines an immediate dose is necessary and doses of the medication are not available in the dental clinic, the dentist shall order the medication(s) in PowerChart and immediately alert pharmacy or TTA staff of the urgency of the order to allow:<\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>Pharmacy staff to dispense the medication dose during their normal operating hours.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block\">\n\t\t\t\t\t<p>The medication to be obtained from the TTA\u2019s after-hours medication supply outside of normal pharmacy operating hours.<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p><strong>References<\/strong><\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block is-style-bullet\">\n\t\t\t\t\t<p>Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.5.10, Direct Orders (Medical\/Dental)<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-bullet\">\n\t\t\t\t\t<p>Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.6.1, Health Records Organization and Maintenance<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-bullet\">\n\t\t\t\t\t<p>Health Care Department Operations Manual, Chapter 3, Article 5, Section 3.5.5, CCHCS Drug Formulary<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-bullet\">\n\t\t\t\t\t<p>Health Care Department Operations Manual, Chapter 3, Article 5, Section 3.5.8, Prescription\/Order Requirements and Medication Availability<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-bullet\">\n\t\t\t\t\t<p>Health Care Department Operations Manual, Chapter 3, Article 5, Section 3.5.16, Medication Inventory Management, Labeling, and Storage<\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p><strong>Revision History<\/strong><\/p>\n\t\t\t\t\n\t<ul class=\"cdcr-dom-group-block\">\n\t\t\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p>Effective: 04\/2006<br>Revised: 11\/2017, 11\/2020, 02\/2022<\/p>\n\t\t\t\t\t<\/li>\n\t\n\n\t<li class=\"cdcr-dom-item-block is-style-no-marker\">\n\t\t\t\t\t<p><\/p>\n\t\t\t\t\t<\/li>\n\t\n\t<\/ul>\n\t\n\t<\/li>\n\t\n\t<\/ul>\n\t","protected":false},"parent":466,"template":"","class_list":["post-508","dom","type-dom","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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