# COMAR Title 10 — Maryland Department of Health

## Subtitle 34 — Board of Pharmacy

### Chapter 35 — Infusion Pharmacy Services in an Alternate Site Care Environment

#### Regulation .04 Pharmacist Responsibilities.

*COMAR 10.34.35.04*

A. A pharmacist in an infusion pharmacy shall adhere to the policies and procedures set forth in Regulation .06 of this chapter.

B. A pharmacist shall:

  (1) Provide infusion therapy services in accordance with:

    (a) Orders issued by a licensed authorized prescriber of record; and

    (b) Where applicable, protocols issued by a licensed authorized prescriber of record.

  (2) Perform and document initial and ongoing assessments of the appropriateness of infusion therapy using the following information:

    (a) Patient demographics including:

      (i) Name;

      (ii) Address;

      (iii) Telephone number;

      (iv) Gender; and

      (v) Date of birth;

    (b) Emergency contact information;

    (c) Diagnoses, including:

      (i) Diagnosis being treated; and

      (ii) Concurrent conditions, including pregnancy and lactation status if applicable;

    (d) Medical history;

    (e) Allergies;

    (f) If applicable, height;

    (g) Weight;

    (h) Parenteral medication orders, including length of therapy;

    (i) Parenteral infusion access device:

      (i) Location;

      (ii) Type; and

      (iii) If available, date of placement;

    (j) Ongoing medication profile review and reconciliation at end of therapy;

    (k) First dose status;

    (l) Caregiver information including, but not limited to:

      (i) Name;

      (ii) Address;

      (iii) Phone number; and

      (iv) Relationship to patient;

    (m) If applicable, contact information for other agencies or individuals involved in the patient’s home care;

    (n) Documented applicable medical and social factors and functional limitations which may affect infusion therapy including but not limited to:

      (i) Language;

      (ii) Sight;

      (iii) Hearing;

      (iv) History of IV drug abuse;

      (v) History of drug or alcohol abuse; or

      (vi) Other physical or mental limitations; and

    (o) If applicable to therapy, baseline labs;

  (3) Create a patient care plan specific to the patient’s:

    (a) Diagnosis;

    (b) Prescribed therapy; and

    (c) Concurrent conditions;

  (4) When compounding sterile preparations, comply with COMAR 10.34.19;

  (5) If sterile compounding is outsourced, comply with COMAR 10.34.04;

  (6) As applicable, retrieve and assess lab values and other monitoring parameters;

  (7) Document in the patient chart:

    (a) New prescription orders;

    (b) Changes in prescription orders;

    (c) Information obtained from the patient or caregiver; and

    (d) Other necessary information obtained from the:

      (i) Patient;

      (ii) Caregiver;

      (iii) Infusion nurse;

      (iv) Licensed authorized prescriber of record; or

      (v) Other sources relevant to patient care;

  (8) Verify prescription label accuracy;

  (9) Communicate as appropriate, throughout the patient’s therapy with the:

    (a) Licensed authorized prescriber of record or agent of the licensed authorized prescriber of record;

    (b) Patient’s infusion nurse;

    (c) Patient; and

    (d) Caregiver; and

  (10) Review therapy-specific considerations such as pain and nutrition status.