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Prepare for potential late-night access changes now

Pharmacy Regulation Resource, December 21, 2005

By this time next year, hospitals may need to have new procedures in place for after-hours medication access if the pharmacy closes at night, JCAHO observers say.

The JCAHO in December 2004 proposed to change standard MM.4.50 to restrict to a limited area outside the main pharmacy access to medications if the pharmacy closes at night and on the weekend.

Only authorized staff would be able to access the night medications, according to the proposed revision.

The commission has been reviewing comments on the proposal, and some expect it will become official sooner rather than later.

"I fully expect the Joint Commission in the near future to say medications must be outside the pharmacy and locked," says Patricia Kienle, MPA, FASHP, operations director for Cardinal Health in Houston. "We need to keep our eyes on this one."

Kienle says she anticipates the JCAHO to make the requirement official by 2007 or 2008.

Hospitals should start preparing now for any potential JCAHO mandate, says John Uselton, BSPharm, vice president of operations improvement for Cardinal. Hospitals should start eliminating after-hours access to the main pharmacy, restricting it to a night cabinet outside the main pharmacy, he says.

If nurses are allowed to enter the pharmacy after it closes, be sure to prove their competencies to handle and review medications, Uselton says. Hospitals should have a pharmacist on call to handle any questions.

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