# Title 61 — State Board of Pharmacy

## Article 61-09 — Prescription Drug Inventory of Ambulance Services

## Chapter 61-09-01 — Prescription Drug Inventory of Ambulance Services

### § 61-09-01-01. Prescription drug safeguard and control policy.

Each ambulance service shall adopt a written prescription drug safeguard policy which, as a
condition precedent to obtaining prescription drugs for ambulance service purposes, at a minimum,
must include the following requirements:
1. All prescription drugs must be obtained from a North Dakota licensed pharmacy, wholesaler,
or authorized prescriber, at the request of the ambulance service's medical director or
designee. The prescription drugs must be the property of the pharmacy or medical director
and not the property of the ambulance service.
2. The initial inventory of prescription drugs must be obtained by an ambulance service only
upon the written authorization of the ambulance service's medical director who must be a
"practitioner" as defined by subsection 17 of North Dakota Century Code section 43-15-01.
3. The pharmacist-in-charge of the licensed pharmacy, a licensed pharmacist, or the medical
director must be responsible for the security and accountability of the prescription drug
inventory obtained by an ambulance service.
4. Dispensing or administration of all prescription drugs must be pursuant to a standing order,
oral instructions, or prescription of a practitioner.
5. All medications administered must be promptly documented on a patient care report, reviewed
by the ambulance service's medical director on a monthly basis either directly or indirectly
through a quality assurance process approved by the medical director.
6. Replenishment of prescription drugs must be requested by a responsible individual. If
obtained from a pharmacy, the request must be documented on an administration record
justifying the order. If obtained by, or on behalf of, the medical director, drugs must be
obtained from a North Dakota licensed pharmacy, a wholesaler, or an authorized prescriber.
7. Expired, damaged, or unused prescription drugs must be returned to the licensed pharmacy
where obtained or disposed of by the medical director or the medical director's designee,
according to a written protocol established for this purpose.
8. Lost, stolen, or misused prescription drugs must be reported to the ambulance service's
medical director or the pharmacy where they were obtained.
9. The licensed ambulance service must have a process, approved by the ambulance service's
medical director, or pharmacist-in-charge where the drugs were obtained that accounts for all
schedule II, III, and IV controlled substances, at least daily. The daily accounting of schedule II
controlled substances must balance and be documented on a daily log.

10. Controlled substances must be sealed in a double lock secure system. A record separate from
the other prescription drugs is to be kept for schedule II controlled substances. A system
approved by the ambulance service's medical director to account for the use and waste of
schedule II, III, and IV controlled substances must be used. The system must include:
a. Patient's name and address (if available);
b. Medication and strength or amount given and amount wasted (if any);
c. Date;
d. Physician's name; and
e. The signature of the individual administering the controlled substance.
11. Any unused portion of a prescription drug must be disposed of in a manner that it cannot be
collected or recovered. The disposal of all controlled substances must be witnessed and
cosigned by another person legally qualified to administer controlled substances.
History: Effective July 1, 1990; amended effective October 1, 2012.
General Authority: NDCC 28-32-02, 43-15-10(12), 43-15-10(14)
Law Implemented: NDCC 28-32-03, 43-15-10 (12), 43-15-10 (14)
### § 61-09-01-02. Requirement of pharmacy supplier of ambulance service drugs.

The pharmacist-in-charge of the licensed pharmacy or the pharmacist supplying prescription drugs
to an ambulance service, prior to supplying said drugs, shall review the written prescription drug
safeguard policy of the ambulance service to determine that all of section 61-09-01-01 requirements
are contained therein and that the ambulance service is complying with those requirements. No
prescription drugs may be supplied to an ambulance service if the requirements of section 61-09-01-01
are not contained in the written prescription drug safeguard policy or if the ambulance service is not in
compliance with these requirements.
History: Effective July 1, 1990; amended effective October 1, 2012.
General Authority: NDCC 28-32-02, 43-15-10(12), 43-15-10(14)
Law Implemented: NDCC 28-32-03, 43-15-10(12), 43-15-10(14)
