# Title 61 — State Board of Pharmacy

## Article 61-04 — Professional Practice

## Chapter 61-04-11 — Administration of Medications and Immunizations

### § 61-04-11-01. Definitions.

For purposes of this chapter:
1. "Authorized pharmacist" means a pharmacist who has successfully completed an appropriate
study or training pertaining to the administration of drugs and maintains continuing
competency according to the standard of care.
2. "Authority" means designation on an active pharmacist license that a pharmacist is providing
administrations and has attested the pharmacist is knowledgeable about and meet the
requirements in North Dakota Century Code section 43-15-31.5 and this chapter.
3. "Qualified pharmacy technician" means a registered pharmacy technician who has
successfully completed an appropriate study or training pertaining to the administration of
injections and maintains continuing competency.
4. "Written protocol" means a standing medical order between a duly licensed practitioner and an
authorized pharmacist which contains information required by board rules.
History: Effective May 1, 2002; amended effective April 1, 2020; January 1, 2022.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-02. Qualifications established to obtain authority.

A pharmacist must attest to possessing the following qualifications in order to obtain authority from
the board:
1. Obtain and maintain a license to practice pharmacy issued by the North Dakota state board of
pharmacy;
2. Successfully complete the educational requirements set forth in North Dakota Century Code
section 43-15-31.5 according to the administrations that a pharmacist intends to perform. The
educational requirements may be obtained through the pharmacist's accreditation council for
pharmacy education accredited doctor of pharmacy program in which the pharmacist is or will
complete. Educational requirements also may be obtained through training received after
graduation and should be sufficient to ensure any intended administrations can be provided
competently to meet the standard of care;
3. Obtain and maintain current certification in cardiopulmonary resuscitation or basic cardiac life
support;

4. Complete an attestation process adopted by the board and, upon any request, provide
required documentation; and
5. Maintain continuing competency to retain the authority according to the pharmacist's standard
of care.
History: Effective May 1, 2002; amended effective April 1, 2020.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-03. Procedures to obtain certificate of authority.

Repealed effective April 1, 2020.
### § 61-04-11-04. Requirements of practitioner order for a pharmacist to administer injections.

The order must be written, received electronically or if received orally be reduced to writing, and
must contain at a minimum the:
1. Identity of the practitioner issuing the order;
2. Identity of the patient to receive the injection;
3. Identity of the medication or vaccine, and dose, to be administered; and
4. Date of the original order and the dates or schedule, if any, of each subsequent administration.
History: Effective May 1, 2002; amended effective January 1, 2005; April 1, 2020.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-05. Requirements of written protocol.

A practitioner may prepare a written protocol governing the administration of medications with an
authorized pharmacist for a specific period of time or purpose. The written protocol may be valid for a
time period not to exceed two years, subject to earlier withdrawal by the practitioner. The protocol must
contain the:
1. Identity of the participating practitioner and the pharmacist;
2. Identity of the drug which may be administered;
3. Identity of the patient or groups of patients to receive the authorized drug;
4. Identity of the authorized routes and sites of administration allowed;
5. Identity of the course of action the pharmacist shall follow in the case of reactions following
administration;
6. Recordkeeping requirements and procedures for notification of administration.
History: Effective May 1, 2002; amended effective April 1, 2020.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-06. Requirements of records and notifications.

A pharmacist administering shall meet the following recordkeeping and notification requirements:

1. Notification of administration must be made to the ordering physician or nurse practitioner and
other authorities as required by law and rule. Notification may be through inclusion of the
record in the patient's medical record or by submission to the immunization information
system.
a. When administration has occurred pursuant to an order, the pharmacist shall notify the
ordering physician or nurse practitioner within forty-eight hours of the identity of the
patient, identity of the medication or vaccine administered, route of administration site of
the administration, dose administered, and date of administration and the disposition of
any adverse events or reactions experienced by the patient.
b. When administration has occurred pursuant to a written protocol, the pharmacist shall
notify the participating physician or nurse practitioner within fourteen days of the identity
of the patient, identity of the medication or vaccine administered, site of the
administration, dose administered, and date of administration and the disposition of any
adverse events or reactions experienced by the patient.
c. In the case of immunizations and vaccinations, the pharmacist shall also provide
notification to the physician or nurse practitioner of the manufacturer and lot number of
the product administered.
2. Every record, including notification, which is required to be made under this section, must be
kept by the administering pharmacist and by the pharmacy when in legal possession of the
drugs administered for at least two years from the date of administration. Records of
administration must contain all information required in subsection 1, plus the name of the
ordering physician or nurse practitioner. Records of administration by order must be by patient
name and, in the case of administration by written protocol, records may be maintained in
roster form.
History: Effective May 1, 2002; amended effective April 1, 2020.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-07. Location of administration by injection.

Pharmacists may administer medications at any location within North Dakota or may be limited to
those specifically identified in a written protocol. The location must:
1. Ensure privacy;
2. Be maintained to promote an aseptic environment;
3. Have adequate telecommunications devices to summon aid and communicate emergency
situations; and
4. Have adequate equipment and supplies to respond to adverse events and emergency
situations.
History: Effective May 1, 2002; amended effective April 1, 2020.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-08. Policy and procedural manual.

The pharmacy shall maintain a policy and procedural manual, with a section related to the
administration of medications, in compliance with section 61-02-01-18.

History: Effective May 1, 2002; amended effective October 1, 2014; April 1, 2020.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
### § 61-04-11-09. Qualified pharmacy technician administration of medications.

An authorized pharmacist may delegate the administration of a subcutaneous or intramuscular
injectable medication to a qualified pharmacy technician given the following:
1. The medication administration has been delegated by the authorized pharmacist;
2. The authorized pharmacist is readily and immediately available to the qualified pharmacy
technician either in-person or by way of an audio and video link;
3. The qualified technician has completed a practical training program that is approved by the
board. This training program must include hands-on injection technique and the recognition
and treatment of emergency reactions;
4. The qualified technician maintains a continuing competency on injections of medications
which are expected to be performed;
5. The qualified technician has and maintains a current certification in cardiopulmonary
resuscitation or basic cardiac life support; and
6. The authorized pharmacist maintains the responsibility for all administrations that are
delegated to a qualified pharmacy technician. This involves recordkeeping, adverse event
reporting, and ensuring the pharmacy technician remains qualified.
History: Effective January 1, 2022.
General Authority: NDCC 43-15-10
Law Implemented: NDCC 43-15-10, 43-15-31.5
