Chapter 4729:2-3 | Pharmacy Intern Practices

Rule 4729:2-3-01 | Practice as a pharmacy intern.

• Effective: July 1, 2024
• Promulgated Under: 119.03

In addition to assisting a pharmacist with technical functions, a pharmacy intern may perform the following professional functions under the direct supervision of a pharmacist:

(A) The sale of schedule V controlled substances pursuant to agency 4729 of the Administrative Code.

(B) The receipt of oral prescriptions pursuant to rule 4729:5-5-10 of the Administrative Code and other applicable provisions of agency 4729 of the Administrative Code.

(C) The transfer and receipt of a non-controlled prescription copy pursuant to rule 4729:5-5-11 of the Administrative Code and other applicable provisions of agency 4729 of the Administrative Code.

(D) The act of patient counseling pursuant to rule 4729:5-5-09 of the Administrative Code and other applicable provisions of agency 4729 of the Administrative Code.

(E) The administration of immunizations pursuant to section 4729.41 of the Revised Code and agency 4729 of the Administrative Code.

(F) The documentation of informed consent to administer an immunization pursuant to section 4729.41 of the Revised Code.

(G) The dispensing of overdose reversal drug pursuant to section 3715.502 of the Revised Code and other dangerous drugs as authorized under Chapter 4729. of the Revised Code.

(H) Non-sterile compounding.

(I) Sterile compounding.

(J) Sending or receiving electronic prescriptions between pharmacies accessing the same prescription records in a centralized database or pharmacy computers linked in any other manner.

(K) Contacting a prescriber or prescriber's agent to obtain clarification for a prescription order if the clarification does not require the exercise of professional judgment.

(L) Performing diagnostic laboratory testing pursuant to agency 4729 of the Administrative Code.

(M) Requesting refill authorizations for dangerous drugs from a prescriber or the prescriber's agent.

(N) Notwithstanding the definition of direct supervision, a pharmacy intern may stock an automated drug dispensing unit and floor stock at a location licensed as a terminal distributor of dangerous drugs if a pharmacist is not physically present at the licensed location and all of the following apply:

(1) A pharmacist is readily available to answer questions of the intern;

(2) A pharmacist is responsible for conducting routine verifications of the activities of the intern to prevent the diversion of dangerous drugs;

(3) A pharmacist is fully responsible for all activities conducted by the intern at the licensed location.

Last updated July 1, 2024 at 5:18 PM

Supplemental Information

Authorized By: 4729.26, 3719.28
Amplifies: 4729.28, 4729.41
Five Year Review Date: 7/1/2029
Prior Effective Dates: 10/5/2015, 3/1/2019, 1/16/2020

Rule 4729:2-3-02 | Therapeutic diabetic shoes.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Pursuant to section 4779.02 of the Revised Code, a pharmacy intern, acting under the direct supervision of a pharmacist, may fit and measure individuals for therapeutic diabetic shoes and shoe inserts and may dispense those shoes and shoe inserts.

(B) A pharmacy intern, acting under the direct supervision of a pharmacist, shall not provide any other services that are authorized under Chapter 4779. of the Revised Code.

Last updated July 1, 2024 at 5:19 PM

Supplemental Information

Authorized By: 4729.26
Amplifies: 4779.02
Five Year Review Date: 7/1/2029
Prior Effective Dates: 10/19/2007

Rule 4729:2-3-03 | Immunization administration by pharmacy interns.

• Effective: June 1, 2023
• Promulgated Under: 119.03

(A) Pharmacy interns working under the direct supervision of a pharmacist may administer immunizations listed in paragraph (C) of this rule if an intern complies with the following:

(1) Successfully completes a course in the administration of immunizations that meets the requirements set forth in rule 4729:1-3-02 of the Administrative Code.

(2) Practices in accordance with a definitive set of treatment guidelines specified in a protocol established by a physician that complies with the requirements of rule 4729:1-3-02 of the Administrative Code.

(3) Receives and maintains certification to perform basic life-support procedures by successfully completing a basic life-support training course certified by the American red cross, American heart association or other training course approved by the board. Certification shall be obtained and maintained through courses that are conducted in-person or, at a minimum, offer an in-person or electronic hands-on training component.

(4) The supervising pharmacist has completed all of the training necessary to administer immunizations in accordance with rule 4729:1-3-02 of the Administrative Code.

(B) Failure to adhere to the standard of care for administration of an immunization shall be considered a violation of this rule and may subject a pharmacy intern to discipline in accordance with rule 4729:2-4-01 of the Administrative Code.

(C) A pharmacy intern working under the direct supervision of a pharmacist may administer the same immunizations authorized for pharmacist administration as authorized by section 4729.41 of the Revised Code and rule 4729:1-3-02 of the Administrative Code.

(D) A pharmacy intern shall obtain informed consent pursuant to rule 4729:5-5-04 of the Administrative Code to administer an immunization.

(E) A pharmacy intern shall comply with the vaccine information statement requirements of the National Vaccine Childhood Injury Act, 42 USC Section 300aa-26 (12/14/1993).

(F) For each immunization administered to an individual by a pharmacy intern, other than an immunization for influenza administered to an individual eighteen years of age or older, the pharmacy intern shall notify the individual's primary care provider or, if the individual has no primary care provider, the board of health of the health district in which the individual resides or the authority having the duties of a board of health for that district under section 3709.05 of the Revised Code. The notice shall be given not later than thirty days after the immunization is administered. Notification shall be conducted using one of the following methods that is capable of confirming delivery of the required notification:

(1) Electronic mail;

(2) Interoperable electronic medical records system;

(3) Facsimile;

(4) Electronic prescribing system;

(5) Electronic pharmacy record system;

(6) Documented verbal communication;

(7) Reporting to the state's immunization registry; or

(8) Any other method of notification that might reasonably be expected to allow for the confirmed transmission of the required notification.

(G) A pharmacy intern shall maintain the following records on file at the location(s) where the pharmacy intern administers immunizations in accordance with this rule:

(1) Proof of successful completion of a training course specified in paragraph (A)(1) of this rule; and

(2) Proof of maintenance of certification to perform basic life-support procedures in accordance with paragraph (A)(3) of this rule.

Last updated June 1, 2023 at 8:30 AM

Supplemental Information

Authorized By: 4729.26, 3719.28
Amplifies: 4729.44, 4729.41
Five Year Review Date: 12/1/2025

Rule 4729:2-3-04 | Dispensing of naloxone by pharmacy interns.

• Effective: December 1, 2020
• Promulgated Under: 119.03

(A) A pharmacy intern under the direct supervision of a pharmacist may dispense naloxone without a prescription to either of the following in accordance with an approved protocol specified in paragraph (B) of rule 4729:1-3-04 of the Administrative Code:

(1) An individual who there is reason to believe is experiencing or at risk of experiencing an opioid-related overdose;

(2) A family member, friend, or other person in a position to assist an individual who there is reason to believe is at risk of experiencing an opioid-related overdose.

(B) A pharmacy intern under the direct supervision of a pharmacist who dispenses naloxone pursuant to this rule shall instruct the individual to whom naloxone is dispensed verbally or in writing to summon emergency services as soon as practicable either before or after administering naloxone.

(C) Except as provided in paragraph (D) this rule, a pharmacy intern shall provide in-person training, unless the in-person requirement is waived by the board, and written educational materials to the individual to whom naloxone is dispensed that includes all the following:

(1) Risk factors of opioid overdose;

(2) Strategies to prevent opioid overdose;

(3) Signs of opioid overdose;

(4) Steps in responding to an overdose;

(5) Information on the naloxone dispensed;

(6) Procedures for administering the naloxone dispensed;

(7) Proper storage and expiration of the naloxone dispensed; and

(8) Information on where to obtain a referral for substance abuse treatment.

(D) Patient training as required by paragraph (C) of this rule is not required if the patient has previously received training and all the following apply:

(1) The patient is offered training and refuses;

(2) The pharmacy intern has documentation confirming training pursuant to this rule has been provided within the previous twelve months;

(3) A pharmacy intern under the direct supervision of a pharmacist who dispenses naloxone pursuant to this rule shall still instruct the individual to whom naloxone is dispensed verbally or in writing to summon emergency services as soon as practicable either before or after administering naloxone.

(E) A terminal distributor of dangerous drugs shall ensure that all pharmacy interns that dispense naloxone pursuant to this rule are trained on the use of naloxone and can meet the training requirements listed in paragraphs (B) and (C) of this rule.

Supplemental Information

Authorized By: 3719.28, 4729.26
Amplifies: 4729.44, 4729.41
Five Year Review Date: 12/1/2025

Rule 4729:2-3-05 | Pharmacy intern administration of diagnostic tests.

• Effective: January 1, 2020
• Promulgated Under: 119.03

(A) A pharmacy intern under the direct supervision of a pharmacist may administer clinical laboratory improvement amendments (CLIA) waived diagnostic laboratory testing provided the following conditions are met:

(1) The pharmacy or facility licensed as a terminal distributor of dangerous drugs is certified by the United States department of health and human services (HHS), as a clinical laboratory through the CLIA;

(2) The pharmacy or facility licensed as a terminal distributor of dangerous drugs has obtained a CLIA certificate of waiver from HHS; and

(3) The responsible person of the terminal distributor of dangerous drugs and the terminal distributor of dangerous drugs shall ensure and document that all pharmacy interns conducting CLIA waived tests pursuant to this rule receive appropriate training to conduct testing in a safe and effective manner.

(B) A pharmacy intern under the direct supervision of a pharmacist may evaluate the results of a test administered under this rule when advising a patient or a health care professional treating a patient if the test relates to the patient's drug therapy.

(C) This rule applies only to the administration and evaluation of laboratory testing by individuals licensed or registered in accordance with Chapter 4729. of the Revised Code.

Supplemental Information

Authorized By: 4729.26, 3719.28
Amplifies: 4729.44, 4729.41
Five Year Review Date: 1/1/2025

Rule 4729:2-3-06 | Dispensing of epinephrine autoinjectors by pharmacy interns.

• Effective: January 18, 2020
• Promulgated Under: 119.03

(A) A pharmacy intern under the direct supervision of a pharmacist may dispense epinephrine autoinjector without a prescription to either of the following in accordance with an approved protocol specified in paragraph (B) of rule 4729:1-3-06 of the Administrative Code:

(1) An individual who there is reason to believe is experiencing or at risk of experiencing anaphylaxis if the pharmacy affiliated with the pharmacist has a record of previously dispensing epinephrine to the individual in accordance with a prescription issued by a licensed health professional authorized to prescribe drugs;

(2) An individual acting on behalf of a qualified entity, as defined in section 3728.01 of the Revised Code.

(B)

(1) A pharmacy intern under the direct supervision of a pharmacist who dispenses an epinephrine autoinjector pursuant to this rule shall instruct the individual to whom the epinephrine autoinjector is dispensed, either verbally or in writing, to summon emergency services as soon as practicable either before or after administering epinephrine.

(2) A pharmacy intern who dispenses an epinephrine autoinjector to an individual identified in paragraph (A) of this rule shall provide notification of the dispensing to the individual's primary care provider, if known, or to the prescriber who issued the individual the initial prescription for an epinephrine autoinjector. Notification shall be conducted using one of the following methods that is capable of confirming delivery of the required notification:

(a) Electronic mail;

(b) Interoperable electronic medical records system;

(c) Facsimile;

(d) Electronic prescribing system;

(e) Electronic pharmacy record system;

(f) Documented verbal communication;

(g) Any other method of notification that might reasonably be expected to allow for the confirmed transmission of the required notification.

(C) When a pharmacy intern dispenses an epinephrine autoinjector pursuant to this rule, the pharmacy intern shall provide to the person receiving the device instruction on the proper method of administering epinephrine with the device.

(D) A terminal distributor of dangerous drugs shall ensure that all pharmacy interns that dispense epinephrine autoinjectors pursuant to this rule are trained on the use of epinephrine and can meet the training requirements listed in paragraphs (B) and (C) of this rule.

(E) This rule does not affect the authority of a pharmacy intern to contact a prescriber to obtain a new oral prescription for an epinephrine autoinjector in accordance with the applicable provisions of division 4729:5 of the Administrative Code.

Supplemental Information

Authorized By: 4729.26, 4729.47
Amplifies: 4729.47
Five Year Review Date: 1/18/2025