Within a Hospital or free-standing Emergency Department setting, the medical staff may approve guidelines that are clinically accepted as the standard of care, or are approved by the Medical Staff of the hospital through the typical approval process (such as the Pharmacy and Therapeutics Committee), which allow pharmacists to change, discontinue, adjust, monitor, order pertinent labs, and make subsequent adjustments to medications as applicable to the approved guideline without requiring a physician order to implement the guideline.  In addition, a practitioner may write an order for \"pharmacy to dose" a medication which allows the pharmacist to dose, monitor, order pertinent labs, and make subsequent adjustments to any medication specified in the order based on the pharmacist's clinical judgment.

In accordance with Virginia law, the petition has been filed with the Register of Regulations and will be published on January 25, 2016.  Comment on the petition may be sent by email, regular mail or posted on the Virginia Regulatory Townhall at www.townhall.virginia.gov; comment will be requested until February 24, 2016.  Following receipt of all comments on the petition to amend regulations, the Board will decide whether to make any changes to the regulatory language in Regulations Governing the Practice of Pharmacy.  It will also be reviewed by the Assistant Attorney General who can advise the Board on whether the request requires a change in the Code of Virginia. This matter will be on the Board's agenda for its meeting scheduled for March 25, 2016.

Take no action

At its meeting on March 25th, the Board considered the petition; there were no public comments received in support or in opposition.  Following a lengthy discussion, the Board concluded that it needed additional information and research and some legal advice from its board counsel.  For that purpose, the petition was denied, but the matter was referred to the Regulation Committee of the Board for further consideration.  While the Board does not intend to initiate rulemaking at this time, the Committee will further review the issue which will include a discussion of the statute relating to collaborative practice.