University of Georgia Athletic Association
Prescription Drug Program Policies and Procedures
Index
Section One:
Policy Statements
Section Two:
Procedure
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Administrative Documents
Maintenance of Incoming Prescription Medications
Storage of Prescription Medications
Portable Medical Treatment Kits
Therapeutic Dose Packs
Dispensing Prescription Medications
Record Keeping of Prescription Medications
Electronic Management of Prescription Medications
Manufacture Sample Medications
A.
Acquisition
B.
Disposition
C.
Storage
D.
Dispensation
E.
Electronic Assistance
F.
Receipt forms
Advisory Committee
Prescription Tracking and Reporting Software
Destruction and Disposal or Expired Medications
Section Three:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
Appendix
Prescription Drug Formulary
Team Physician DEA Certificates
Team Pharmacy FDA Manufacture license
Team Pharmacy Retail Pharmacy and DEA licensure
Staff Athletic Trainer certificates and licenses
Agent of Record Statement
Student Athlete to Staff Athletic Trainer Agency Statement
Team Physician to Team Pharmacy Authorization Statement
Non Child Safety Resistant Notice
Manufacturer Sample Medication Receipt Log
Banyan Stat Kit Contents
Unsecured Medication Exception List
Transdermal Medications
State and Federal Regulatory Reference
PTP Software Guide
1
University of Georgia Athletic Association
Prescription Drug Program Policies and Procedures
9/18/01
Prescription Drug Program Policy/Procedure
1.
The Prescription Drug Program exists to;
a. Assist the University of Georgia Athletic Association (UGAA) in continuing to
ensure the best possible medical care for all student athletes.
b. Enable team physicians to dispense and administer prescription medications to
UGAA student athletes for sport-related injuries and common illnesses at the
time of examination during daily physician clinic, sporting events or otherwise.
c. Allow the UGAA student athlete the convenience of receiving prescription
medications at the time of physician diagnosis to expedite treatment and
rehabilitation.
d. Ensure compliance is met in the areas of ordering, receipt, storage,
transportation, dispensing, administration, disposal, and record keeping
according to federal and state law, and guidelines established by the NCAA and
NATA. Compliance, as it relates to the management of prescription
medications, is critical to the health, well-being and integrity of the UGAA
student athlete, team physicians, team pharmacist, staff athletic trainers and the
University of Georgia.
e. Establish written procedures to define roles of responsibility, and the methods by
which prescription drugs are ordered, received, stored, dispensed, administered,
disposed and recorded.
2.
A Prescription Drug Formulary will determine which medications are stored in the
athletic training facility medical offices to treat the UGAA student athletes. The design
of the Prescription Drug Formulary is the responsibility of team physicians, team
pharmacist, and head athletic trainer. Non-formulary medications must be authorized the
team physicians prior to being prescribed or dispensed and may be the financial
responsibility of the UGAA student athlete. Refer to Appendix A for Prescription Drug
Formulary.
3.
All team physicians must be licensed to practice medicine in the State of Georgia, and
must be currently registered with the DEA. The head team physician, primary care and
orthopedic team physicians must have additional DEA Certificates listing the physical
address of the UGAA Athletic Training Facility Medical Offices. Refer to Appendix B
for copy of DEA Certificate.
4.
The team pharmacist and team pharmacy must be licensed by the Board of Pharmacy in
the State of Georgia and also maintain a current license as a FDA re-packager of drugs.
Refer to Appendix C and D for copies of FDA Drug Manufacturer License and California
State Board of Pharmacy Retail License..
5.
All staff athletic trainers must be certified by the NATABOC and licensed by the Georgia
Board of Athletic Trainers, and may assist the team physician as medical staff assistants
under written protocol and signed agency statements, with ordering, receipt, storage,
2
disposal and record keeping of prescription drugs. Refer to Appendix E for copy of
Authorized Athletic Staff Certificates and F for signed agency statements.
6.
The Head Team Physician shall hold primary responsibility for the “Prescription Drug
Program.” Secondary responsibility shall lie with the assistant team physicians and staff
athletic trainers acting under delegated authority and protocol. The sports medicine team
shall work together to ensure compliance through continuity of communcation.
Prescription Drug Program Procedure
1.
Administrative Documents
a. The head team physician must have current DEA Certificates listing the
exact physical address of the UGAA athletic training facility medical offices.
The ongoing costs of the certificate will be the financial responsibility of the
UGAA. The current DEA Certificate will be displayed in the UGAA athletic
training facility medical offices at all times and a copy will be kept on file at
the team pharmacy. See Appendix B for copy of DEA Certificate.
b. All team physicians will sign an Agent of Record Statement authorizing
certain staff athletic trainers as staff medical assistants to assist with
prescription medication medical treatment protocols. This agency will
specifically authorize the staff athletic trainers to assist the team physicians
with ordering, receipt, storage, disposal, and record keeping of prescription
drugs. The Agent of Record Statement will be readily retrievable, renewed
and resigned each academic year. A copy of the agency statement will be
kept on file at the team pharmacy. An authorized agent cannot delegate his
or her responsibilities to any other person for any reason whatsoever. See
Appendix F for actual copy of Agent of Record Statement.
c. Each academic year, all student athletes who wish to participate in the
Prescription Drug Program, shall give written permission to the authorized
staff athletic trainers to act as their agent when forwarding a prescription
request by their team or personal physician to the team pharmacy, when
calling the team pharmacy to request a refill of a previously prescribed
medication, receiving, storing, transporting and securing prescription
medications prescribed for them on their behalf. See Appendix G for actual
copy of Student Athlete to Staff Athletic Trainer Agency Statement.
d. The head team physician and assistant team physicians will sign a pharmacy
authorization statement for authorized staff athletic trainers giving
permission to forward prescription medication requests and call the team
pharmacy to restock formulary drugs according to their direction and
established protocols. This statement shall be renewed and signed each
academic year. A copy of the statement shall be maintained on file at the
team pharmacy. See Appendix H for actual copy of Pharmacy
Authorization.
2.
Maintenance of Incoming Prescription Medications
a.
The authorized staff athletic trainers under direction and protocol of their
team physicians shall forward new and refill prescription requests from
the team physician as well as call the team pharmacy to replenish
formulary medication stock as needed. Upon receipt of the medications
at the licensed athletic medical office, the authorized staff athletic
trainers will confirm the accuracy of the contents by checking items
against the delivery slip. The signed and dated delivery slip shall be
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3.
4.
properly filed and readily retrievable. The medications shall then be
stored and secured. Any discrepancies shall be immediately reported to
the team pharmacist for evaluation and correction if necessary.
b.
The inventory shall be maintained electronically and a record shall be
kept as to date, time and authorized staff athletic trainer recording said
prescription medication inventory. A report of said inventory shall be
readily retrievable at all times.
c.
All medications shall be stored and secured properly within the
designated confines of the UGAA athletic training facility medical
offices. Medications that are delivered in the absence of the authorized
staff athletic trainers, shall be duly signed for by the staff athletic trainer
on duty whom shall take the unopened package and place it into a
secured and locked cabinet. A note will be placed on the desk of the
authorized staff athletic trainer stating that the package was received and
its location within the cabinet. Upon arrival of the authorized staff
athletic trainer the package will be properly inventoried according to the
above procedures.
Storage of Prescription Medications
All prescription medications will be stored in a locked cabinet, or a locked
portable medical treatment kit. The medical cabinet will have a labeled section
for each specific medication received when stocking or restocking. Manufacturer
samples and controlled substances shall be separately locked and secured. When
the medical office is not in use for clinic, the office door is locked as well as the
cabinets where medications are stored. All locked and secured portable medical
treatment kits will be stored in a locked cabinet within the medical office.
Portable Medical Treatment Kits
The portable medical treatment kits are used to store prescription medications
when an authorized UGAA athletic team is traveling, practicing, competing at
home or in some other designated location or event as determined necessary by
the team physician. The kit is stocked as to the needs of that particular team or
practice. A kit is in use only in the presence of the team physician. The kit shall
remain locked when not in use by the team physician and shall be duly returned
to the cabinet in the UGAA athletic training room medical office. All
medications dispensed or administered shall be electronically recorded according
to protocol.
5. Banyan Stat Kit
A Banyan Stat Kit will be stored in the medical office. The main purpose of the
Stat Kit is to provide 30 minutes of care in emergency situations – to sustain life
during the critical, early stages, until transportation to the hospital is available.
Due to the emergency nature of the Banyan kit, it will not be locked but will be
secured with a tamper resistant security tag. See Appendix I for copy of Banyan
Stat Kit Contents.
6. Therapeutic Dose Packs
a. Prescription medications are pre-packaged in therapeutic dose packs.
Therapeutic dose packs are required for the following reasons: easy
identification of the pills by visual inspection, easy identification of theft or
loss of pills, eases the process of accounting and reconciliation without the
need to open the package to count the number of pills remaining and allows
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for optimal administration of unit dose or full therapeutic dose, depending
upon the needs of the physician. All blister packages are labeled according
to FDA guidelines and National Association of Boards of Pharmacy
guidelines. Therapeutic dose packs have not been proven to be child
resistant and appropriate warnings are given to the student-athlete upon
receipt of the medication. In addition, a sign posted in the medical office
shall so state that the therapeutic dose packs are non-child resistant.
Authorized staff athletic trainers will have controlled access to the key to the
athletic medical office and medical cabinet to assist the physician(s) during
clinic or after contests, which may occur on weekends or late evenings. See
appendix I for a copy of the notice.
b. All prescription medications stored in the medical office will be properly
labeled with: name, strength, quantity, expiration date, name of team
physician, and name of manufacturer. In some cases manufacturer suggested
uses or team physician requested uses shall appear on the prescription label.
7.
Dispensing Prescription Medications
a. Only a licensed team physician or licensed pharmacist may dispense
prescription medications. Dispensing prescription medications cannot be
delegated to an athletic trainer; it is beyond their scope of practice. Staff
athletic trainers may only assist the team physician non-discretionary tasks as
outlined in the prescription drug program.
b. Whenever a prescription medication is dispensed or administered, a SOAP
note must be written and signed by the physician. In addition, each
dispensation or administration shall be recorded electronically as to the name
of the athlete, the name of the prescribing physician, the name, strength, and
quantity of the medication, the affected body part, the initials of the
recording medical assistant and the date and time of the activity.
c.
The name or identifying number or code for the athlete and the date of
service shall be written on the pack prior to dispensing. Directions shall be
communicated either through protocol, suggested use or specific instructions.
There will also be available an information medication usage leaflet for the
athlete available upon request or upon instructions of the physician.
d. When the athlete’s medication is dispensed by the team pharmacy, the order
may be forwarded on behalf of the team physician by the medical staff
assistant. The properly dispensed medication shall be delivered by private
carrier to the university athletic medical office in an expedient manner.
8.
Record Keeping of Prescription Medications
a. All prescription medications received, dispensed and/or administered will be
electronically recorded into the audit reconciliation inventory software
program by the properly authorized staff athletic trainers.
b. After the prescription medication is dispensed or administered, a SOAP note
describing the examination will be signed by the treating team physician and
all pertinent information will be stored electronically.
5
c.
Audit and Reconciliation inventory reports of all prescription drugs will be
conducted quarterly to ensure accuracy of inventory and compliance. The
quarterly report shall be signed by the team physician, filed and readily
retrievable.
d. Annual audit and reconciliation’s of all relabeled and repackaged therapeutic
dose packs, manufacturer samples and controlled substances shall recorded
and signed by the team physician and the medical assistant helping with the
recording of the audit. Each audit shall be maintained separately and be
readily retrievable.
e.
9.
An annual end of season booklet will be provided by the team pharmacy.
This booklet shall contain records of all prescription medication dispensed,
administered, returned and received by the university athletic medical office.
This booklet shall be maintained on file for a period of three years according
to federal law.
Electronic Management of Prescription Medications
a. Each therapeutic dose pack and/ or manufacturer re-labeled package of
prescription medications shall contain a unique and separate bar-code
identifier.
b. Each UGAA student-athlete and other athletic department personnel
designated by the team physicians shall be assigned a unique bar-code
identifier specific to their name.
c. Each prescribing and dispensing team physician shall be assigned a unique
bar code identifying number.
d. Each authorized medical staff assistant shall be assigned a unique bar code
identifying number.
e. As medications are received into the prescription drug inventory, a portable
hand held scanner shall scan the bar code on the medication package. The
scanner shall track the date, time, name of medication, strength, dosage form,
quantity, lot number and electronic initials of the team physician and the
authorized staff athletic trainer.
f. As medications are dispensed or administered by the team physician, the
package shall be scanned, as well as the unique bar code for the recipient of
the medication. By linking this information together all records shall be kept
intact.
g. After the scanner is uploaded into the prescription drug software program,
reports are generated as to usage, date, body part, physician and type of
medication. These reports will be given to the appropriate team physicians
weekly for their perusal and signature. A copy shall be maintained and
readily retrievable in the university athletic medical office.
h. A reconciliation audit shall be performed annually by comparing the
remaining physical inventory against the computer inventory report
produced by the software program, any discrepancies shall be discussed with
the team pharmacist and/ or the team physician.
i. Any large discrepancies, losses, or theft shall be reported immediately to the
proper State and Federal Licensing Agencies according to regulations.
6
10.
Sample Medication
a. Manufacturer sample medications shall be maintained in the university
athletic medical office. Sample medications will be inventoried, audited,
stored, dispensed and administered in the same fashion as the therapeutic
dose packs.
b. Sample medications can be shipped and received directly at the university
athletic medical office if requested in writing by the team physician for such
delivery.
c. Sample medications can be personally delivered by the drug manufacturer
representative to the athletic medical office. A receipt for such delivery shall
be signed for by the team physician. See Appendix K.
d. Sample medications may be transferred personally by the team physician. In
this case a receipt is generated listing the physical address of where the
samples originated, the name, strength, lot number, expiration dates and
quantities. This receipt must be signed by the team physician.
e. After sample medications are received a bar code identifier is affixed to the
sample package in a way that will not alter or hide information necessary for
the dispensation of the medication to the athlete.
f.
The sample medication shall be electronically scanned (as an s-medication
name) into the inventory software and then placed on a labeled shelf in a
separately locked cabinet from all other therapeutic dose packs and nonmanufacturer sample packages.
g. When a team physician dispenses a sample medication, the package shall be
scanned out to the athlete according to procedure for recording the
dispensation of prescription medications.
h. An annual audit and reconciliation of all samples received into and dispensed
out of the university athletic medical office shall be generated and signed by
the head team physician.
10.
Destruction and Return of Expired and Un-useable Medications to Team Pharmacy
a. When medications have expired, the authorized athletic medical trainer shall
separate these medications from all others. Then the medications shall be
electronically scanned as “Returned to Pharmacy”. The date of the return, the
medical staff person doing the inventory control and the name of the physician
shall be duly recorded.
b. The medications shall be placed in a box with a report listing all of the
medications to be returned. The box shall be sealed and shipped directly back to
the team pharmacy. The box shall be shipped by traceable private carrier.
c. Medications shall not be destroyed in the medical office.
7
d. Expired Over The Counter medications shall be disposed of in biohazard waste
containers or boxed and shipped to the team pharmacy for destruction and
disposal.
11.
Advisory Committee
An advisory committee consisting of at least the head team physician, team pharmacist,
and head athletic trainer shall meet annually to assess compliance, review formulary, and
make recommendations to improve the program.
12.
Record Keeping of Prescription Medications
a. All prescription medications received will be electronically recorded into the
inventory software program by the properly authorized staff athletic trainers.
b. All prescription medications stored in the locked medical cabinet will be
properly labeled with; name of drug, strength of drug, quantity, expiration
date, name of prescribing physician, and name of manufacturer. Upon
dispensing, the student-athlete’s name and the date of issue will be written on
the label.
c. At the time the prescription medication is dispensed, the student athlete
should have a SOAP note describing the examination signed by the team
physician and all pertinent information will be electronically recorded.
d. Prescription Drug Audits will be conducted quarterly to ensure accuracy of
inventory and compliance.
e. An annual reconciliation report will be provided by the team pharmacist and
will be kept on file for a minimum of seven years according to federal law.
13.
Electronic Record Keeping of Prescription Medications
a.
Each prescription medication package shall contain a unique and
separate bar-code identifier.
b.
Each UGAA Student Athlete and other personnel designated by the team
physicians shall be assigned a unique bar-code identifier specific to their
name.
c.
As medications are received into the Prescription Drug Inventory, a
portable hand held scanner shall scan the package. The scanner shall
track the date, time, name of medication, strength, dosage form, quantity,
lot number and electronic initials of the team physician and the
authorized staff athletic trainer.
d.
As medications are dispensed or administered by the team physician, the
package shall be scanned as well as the unique bar code for the recipient
of the medication. By linking this information together all records shall
be kept intact.
e.
After the scanner is uploaded into the Prescription Drug Software
Program, reports will be generated as to usage by player, date, physician
and type of medication. These reports will be given to the appropriate
team physicians weekly for their perusal and a copy shall be maintained
and readily retrievable in the Medical Office.
f.
A reconciliation audit shall be performed annually by comparing the
physical inventory against the inventory management produced by the
software program, any discrepancies shall be immediately reported to the
team physician.
8
14.
Sample Medication
A separate electronic record keeping system known as Patient Sample Program (PSP™)
shall be utilized to track samples as they pertain to physician dispensing according to
JACHO guidelines. All samples brought into the athletic medical office shall be duly
recorded as to the name of the drug representative or physician bringing in such
medications. All samples shall be stored separately from other medications in a locked
cabinet within the athletic medical office. All samples dispensed by the physician shall
be recorded as to which athlete received the medication, the quantity, lot number, date
and the initials of the medical assistant (ATC) assisting the physician with the record
keeping process. There shall be a separate and distinct sample drug audit and annual
reconciliation report. All expired samples shall be recorded and given to the team
pharmacy for proper destruction.
15.
Advisory Committee
An advisory committee consisting of head team physician, team pharmacist, and head
athletic trainer shall meet annually to assess compliance, review formulary, and make
recommendations to improve the program.
16.
Electronic Prescription Software Program – At this time UGAA chooses to utilize the
Physician – Trainer – Pharmacist PTP™. The PTP™ is used extensively throughout the
United States and Canada for Professional Sports Teams and Universities. PTP™ has
been on the market for the last seven years and has developed the reputation as the first
and only prescription drug software program for the athletic training medical office.
9
Appendix A Prescription Drug Formulary 2001-02
10
Appendix B Copy of Team Physician DEA Certificates
11
Appendix C Copy of Team Pharmacy FDA Manufacture License
12
Appendix D Copy of Team Pharmacy Retail Pharmacy and DEA License
13
Appendix E Copy of Staff Athletic Trainer NATABOC Certifications
Copy of Staff Athletic Trainer Georgia Athletic Training Licenses
Copy of Staff Athletic Trainer NREMT Certificates (as applicable)
Copy of Staff Athletic Trainer Georgia Emergency Medical Technician licenses
14
Appendix F
Agent of Record Agency Statement
Date: 7-26-01
University of Georgia Athletic Association
Butts-Mehre Hall
1 Selig Circle
Athens, Georgia 30603-1472
(706) 542-9060 or –7900
Stegeman Coliseum
100 Smith Street
Athens, Georgia 30603-1472
(706) 542-6521 or -7885
Team Physician’s
Ron Elliott, MD (GA 27372)
Natalie Russo, MD (GA 29772)
John Dorris, MD (GA 040899)
Robert Hancock, MD (GA 040090)
Mixon Robinson, MD (GA 018726 )
Head Team Physician
Team Physician
Orthopedic Team Physician
Orthopedic Team Physician
Orthopedic Team Physician
DEA # AE8827531
DEA # BR0107145
DEA # BD5559793
DEA # BH3040223
DEA # AR1001332
Do hereby grant the following agency to the athletic training staff members listed below:
Athletic Trainers
Ron Courson, ATC, PT, NREMT-I
Steve Bryant, ATC
Mike Clanton, ATC, NREMT-I
Mike Dillon, ATC, NREMT-I
Anna Ferguson, ATC
Lisa Irby, ATC, NREMT-I
Rebecca Klinger, ATC, NREMT-I
Lenny Navitskis, ATC, NREMT-I
Harris Patel, ATC
Jeff Tanner, ATC, NREMT-I
Head Athletic Trainer
Associate Athletic Trainer
Associate Athletic Trainer
Associate Athletic Trainer
Assistant Athletic Trainer
Assistant Athletic Trainer
Assistant Athletic Trainer
Assistant Athletic Trainer
Assistant Athletic Trainer
Assistant Athletic Trainer
“I authorize the above listed members of my athletic medical staff to act as my agents under my
supervision and guidance to assist me with medical care and treatment of my patients for the
UGA Department of Athletic Medicine. This agency is limited to my specific needs and may
include among other things; forwarding a prescription request for dangerous drugs or controlled
substances on my behalf, calling the pharmacy to restock medication upon my instruction and
protocols, signing as the recipient for medication deliveries, storage, inventory control, record
keeping, disposal, delivery and transportation of medical supplies and medications to and from
my athletic medical office.”
Signature of Team Physicians
15
Appendix G
Student Athlete to Staff Athletic Trainer Agency Statement
I authorize my athletic trainer as my agent to procure, store, and administer any medications,
which are prescribed for me by my physician. My signature below authorizes the above
statement.
Name
Signature
SS #
DOB
16
Appendix H
HOMELINK NATIONAL PHARMACY
381 VAN NESS AVE., SUITE 1507
TORRANCE, CA 90507
1.800.272.4767
1.800.346.5436 FAX
Team Physician to Team Pharmacist Authorization Statement
University of Georgia Athletic Association
Butts-Mehre Hall
1 Selig Circle
Athens, Georgia 30603-1472
(706) 542-9060 or –7900
Stegeman Coliseum
100 Smith Street
Athens, Georgia 30603-1472
(706) 542-6521 or -7885
Ron Elliott, MD
Head Team Physician
State License Number-GA 27372
Natalie Russo, MD Team Physician
State License Number-GA 29772
Authorized medical staff:
Ron Courson, ATC, PT, NREMT-I Head Athletic Trainer
Steve Bryant, ATC
Associate Athletic Trainer
By signature below, I authorize Homelink National Pharmacy to accept valid,
prescription requests forwarded by me through my authorized athletic medical staff under
my supervision, direction and protocol, these requests may be for individual patients or
general stock. Please ship all medication orders to the athletic medical office listed
above. I request all dangerous drugs to be packaged in non-child proof resistant blister
packs, and all controlled substances to be packaged in child resistant containers. This
authorization shall be in effect for the entire academic year.
___________________________________________
Signature of Team Physician
________________
Date
___________________________________________
Signature of Team Physician
________________
Date
17
Appendix I Non Child Safety Resistant Notice
Please note:
Medications may be
given in packages
that are not child
resistant.
18
Appendix J Manufacturer Sample Medication Receipt Log
19
University of Georgia Sports Medicine
Manufacturer Sample Medication Receipt Log
Date: ____________
Location coming from ______________________________________
________________________________________________________
Name of Drug Representative if direct delivery ___________________
Physician delivering: _________________________
Physician receiving: ___________________________
Medication: ____________ Strength _____________
Expiration date: ____________
Lot # _____________
Quantity: ______________
“The above sample medication was delivered to the University of Georgia Sports
Medicine department within the University of Georgia Athletic Association. The
medication(s) will be used in compliance with the University of Georgia Athletic
Association existing prescription drug policies and procedures.”
Receiving
Physician Signature: ________________________ Date: _____________
Medical Staff
ATC Signature: ____________________________
Date: ______________
Drug Representative ________________________ Date: ________________
20
Appendix K Banyan Stat Kit Contents
21
Appendix L Unsecured Medication Exception List
22
University of Georgia Sports Medicine
Unsecured Medication Exception List
It has been determined between the Team Physician and the Head Athletic Trainer that
certain medications that require a prescription will be stored outside the secured medical
cabinet. These medications are used for on-going treatments as per protocol and are only
applied by authorized agents of the Physician’s Athletic Medical staff.
1._________________________________ _____________________
name of medication
reason
2. __________________________________________________
name of medication
reason
3.__________________________________________________
name of medication
reason
4.___________________________________________________
name of medication
reason
______________________________
Signature of Team Physician
__________________
Date
______________________________
Signature of Head Athletic Trainer
__________________
Date
23
Appendix M Transdermal Medications
University of Georgia Sports Medicine
Transdermal Medications
It has been determined between the Team Physician and the Head Athletic Trainer that
certain transdermal medications (topical NSAIDs) that require a prescription will be
utilized for the treatment of localized musculoskeletal disorders. These medications are
used for on-going treatments as per protocol and are only applied by authorized agents of
the Physician’s Athletic Medical staff.
Transdermal Medical Protocol:
Indications: localized musculoskeletal injuries
Contraindications: Topical NSAIDs transdermal medication application should be
avoided in patients with ongoing GI disorders secondary to NSAID use, and in patients in
whom NSAIDs cause urticaria, angioedema, or bronchospasm. They are relatively
cointraindicated in patients on warfarin therapy, patients with hypertension, heart failure,
or renal insuffiency.
Adverse Reactions: Some of the minor adverse reactions that have occurred with the use
of topical NSAIDs include erythema, dermatitis, and ruritus at the site of application.
Local skin irritations resolve after the discontinuation of the drug and cross-sensitization
between agents has also been reported
Application: After prepping the application site with alcohol, approximately 2-3 ml of
the transdermal medication should be applied to the treatment site using powder free
purple nitrile exam gloves. Following application, a telfa pad or similar dressing
followed by a compression wrap should be applied.
______________________________
Signature of Team Physician
__________________
Date
______________________________
Signature of Head Athletic Trainer
__________________
Date
24
Appendix N Georgia Board of Pharmacy Definitions
480-30-.01 Definitions.
For purpose of these Rules and Regulations, the following definitions apply:
(a) "Dispensing procedure" means a written document signed by a licensed pharmacist
and a licensed physician which document establishes the appropriate manner under which
drugs may be dispensed under authority of a nurse protocol or job description.
(b) "Drugs" shall mean any dangerous drug under O.C.G.A. 16-13-71, et seq., or, where
applicable, any controlled substance under O.C.G.A. 16-13-21, et seq.
(c) "Job Description" means a document signed by a licensed physician and describing
the duties which may be performed by a physician's assistant, by which document the
physician delegates to that physician's assistant the authority to perform certain medical
acts pursuant to O.C.G.A. 43-34-26.1(b).
(d) "Nurse protocol" means a written document mutually agreed upon and signed by a
nurse and licensed physician by which document the physician delegates to that nurse the
authority to perform certain medical acts pursuant to O.C.G.A. 43-34-26.1(b).
43-34-26.1 G *** CODE SECTION *** 01/23/01 43-34-26.1
...
(3) In addition, a physician may delegate to a nurse or physician's assistant the authority
to order dangerous drugs, medical treatments, or diagnostic studies and a nurse or
physician's assistant is authorized to dispense dangerous drugs, in accordance with a
dispensing procedure and under the authority of an order issued in conformity with a
nurse protocol or job description, if that nurse or physician's assistant orders or dispenses
such drugs, treatments, or studies to a patient of an outpatient clinic: (A) Which is owned
or operated by a licensed hospital; (B) Which provides such drugs, treatments, or studies
free or at a charge to the patient based solely upon the patient's ability to pay; provided,
however, such charge shall not exceed the actual cost to the outpatient clinic;
480-30-.02 General Requirements.
Any person who dispenses drugs in accordance with a dispensing procedure and under
the authority of a job description or nurse protocol shall comply with all record-keeping,
labeling, packaging, and storage requirements imposed upon pharmacists and pharmacies
with regard to such drugs pursuant to O.C.G.A. Ch. 26-4 and Ch. 16-13, and those
regulations contained in this Chapter.
25
Appendix O PTP Software Guide
PTP Software Guide
RX Menu:
RX In – used to enter new meds into the inventory – (scan med → type info into scanner
→
enter atc id #)
RX Out – used when dispensing meds – (scan med → scan player id # → enter quantity
→
body part → physician id # → atc id # → insurance code)
Audit – shows the estimated inventory that you have scanned into the computer – (scan
with scanner & then enter it into computer to compare it with your actual
inventory)
Databases Menu:
Modify history database- shows all information that you entered. You can use this
menu to
modify any data that you may have entered incorrectly.
Modify inventory database- use this to modify the quantity given of a specific
medication.
Modify audit database- use only when you are performing an inventory audit & you
have accidentally scanned or entered incorrect data.
Modify roster database- use to enter or modify player information, make a player
inactive, etc. Can also use to generate a roster (bar code list).
AOB (Assignment of benefits)- use to generate a report for athlete’s to sign for
you to
be able to file their insurance, to give you authorization, etc.
Modify physician list- use to add/edit physician’s name &/or id #.
Modify A.T.C. list- use to add/edit ATC’s initials &/or id #.
Modify body part list- use this to view, edit, or print a list of body parts. The list will
print starting from the head & ending at the toes.
Report by Menu:
Use this menu to print reports sorted by a specific topic (ie. date range, player, drug,
physician, insurance, select drugs, etc.)
Xreport (w/ID)- will print X report without names, but rather with id #s only.
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Inventory scanned- prints all medications received from the pharmacy that you have
scanned
into the system.
Computer inventory- prints report of what you should have at a given time based on
what you
have scanned out to patients.
Detail audit- shows the rx #, drug name, computer inventory, & will show the variance
between
the actual vs. supposed inventory that you have.
League summary report- allows you to enter a start & end date. Then it will generate a
brief summary of a drug, etc. This does not include names, id #s, or all other drugs.
Physical inventory- prints information scanned on a specific audit.
New RX orders- use this when you want to order more meds. (select the medicine
desired →
select edit →enter the # of items/pk & # of packs →choose package type
→ enter
specific athlete name under “comments” section →choose save →print
report → fax to
homelink pharmacy)
Inactive player- prints a report of all inactive players.
Utilities Menu:
Backup to floppy- use to backup data to a floppy disk.
Clean all databases- use to re-sort all lists & clears up any Y2K problems.
Append history database- use to enter information from a floppy disk if you have a
problem
with the scanner & still have information left on it that hasn’t been
downloaded to the
computer yet.
Append inventory database- use to update inventory from the inventory disk when
adding new meds to your inventory list.
**Be sure to request a inventory disk when you place an order so you will not have
to scan all new medications into the computer**
Send data to pharmacy- use this to send data through the phone line to the pharmacy.
Or, you
can save the “data.lzh” file from the ptp directory & email it to homelink
pharmacy as an
attachment instead.
Order drug list update- use to update the drug list to be used when ordering new
prescriptions.
Exit- use to exit the PTP software program.
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