Pharmacy Statewide Protocols

Pursuant to Iowa Code section 155A.46, the Board has developed, in collaboration with the Iowa Department of Health and Human Services, statewide protocols which authorize a pharmacist to:

• Order and dispense an FDC-approved opioid antagonist to reverse opioid-related overdose,
• Order and dispense nicotine-replacement tobacco cessation products, 
• Order and administer immunizations,
• Initiate point-of-care testing and treatment of acute influenza, and
• Initiate point-of-care testing and treatment of acute Group A streptococcal (GAS) pharyngitis. 

The statewide protocols authorize the pharmacist to be the ordering practitioner under these protocols.

Opioid Antagonists

• Review the statewide protocol for the use of opioid antagonists.
• Download and print copies of the eligibility assessment form.
• Download and print copies of the Iowa Naloxone Brochure.
• Each participating pharmacist must complete at least one hour of continuing education related to opioid antagonist utilization. Each pharmacist must confirm completion of applicable continuing education by logging into their Online Profile and updating the information under Statewide Protocols. 
• Participating pharmacies must have policies and procedures (and train staff on the P&Ps) related to opioid antagonist dispensing under this statewide protocol.

Nicotine-Replacement Tobacco Cessation

• Review the statewide protocol for nicotine-replacement tobacco cessation.
• Download and review the most current version of the US Department of Health and Human Services, Public Health Services, Clinical Practice Guideline - Treating Tobacco Use and Dependence.
• Each participating pharmacist must complete at least one hour of continuing education related to smoking cessation. Each pharmacist must confirm completion of applicable continuing education by logging into their Online Profile and updating the information under Statewide Protocols. 

Immunizations

• Review the statewide protocol for immunizations.
• Review CDC ACIP Immunization schedules.
• Each participating pharmacist must complete an approved program on vaccine administration and complete training on basic life support for health care providers which includes hands-on training.  Each pharmacist must confirm completion of applicable continuing education by logging into their Online Profile and updating the information under Statewide Protocols. 
• ​Ensure the completion of at least one hour of continuing education during the renewal period in which the pharmacist is engaged in vaccine administration.

Point-of-Care Test and Treat - Influenza

• Review the statewide protocol for point-of-care testing and treatment of influenza.
• Review CDC Influenza Antiviral Medications: Summary for Clinicians.
• Each participating pharmacist must complete education and training from an ACPE-accredited provider in point-of-care CLIA-waived testing techniques appropriate to the test to be used.
• Individuals involved with patient specimen collection shall have documented hands-on training for specimen collection which includes infection control measures.
• Ensure the completion of at least one hour of continuing education during the renewal period in which the pharmacist is engaged in test and treat for influenza.

Point-of-Care Test and Treat - Strep A

• Review the statewide protocol for point-of-care testing and treatment of strep A.
• Review the current Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis by the Infectious Disease Society of America (IDSA).
• Each participating pharmacist must complete education and training from an ACPE-accredited provider in point-of-care CLIA-waived testing techniques appropriate to the test to be used.
• Individuals involved with patient specimen collection shall have documented hands-on training for specimen collection which includes infection control measures.
• Ensure the completion of at least one hour of continuing education during the renewal period in which the pharmacist is engaged in test and treat for strep.

Point-of-Care Test and Treat - COVID 19

At this time, the Board has not approved a statewide protocol for testing for and treating COVID-19.

• Federal HHS recently issued a 9th Amendment to its PREP Act Declaration in which it authorizes pharmacists to order and administer COVID-19 therapeutics which are:
  • Authorized or approved by FDA and
  • Administered orally, intramuscularly, or subcutaneously
• The amendment also authorizes qualified technicians and interns to administer COVID-19 therapeutics
• Individuals who will be ordering and/or administering COVID-19 therapeutics must:
  • Maintain current CPR certification
  • Complete ACPE-approved training which includes:
    • Hands-on injection technique,
    • Clinical evaluation of indications and contraindications of COVID-19 therapeutics,
    • Recognition and treatment of emergency reactions to COVID-19 therapeutics, and
    • Any other training required by the FDA.
• Training programs which are known to the Board at this time (note this may not be all-inclusive and does not imply Board endorsement):
  • CEImpact: PREP Act Required Training for COVID-19 Therapeutics (Pharmacists) (One hour, $14)
  • CEImpact: PREP Act Required Training for COVID-19 Therapeutics (Technicians) (One hour, $14)
  • APhA: COVID-19 Monoclonal Antibody Assessment and Administration (One hour, Free)
  • Prescryptive: Administering COVID-19 Monoclonal Antibodies (One hour, Free)
• Pharmacists are required to be readily and immediately available to technicians when administering COVID-19 therapeutics
• Pharmacies must retain records of the order/administration of COVID-19 therapeutics and report the administration to:
  • The patient’s primary care provider, if known, and
  • HHS TeleTracking COVID-19 Portal
• Pharmacies which intend to order/administer COVID-19 therapeutics (pursuant to the HHS PREP Act or by Board-approved SWP, if available) shall:
  • Update the pharmacy profile in the board’s database to indicate “yes” to the pharmacy service “Statewide Protocol - COVID-19 Test and Treat”
  • Complete the IDPH COVID-19 Monoclonal Antibody Provider Request Form