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Question
Can the registered nurse administer epinephrine for anaphylaxis without an order?
Answer

The registered nurse may carry and administer epinephrine under the direction of an authorized health care practitioner. The registered nurse may not administer epinephrine without an order from an authorized health care practitioner. The order or prescription may be for a specific patient or through the use of standing orders. Another option is for the facility or employer to become an authorized entity. SSB 6421 was passed in 2016 allowing authorized entities to obtain epinephrine autoinjectors. This allows an authorized health care practitioner to issue a prescription made out in the name of the authorized entity. Authorized entities that choose to acquire epinephrine autoinjectors must have people connected with the entity, such as employees, who have completed an anaphylaxis and epinephrine autoinjector training. These people will be responsible for the storage, maintenance, and general oversight of the epinephrine autoinjectors. They may administer or provide an epinephrine autoinjector to people who are experiencing anaphylaxis. An authorized entity is required to report to the Washington State Department of Health each incident of use of an obtained epinephrine autoinjector that was provided or administered to a person. Other laws may apply depending on the setting. RCW 28A.210.380 and 28A.210.383 regulations stipulate the requirements for epinephrine autoinjector use in public and private schools including the option of having a school stock supply of epinephrine autoinjectors for nurses to give following standing orders approved by an authorized health care practitioner. See the Washington State Department of Health’s Epinephrine Autoinjectors and Anaphylaxis Training and Reporting for Authorized Entities Frequently Asked Questions  and the SSB 6421 Status Update Document for more information.

FAQ Category
Dispensing, Compounding, Legend Drugs, Controlled Substances
Audience