S.I. No. 200/2007 - Misuse of Drugs (Amendment) Regulations 2007

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S.I. No. 200/2007 - Misuse of Drugs (Amendment) Regulations 2007
S.I. No. 200 of 2007
Misuse of Drugs (Amendment) Regulations 2007.
I, Mary Harney, Minister for Health and Children, in exercise of the powers conferred on me by sections 4, 5 (as amended by section 4 of the Irish Medicines Board (Miscellaneous Provisions) Act 2006 (No. 3 of 2006)), 18 and 38 of the Misuse of Drugs Act 1977 (No. 12 of 1977), hereby make the following Regulations:
Citation
1.         These Regulations may be cited as the Misuse of Drugs (Amendment) Regulations 2007.
Interpretation.
2.         In these Regulations, “Principal Regulations” means the Misuse of Drugs Regulations 1988 (S.I. No. 328 of 1988) as amended by the Misuse of Drugs (Amendment) Regulations 1993 (S.I. No. 342 of 1993).
Amendment of article 3 of Principal Regulations.
3.         Article 3(1) of the Principal Regulations is amended by substituting the following for the definitions of “practitioner” and “prescription”:
“‘practitioner’ means -
(a)       a registered medical practitioner, a registered dentist or a registered veterinary surgeon, or
(b)       subject to article 3A, a registered nurse;
‘prescription’ means a prescription issued by -
(a)       a registered medical practitioner for the medical treatment of an individual,
(b)       a registered dentist for the dental treatment of an individual,
(c)       a registered veterinary surgeon for the purposes of animal treatment, or
(d)       subject to article 3A, a registered nurse for the medical treatment of an individual;”.
Insertion of new articles 3A and 3B into Principal Regulations.
4.         The Principal Regulations are amended by inserting the following immediately after article 3 but in Part I:
“Provisions applicable to practitioners who are registered nurses.
3A.      (1)        Notwithstanding any other provision of these Regulations but subject to sub-articles (2) and (3), a reference (howsoever expressed) in these Regulations to Schedule 2 or 3 shall, in the case of a reference in these Regulations to a registered nurse in the nurse's capacity as a practitioner insofar, but only insofar, as that capacity relates to the issuing of prescriptions (and irrespective of whether the term ‘practitioner’ or ‘registered nurse’ is used), be construed to mean a reference to Schedule 8.
            (2)       A registered nurse shall not, in the nurse's capacity as a practitioner, issue a prescription for a drug specified in Schedule 4, 5 or 8 unless the following conditions are satisfied:
(a)       the nurse is employed by a health service provider in a hospital, nursing home, clinic or other health service setting (including any case where the health service is provided in a private home),
(b)       the drug is a drug which would be prescribed in the usual course of the provision of the health service provided in the health service setting in which the nurse is employed,
(c)       the prescription is in fact issued in the usual course of the provision of that health service,
(d)       the prescription of the drug is -
(i)          in the case of a drug specified in Part 1 of Schedule 8 -
(I)        for the pain relief of a person in a hospital in respect of probable myocardial infarction,
(II)       for the relief of the acute or severe pain of a person in a hospital after trauma, or
(III)      for the post-operative pain relief of a person in a hospital who falls within subparagraph (I) or (II),
(ii)        in the case of a drug specified in Part 2 of Schedule 8, for palliative care,
(iii)       in the case of a drug specified in Part 3 of Schedule 8, for the purposes of midwifery, and
(iv)       in the case of a drug specified in Part 4 of Schedule 8, for the neonatal care of a person in a hospital, and
(e)        the route of administration of the drug prescribed is or is to be, in the case of a drug specified in Schedule 8, the route, or one of the routes, of administration specified in that Schedule opposite that drug.
            (3)       Nothing in this article shall be construed as restricting -
(a)       a health service provider from -
(i)          prohibiting a registered nurse employed by the provider from issuing, in the course of that employment, a prescription for any drug, or any class of drug, for which the nurse may otherwise issue a prescription pursuant to these Regulations, or
(ii)          imposing conditions, in addition to those referred to in sub-article (2), which must be satisfied before a registered nurse employed by the provider may, in the course of that employment, issue a prescription pursuant to these Regulations, or
(b)       the performance of any function conferred on An Bord Altranais under -
(i)          the Nurses Act 1985 (No. 18 of 1985); or
(ii)         any other enactment or statutory instrument.
            (4)       In this Regulation, ‘health service provider’ means the Health Service Executive, a hospital, a nursing home, a clinic or other person whose sole or principal activity or business is the provision of health services, or a class of health services, to the public or a class of the public.
Person may refuse to supply drug if reasonable cause to believe conditions referred to in article 3A have not been satisfied.
3B.       Without prejudice to the generality of the other provisions of these Regulations pursuant to which a person may refuse to supply a drug, a person may refuse to supply a drug pursuant to a prescription issued by a registered nurse if the person has reasonable cause to believe that the conditions referred to in article 3A have not been satisfied in relation to the practitioner, the drug and the prescription.”.
Amendment of article 6 of Principal Regulations.
5.         Article 6(b) and (c) of the Principal Regulations is amended by substituting “, registered dentist or registered nurse” for “or registered dentist” in every place where it occurs.
Amendment of article 7 of Principal Regulations.
6.         Article 7 of the Principal Regulations is amended -
(a)        in sub-article (1), by substituting “Subject to sub-article (1A), a” for “A”, and
(b)        by inserting the following after sub-article (1):
            “(1A)    The reference to practitioner in sub-article (1) shall not include a registered nurse insofar as paragraph (b) of that sub-article is concerned.”.
Amendment of article 8 of Principal Regulations.
7.         Article 8(1)(ii) of the Principal Regulations is amended by substituting “, a registered dentist or a registered nurse (which may be the sister or acting sister, as the case may be)” for “or a registered dentist”.
Amendment of article 9 of Principal Regulations.
8.         Article 9(2) of the Principal Regulations is amended -
(a)        by substituting “on the prescription of a registered medical practitioner or registered nurse” for “on the prescription of a registered medical practitioner”, and
(b)        by substituting the following for paragraph (a):
“(a)      that person was then being supplied with any controlled drug by or on the prescription of another registered medical practitioner or registered nurse and failed to disclose that fact to the first-mentioned registered medical practitioner or registered nurse, as the case may be, before the supply by him or on his prescription, or”.
Amendment of article 10 of Principal Regulations.
9.         Article 10 of the Principal Regulations is amended by substituting the following for sub-articles (2) and (3):
            “(2)     Nothing in sub-article (1) shall be construed as authorising a midwife to have pentazocine or pethidine in her possession unless it has been obtained on foot of -
(a)        a written order -
(i)        signed by -
(I)        the midwife, and
(II)       a registered medical practitioner, or a registered nurse who falls within the definition of ‘practitioner’ in article 3(1), practising in the area in which the midwife practises, and
(ii)        setting out the name and address of the midwife, the purpose for which the drug is required and the quantity to be obtained, or
(b)        if the midwife falls within the definition of ‘practitioner’ in article 3(1) (but without prejudice to the generality of paragraph (a)), a written order signed by the midwife setting out the name and address of the midwife, the purpose for which the drug is required and the quantity to be obtained.
            (3)       In this article, ‘midwife’ means a person registered in the midwives division of the register of nurses maintained under section 27 of the Nurses Act 1985.”.
Amendment of article 11 of Principal Regulations.
10.        Article 11(1) of the Principal Regulations is amended by inserting the following after paragraph (f):
“(fa)     a registered nurse engaged in providing palliative care when acting in the course of the nurse's duty as a nurse so engaged;”.
Amendment of article 12 of Principal Regulations.
11.        Article 12(5)(a) of the Principal Regulations is amended by substituting “, a registered dentist or a registered nurse (which may be the matron or acting matron, as the case may be)” for “or a registered dentist”.
Amendment of article 13 of Principal Regulations.
12.        Article 13(1) of the Principal Regulations is amended by substituting the following for paragraph (d):
“(d)      clearly indicate the name of the person issuing it and state -
(i)        whether he is a registered medical practitioner, registered dentist, registered veterinary surgeon or registered nurse, and
(ii)        in the case of a registered nurse, the registration number assigned to the nurse in the register of nurses established under section 27 of the Nurses Act 1985; and”.
Insertion of new Schedule 8 into Principal Regulations.
13.        The Principal Regulations are amended by inserting the following after Schedule 7:
“SCHEDULE 8
DRUGS WHICH PRACTITIONERS WHO ARE REGISTERED NURSES MAY PRESCRIBE WITHIN SCHEDULES 2 AND 3
PART 1
Drugs for pain relief in hospital
Drug
Route of administration
Morphine sulphate
Oral, intravenous, intramuscular
Codeine phosphate
Oral
PART 2
Drugs for palliative care
Drug
Route of administration
Morphine sulphate
Oral, subcutaneous
Hydromorphone
Oral, subcutaneous
Oxycodone
Oral, subcutaneous
Buprenorphine
Transdermal
Fentanyl
Transmucosal, transdermal
Methylphenidate
Oral
Codeine phosphate
Oral
PART 3
Drugs for purposes of midwifery
Drug
Route of administration
Pethidine
Intramuscular
PART 4
Drugs for neonatal care in hospital
Drug
Route of administration
Morphine sulphate Fentanyl
Oral, intravenous Intravenous
Fentanyl
Intravenous
GIVEN under my Official Seal,

1 May 2007
MARY HARNEY

Minister for Health and Children.
EXPLANATORY NOTE
(This note is not part of the Instrument and does not purport to be a legal interpretation).
These Regulations may be cited as the Misuse of Drugs (Amendment) Regulations 2007.
The purpose of these Regulations is to allow registered nurses to prescribe controlled medicinal products in certain circumstances.
Department of Health and Children
1 May 2007

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