North Dakota Code § 43-15-31.4

Limited prescriptive practices
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1. A pharmacist has limited prescriptive practices to initiate or modify drug therapy 
following diagnosis or established protocols by a licensed physician or an advanced 
practice registered nurse, under the supervision of the licensed physician or advanced 
practice registered nurse , in accordance with this section. The licensed physician, 
advanced practice registered nurse, and the pharmacist must have access to the 
patient's appropriate medical records. The care provided to the patient by the 
pharmacist must be recorded in the patient's medical records and communicated to 
the licensed physician or the advanced practice registered nurse.
2. The licensed physician or advanced practice registered nurse, and the pharmacist, 
shall prepare a collaborative agreement concerning the scope of the pharmacist's 
prescriptive practices and shall update the agreement if the scope of the pharmacist's 
prescriptive practices is modified . The collaborative agreement, or an amendment to 
the agreement, is effective if executed by the licensed physician or advanced practice 
registered nurse, and the pharmacist.
3. The collaborative agreement may be between a medical director and 
pharmacist-in-charge. The medical director and pharmacist -in-charge shall document 
and update the agreement for any physician, advanced practice registered nurse, and 
pharmacist covered under the agreement.
4. A collaborative agreement must be made available to the respective licensing boards 
of the parties to the agreement.

5. The collaborative agreement must include a provision that requires the pharmacist to 
immediately notify the licensed physician or advanced practice registered nurse if the 
pharmacist initiates or modifies a drug therapy.

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