{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/54.1-3408.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/54.1-3408.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/54.1-3408.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/54.1-3408.html"}],"law_id":77665,"edition_id":1,"section_id":77665,"structure_id":13871,"section_number":"54.1-3408","catch_line":"Professional use by practitioners","history":"Code 1950, \u00a7 54-497; 1956, c. 225; 1970, c. 650, \u00a7 54-524.65; 1973, c. 468; 1976, cc. 358, 614; 1977, c. 302; 1978, c. 224; 1980, cc. 270, 287; 1983, cc. 456, 528; 1984, cc. 141, 555; 1986, c. 81; 1987, c. 226; 1988, c. 765; 1990, c. 309; 1991, cc. 141, 519, 524, 532; 1992, cc. 610, 760, 793; 1993, cc. 15, 810, 957, 993; 1994, c. 53; 1995, cc. 88, 529; 1996, cc. 152, 158, 183, 406, 408, 490; 1997, cc. 272, 566, 806, 906; 1998, c. 112; 1999, c. 570; 2000, cc. 135, 498, 861, 881, 935; 2003, cc. 465, 497, 515, 794, 995, 1020; 2005, cc. 113, 610, 924; 2006, cc. 75, 432, 686, 858; 2007, cc. 17, 699, 702, 783; 2008, cc. 85, 694; 2009, cc. 48, 110, 506, 813, 840; 2010, cc. 179, 245, 252; 2011, c. 292; 2012, cc. 787, 803, 833, 835; 2013, cc. 114, 132, 183, 191, 252, 267, 328, 336, 359, 617; 2014, cc. 88, 491; 2015, cc. 302, 387, 502, 503, 514, 725, 732, 752; 2016, c. 144; 2017, cc. 3, 55, 107, 168, 174, 182, 294, 304, 713; 2018, cc. 62, 247; 2019, cc. 87, 212, 221, 431; 2020, cc. 39, 302, 459, 460, 556, 560, 853, 860, 861, 924, 927, 1095; 2021, Sp. Sess. I, cc. 181, 200, 201, 508; 2022, cc. 695, 696, 733, 774; 2023, cc. 115, 116, 183, 267, 569, 631, 673, 674, 729; 2024, cc. 37, 150, 440, 451, 465, 466, 519; 2025, cc. 59, 65, 277, 341, 370, 386, 446.","full_text":"A\n\nA practitioner of medicine, osteopathy, podiatry, dentistry, or veterinary medicine, a licensed advanced practice registered nurse pursuant to § 54.1-2957.01, a licensed certified midwife pursuant to § 54.1-2957.04, a licensed physician assistant pursuant to § 54.1-2952.1, or a TPA-certified optometrist pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32 shall only prescribe, dispense, or administer controlled substances in good faith for medicinal or therapeutic purposes within the course of his professional practice. A licensed midwife pursuant to § 54.1-2957.7 shall only obtain, possess, and administer controlled substances in good faith for medicinal or therapeutic purposes within the course of his professional practice.B\n\nThe prescribing practitioner’s order may be on a written prescription or pursuant to an oral prescription as authorized by this chapter. The prescriber may administer drugs and devices, or he may cause drugs or devices to be administered by:1\n\nA nurse, physician assistant, or intern under his direction and supervision;2\n\nPersons trained to administer drugs and devices to patients in state-owned or state-operated hospitals or facilities licensed as hospitals by the Board of Health or psychiatric hospitals licensed by the Department of Behavioral Health and Developmental Services who administer drugs under the control and supervision of the prescriber or a pharmacist;3\n\nEmergency medical services personnel certified and authorized to administer drugs and devices pursuant to regulations of the Board of Health who act within the scope of such certification and pursuant to an oral or written order or standing protocol;4\n\nPersons who are employed or engaged at a medical care facility, as defined in § 32.1-3, who have a valid emergency medical services provider certification issued by the Board of Health as a requirement of being employed or engaged at the medical care facility within the scope of such certification, pursuant to an oral or written order or standing protocol to administer drugs and devices at the medical care facility; or5\n\nA licensed respiratory therapist as defined in § 54.1-2954 who administers by inhalation controlled substances used in inhalation or respiratory therapy.C\n\nPursuant to an oral or written order or standing protocol, the prescriber, who is authorized by state or federal law to possess and administer radiopharmaceuticals in the scope of his practice, may authorize a nuclear medicine technologist to administer, under his supervision, radiopharmaceuticals used in the diagnosis or treatment of disease.D\n\nPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine and oxygen for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.\n\t\t\tPursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.\n\t\t\tPursuant to an order or standing protocol issued by the prescriber within the course of his professional practice, any school nurse, school board employee, employee of a local governing body, or employee of a local health department who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or standing protocol that shall be issued by the local health director within the course of his professional practice, any school nurse, licensed athletic trainer under contract with a local school division, school board employee, employee of a local governing body, or employee of a local health department who is authorized by the local health director and trained in the administration of albuterol inhalers and valved holding chambers or nebulized albuterol may possess or administer an albuterol inhaler and a valved holding chamber or nebulized albuterol to a student diagnosed with a condition requiring an albuterol inhaler or nebulized albuterol when the student is believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any employee of a school for students with disabilities, as defined in § 22.1-319 and licensed by the Board of Education, or any employee of a private school that is accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education who is authorized by a prescriber and trained in the administration of (a) epinephrine may possess and administer epinephrine and (b) albuterol inhalers or nebulized albuterol may possess or administer an albuterol inhaler or nebulized albuterol to a student diagnosed with a condition requiring an albuterol inhaler or nebulized albuterol when the student is believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any nurse at an early childhood care and education entity, employee at the entity, or employee of a local health department who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any employee of a public institution of higher education or a private institution of higher education who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any employee of an organization providing outdoor educational experiences or programs for youth who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, and in accordance with policies and guidelines established by the Department of Health, such prescriber may authorize any employee of a restaurant licensed pursuant to Chapter 3 (§ 35.1-18 et seq.) of Title 35.1 to possess and administer epinephrine on the premises of the restaurant at which the employee is employed, provided that such person is trained in the administration of epinephrine.\n\t\t\tPursuant to an order issued by the prescriber within the course of his professional practice, an employee of a provider licensed by the Department of Behavioral Health and Developmental Services or a person providing services pursuant to a contract with a provider licensed by the Department of Behavioral Health and Developmental Services may possess and administer epinephrine, provided such person is authorized and trained in the administration of epinephrine.\n\t\t\tPursuant to an order or standing protocol issued by the prescriber within the course of his professional practice, any employee of a place of public accommodation, as defined in subsection A of § 2.2-3904, who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize pharmacists to possess epinephrine and oxygen for administration in treatment of emergency medical conditions.E\n\nPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize licensed physical therapists to possess and administer topical corticosteroids, topical lidocaine, and any other Schedule VI topical drug.F\n\nPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize licensed athletic trainers to possess and administer topical corticosteroids, topical lidocaine, or other Schedule VI topical drugs; oxygen and IV saline for use in emergency situations; subcutaneous lidocaine for wound closure; epinephrine for use in emergency cases of anaphylactic shock; and naloxone or other opioid antagonist for overdose reversal.G\n\nPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, and in accordance with policies and guidelines established by the Department of Health pursuant to § 32.1-50.2, such prescriber may authorize registered nurses or licensed practical nurses under the supervision of a registered nurse to possess and administer tuberculin purified protein derivative (PPD) in the absence of a prescriber. The Department of Health’s policies and guidelines shall be consistent with applicable guidelines developed by the Centers for Disease Control and Prevention for preventing transmission of mycobacterium tuberculosis and shall be updated to incorporate any subsequently implemented standards of the Occupational Safety and Health Administration and the Department of Labor and Industry to the extent that they are inconsistent with the Department of Health’s policies and guidelines. Such standing protocols shall explicitly describe the categories of persons to whom the tuberculin test is to be administered and shall provide for appropriate medical evaluation of those in whom the test is positive. The prescriber shall ensure that the nurse implementing such standing protocols has received adequate training in the practice and principles underlying tuberculin screening.\n\t\t\tThe Health Commissioner or his designee may authorize registered nurses, acting as agents of the Department of Health, to possess and administer, at the nurse’s discretion, tuberculin purified protein derivative (PPD) to those persons in whom tuberculin skin testing is indicated based on protocols and policies established by the Department of Health.H\n\nPursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize, with the consent of the parents as defined in § 22.1-1, an employee of (i) a school board, (ii) a school for students with disabilities as defined in § 22.1-319 licensed by the Board of Education, or (iii) a private school accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education who is trained in the administration of insulin and glucagon to assist with the administration of insulin or administer glucagon to a student diagnosed as having diabetes and who requires insulin injections during the school day or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia. Such authorization shall only be effective when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tPursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize the possession and administration of undesignated glucagon as set forth in subsection F of § 22.1-274.2.\n\t\t\tPursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize an employee of a public institution of higher education or a private institution of higher education who is trained in the administration of insulin and glucagon to assist with the administration of insulin or administration of glucagon to a student diagnosed as having diabetes and who requires insulin injections or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia. Such authorization shall only be effective when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tPursuant to a written order issued by the prescriber within the course of his professional practice, such prescriber may authorize an employee of a provider licensed by the Department of Behavioral Health and Developmental Services or a person providing services pursuant to a contract with a provider licensed by the Department of Behavioral Health and Developmental Services to assist with the administration of insulin or to administer glucagon to a person diagnosed as having diabetes and who requires insulin injections or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia, provided such employee or person providing services has been trained in the administration of insulin and glucagon.I\n\nA prescriber may authorize, pursuant to a protocol approved by the Board of Nursing, the administration of vaccines to adults for immunization, when a practitioner with prescriptive authority is not physically present, by (i) licensed pharmacists, (ii) registered nurses, or (iii) licensed practical nurses under the supervision of a registered nurse. A prescriber acting on behalf of and in accordance with established protocols of the Department of Health may authorize the administration of vaccines to any person by a pharmacist, nurse, or designated emergency medical services provider who holds an advanced life support certificate issued by the Commissioner of Health under the direction of an operational medical director when the prescriber is not physically present. The emergency medical services provider shall provide documentation of the vaccines to be recorded in the Virginia Immunization Information System.J\n\nA dentist may cause Schedule VI topical drugs to be administered under his direction and supervision by either a dental hygienist or by an authorized agent of the dentist.\n\t\t\tFurther, pursuant to a written order and in accordance with a standing protocol issued by the dentist in the course of his professional practice, a dentist may authorize a dental hygienist under his general supervision, as defined in § 54.1-2722, or his remote supervision, as defined in subsection E or F of § 54.1-2722, to possess and administer topical oral fluorides, topical oral anesthetics, topical and directly applied antimicrobial agents for treatment of periodontal pocket lesions, and any other Schedule VI topical drug approved by the Board of Dentistry.\n\t\t\tIn addition, a dentist may authorize a dental hygienist under his direction to administer Schedule VI nitrous oxide and oxygen inhalation analgesia and, to persons 18 years of age or older, Schedule VI local anesthesia.K\n\nPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered professional nurses certified as sexual assault nurse examiners-A (SANE-A) under his supervision and when he is not physically present to possess and administer preventive medications for victims of sexual assault as recommended by the Centers for Disease Control and Prevention.L\n\nThis section shall not prevent the administration of drugs by a person who has satisfactorily completed a training program for this purpose approved by the Board of Nursing and who administers such drugs in accordance with a prescriber’s instructions pertaining to dosage, frequency, and manner of administration, and in accordance with regulations promulgated by the Board of Pharmacy relating to security and record keeping, when the drugs administered would be normally self-administered by (i) an individual receiving services in a program licensed by the Department of Behavioral Health and Developmental Services; (ii) a resident of the Virginia Rehabilitation Center for the Blind and Vision Impaired; (iii) a resident of a facility approved by the Board or Department of Juvenile Justice for the placement of children in need of services or delinquent or alleged delinquent youth; (iv) a program participant of an adult day center licensed by the Department of Social Services; (v) a resident of any facility authorized or operated by a state or local government whose primary purpose is not to provide health care services; (vi) a resident of a private children’s residential facility, as defined in § 63.2-100 and licensed by the Department of Social Services, Department of Education, or Department of Behavioral Health and Developmental Services; or (vii) a student in a school for students with disabilities, as defined in § 22.1-319 and licensed by the Board of Education.\n\t\t\tIn addition, this section shall not prevent a person who has successfully completed a training program for the administration of drugs via percutaneous gastrostomy tube approved by the Board of Nursing and been evaluated by a registered nurse as having demonstrated competency in administration of drugs via percutaneous gastrostomy tube from administering drugs to a person receiving services from a program licensed by the Department of Behavioral Health and Developmental Services to such person via percutaneous gastrostomy tube. The continued competency of a person to administer drugs via percutaneous gastrostomy tube shall be evaluated semiannually by a registered nurse.M\n\nMedication aides registered by the Board of Nursing pursuant to Article 7 (§ 54.1-3041 et seq.) of Chapter 30 may administer drugs that would otherwise be self-administered to residents of any assisted living facility licensed by the Department of Social Services. A registered medication aide shall administer drugs pursuant to this section in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration; in accordance with regulations promulgated by the Board of Pharmacy relating to security and recordkeeping; in accordance with the assisted living facility’s Medication Management Plan; and in accordance with such other regulations governing their practice promulgated by the Board of Nursing.N\n\nAdvanced medication aides registered by the Board of Nursing pursuant to Article 7 (§ 54.1-3041 et seq.) of Chapter 30 may administer drugs that would be administered by a registered medication aide pursuant to subsection M, in addition to drugs determined permissible by the Board of Nursing, in a nursing home licensed by the Department of Health. Advanced medication aides shall administer drugs pursuant to this section in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration; in accordance with regulations promulgated by the Board of Pharmacy relating to security and recordkeeping; in accordance with the licensed nursing home’s policies and procedures; and in accordance with such other regulations governing their practice promulgated by the Board of Nursing.O\n\nIn addition, this section shall not prevent the administration of drugs by a person who administers such drugs in accordance with a physician’s instructions pertaining to dosage, frequency, and manner of administration and with written authorization of a parent, and in accordance with school board regulations relating to training, security and record keeping, when the drugs administered would be normally self-administered by a student of a Virginia public school. Training for such persons shall be accomplished through a program approved by the local school boards, in consultation with the local departments of health.P\n\nIn addition, this section shall not prevent the administration of drugs by a person to (i) a child in a child day program as defined in § 22.1-289.02 and regulated by the Board of Education or a local government pursuant to § 15.2-914, or (ii) a student of a private school that is accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education, provided such person (a) has satisfactorily completed a training program for this purpose approved by the Board of Nursing and taught by a registered nurse, a licensed practical nurse, an advanced practice registered nurse, a physician assistant, a doctor of medicine or osteopathic medicine, or a pharmacist; (b) has obtained written authorization from a parent or guardian; (c) administers drugs only to the child identified on the prescription label in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration; and (d) administers only those drugs that were dispensed from a pharmacy and maintained in the original, labeled container that would normally be self-administered by the child or student, or administered by a parent or guardian to the child or student.Q\n\nIn addition, this section shall not prevent the administration or dispensing of drugs and devices by persons if they are authorized by the State Health Commissioner in accordance with protocols established by the State Health Commissioner pursuant to § 32.1-42.1 when (i) the Governor has declared a disaster or a state of emergency, the United States Secretary of Health and Human Services has issued a declaration of an actual or potential bioterrorism incident or other actual or potential public health emergency, or the Board of Health has made an emergency order pursuant to § 32.1-13 for the purpose of suppressing nuisances dangerous to the public health and communicable, contagious, and infectious diseases and other dangers to the public life and health and for the limited purpose of administering vaccines as an approved countermeasure for such communicable, contagious, and infectious diseases; (ii) it is necessary to permit the provision of needed drugs or devices; and (iii) such persons have received the training necessary to safely administer or dispense the needed drugs or devices. Such persons shall administer or dispense all drugs or devices under the direction, control, and supervision of the State Health Commissioner.R\n\nNothing in this title shall prohibit the administration of normally self-administered drugs by unlicensed individuals to a person in his private residence.S\n\nThis section shall not interfere with any prescriber issuing prescriptions in compliance with his authority and scope of practice and the provisions of this section to a Board agent for use pursuant to subsection G of § 18.2-258.1. Such prescriptions issued by such prescriber shall be deemed to be valid prescriptions.T\n\nNothing in this title shall prevent or interfere with dialysis care technicians or dialysis patient care technicians who are certified by an organization approved by the Department of Health Professions or persons authorized for provisional practice pursuant to Chapter 27.01 (§ 54.1-2729.1 et seq.), in the ordinary course of their duties in a Medicare-certified renal dialysis facility, from administering heparin, topical needle site anesthetics, dialysis solutions, sterile normal saline solution, and blood volumizers, for the purpose of facilitating renal dialysis treatment, when such administration of medications occurs under the orders of a licensed physician, an advanced practice registered nurse, or a physician assistant and under the immediate and direct supervision of a licensed registered nurse. Nothing in this chapter shall be construed to prohibit a patient care dialysis technician trainee from performing dialysis care as part of and within the scope of the clinical skills instruction segment of a supervised dialysis technician training program, provided such trainee is identified as a “trainee” while working in a renal dialysis facility.\n\t\t\tThe dialysis care technician or dialysis patient care technician administering the medications shall have demonstrated competency as evidenced by holding current valid certification from an organization approved by the Department of Health Professions pursuant to Chapter 27.01 (§ 54.1-2729.1 et seq.).U\n\nPersons who are otherwise authorized to administer controlled substances in hospitals shall be authorized to administer influenza or pneumococcal vaccines pursuant to § 32.1-126.4.V\n\nPursuant to a specific order for a patient and under his direct and immediate supervision, a prescriber may authorize the administration of controlled substances by personnel who have been properly trained to assist a doctor of medicine or osteopathic medicine, provided the method does not include intravenous, intrathecal, or epidural administration and the prescriber remains responsible for such administration.W\n\nA physician assistant, nurse, dental hygienist, or authorized agent of a doctor of medicine, osteopathic medicine, or dentistry may possess and administer topical fluoride varnish pursuant to an oral or written order or a standing protocol issued by a doctor of medicine, osteopathic medicine, or dentistry.X\n\nA prescriber, acting in accordance with guidelines developed pursuant to § 32.1-46.02, may authorize the administration of influenza vaccine to minors by a licensed pharmacist, registered nurse, licensed practical nurse under the direction and immediate supervision of a registered nurse, or emergency medical services provider who holds an advanced life support certificate issued by the Commissioner of Health when the prescriber is not physically present.Y\n\nNotwithstanding the provisions of § 54.1-3303, pursuant to an oral, written, or standing order issued by a prescriber or a standing order issued by the Commissioner of Health or his designee authorizing the dispensing of naloxone or other opioid antagonist used for overdose reversal in the absence of an oral or written order for a specific patient issued by a prescriber, and in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health, a pharmacist, a health care provider providing services in a hospital emergency department, and emergency medical services personnel, as that term is defined in § 32.1-111.1, may dispense naloxone or other opioid antagonist used for overdose reversal and a person to whom naloxone or other opioid antagonist has been dispensed pursuant to this subsection may possess and administer naloxone or other opioid antagonist used for overdose reversal to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose. Law-enforcement officers as defined in § 9.1-101, employees of the Department of Forensic Science, employees of the Office of the Chief Medical Examiner, employees of the Department of General Services Division of Consolidated Laboratory Services, employees of the Department of Corrections designated by the Director of the Department of Corrections or designated as probation and parole officers or as correctional officers as defined in § 53.1-1, employees of the Department of Juvenile Justice designated as probation and parole officers or as juvenile correctional officers, employees of regional jails, employees of any state agency, school nurses, local health department employees that are assigned to a public school pursuant to an agreement between the local health department and the school board, school board employees who have completed training and are certified in the administration of an opioid antagonist for overdose reversal by a program administered or authorized by the Department of Health, other school board employees or individuals contracted by a school board to provide school health services, resident assistants in a student housing facility at a public institution of higher education who have completed training in the administration of an opioid antagonist for overdose reversal pursuant to § 23.1-802.2, and firefighters may also possess and administer naloxone or other opioid antagonist used for overdose reversal and may dispense naloxone or other opioid antagonist used for overdose reversal pursuant to an oral, written, or standing order issued by a prescriber or a standing order issued by the Commissioner of Health or his designee in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health.\n\t\t\tNotwithstanding the provisions of § 54.1-3303, pursuant to an oral, written, or standing order issued by a prescriber or a standing order issued by the Commissioner of Health or his designee authorizing the dispensing of naloxone or other opioid antagonist used for overdose reversal in the absence of an oral or written order for a specific patient issued by a prescriber, and in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health, any person may possess and administer naloxone or other opioid antagonist used for overdose reversal, other than naloxone in an injectable formulation with a hypodermic needle or syringe, in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health.Z\n\nNotwithstanding any other law or regulation to the contrary, a person who is acting on behalf of an organization that provides services to individuals at risk of experiencing an opioid overdose or training in the administration of naloxone or other opioid antagonist for overdose reversal may dispense naloxone or other opioid antagonist, provided that such dispensing is (i) pursuant to a standing order issued by a prescriber and (ii) in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health. If the person acting on behalf of an organization dispenses naloxone or other opioid antagonist in an injectable formulation with a hypodermic needle or syringe, he shall first obtain authorization from the Department of Behavioral Health and Developmental Services to train individuals on the proper administration of naloxone or other opioid antagonist by and proper disposal of a hypodermic needle or syringe, and he shall obtain a controlled substance registration from the Board of Pharmacy. The Board of Pharmacy shall not charge a fee for the issuance of such controlled substance registration. The dispensing may occur at a site other than that of the controlled substance registration provided the entity possessing the controlled substances registration maintains records in accordance with regulations of the Board of Pharmacy. No person who dispenses naloxone or other opioid antagonist on behalf of an organization pursuant to this subsection shall charge a fee for the dispensing of naloxone or other opioid antagonist that is greater than the cost to the organization of obtaining the naloxone or other opioid antagonist dispensed. A person to whom naloxone or other opioid antagonist has been dispensed pursuant to this subsection may possess naloxone or other opioid antagonist and may administer naloxone or other opioid antagonist to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose.\n\t\t\tAA. A person who is not otherwise authorized to administer naloxone or other opioid antagonist used for overdose reversal may administer naloxone or other opioid antagonist used for overdose reversal to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose.\n\t\t\tBB. Pursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize, with the consent of the parents as defined in § 22.1-1, an employee of (i) a school board, (ii) a school for students with disabilities as defined in § 22.1-319 licensed by the Board of Education, or (iii) a private school accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education who is trained in the administration of injected medications for the treatment of adrenal crisis resulting from a condition causing adrenal insufficiency to administer such medication to a student diagnosed with a condition causing adrenal insufficiency when the student is believed to be experiencing or about to experience an adrenal crisis. Such authorization shall be effective only when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tCC. . Pursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize, with the consent of the student’s parents as defined in § 22.1-1, an employee of (i) a school board, (ii) a school for students with disabilities as defined in § 22.1-319 licensed by the Board of Education, (iii) a private school accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education, (iv) a local governing body, or (v) a local health department who is trained in the administration of seizure rescue medications for the treatment of seizures resulting from a condition causing seizures to administer such medications to a student diagnosed with a condition causing seizures when the student is believed to be experiencing or about to experience a seizure. Such authorization shall be effective only when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not capable of reaching the student within the amount of time necessary to effectively perform the administration of the medication.","order_by":null,"text":{"0":{"id":278559,"text":"A practitioner of medicine, osteopathy, podiatry, dentistry, or veterinary medicine, a licensed advanced practice registered nurse pursuant to § 54.1-2957.01, a licensed certified midwife pursuant to § 54.1-2957.04, a licensed physician assistant pursuant to § 54.1-2952.1, or a TPA-certified optometrist pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32 shall only prescribe, dispense, or administer controlled substances in good faith for medicinal or therapeutic purposes within the course of his professional practice. A licensed midwife pursuant to § 54.1-2957.7 shall only obtain, possess, and administer controlled substances in good faith for medicinal or therapeutic purposes within the course of his professional practice.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":278560,"text":"The prescribing practitioner’s order may be on a written prescription or pursuant to an oral prescription as authorized by this chapter. The prescriber may administer drugs and devices, or he may cause drugs or devices to be administered by:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":278561,"text":"A nurse, physician assistant, or intern under his direction and supervision;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":278562,"text":"Persons trained to administer drugs and devices to patients in state-owned or state-operated hospitals or facilities licensed as hospitals by the Board of Health or psychiatric hospitals licensed by the Department of Behavioral Health and Developmental Services who administer drugs under the control and supervision of the prescriber or a pharmacist;","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"4":{"id":278563,"text":"Emergency medical services personnel certified and authorized to administer drugs and devices pursuant to regulations of the Board of Health who act within the scope of such certification and pursuant to an oral or written order or standing protocol;","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"B4"},"5":{"id":278564,"text":"Persons who are employed or engaged at a medical care facility, as defined in § 32.1-3, who have a valid emergency medical services provider certification issued by the Board of Health as a requirement of being employed or engaged at the medical care facility within the scope of such certification, pursuant to an oral or written order or standing protocol to administer drugs and devices at the medical care facility; or","type":"section","prefixes":["B","4"],"prefix":"4","entire_prefix":"B4","prefix_anchor":"B4","level":2,"prior_prefix":"B3","next_prefix":"B5"},"6":{"id":278565,"text":"A licensed respiratory therapist as defined in § 54.1-2954 who administers by inhalation controlled substances used in inhalation or respiratory therapy.","type":"section","prefixes":["B","5"],"prefix":"5","entire_prefix":"B5","prefix_anchor":"B5","level":2,"prior_prefix":"B4","next_prefix":"C"},"7":{"id":278566,"text":"Pursuant to an oral or written order or standing protocol, the prescriber, who is authorized by state or federal law to possess and administer radiopharmaceuticals in the scope of his practice, may authorize a nuclear medicine technologist to administer, under his supervision, radiopharmaceuticals used in the diagnosis or treatment of disease.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B5","next_prefix":"D"},"8":{"id":278567,"text":"Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine and oxygen for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.\n\t\t\tPursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.\n\t\t\tPursuant to an order or standing protocol issued by the prescriber within the course of his professional practice, any school nurse, school board employee, employee of a local governing body, or employee of a local health department who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or standing protocol that shall be issued by the local health director within the course of his professional practice, any school nurse, licensed athletic trainer under contract with a local school division, school board employee, employee of a local governing body, or employee of a local health department who is authorized by the local health director and trained in the administration of albuterol inhalers and valved holding chambers or nebulized albuterol may possess or administer an albuterol inhaler and a valved holding chamber or nebulized albuterol to a student diagnosed with a condition requiring an albuterol inhaler or nebulized albuterol when the student is believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any employee of a school for students with disabilities, as defined in § 22.1-319 and licensed by the Board of Education, or any employee of a private school that is accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education who is authorized by a prescriber and trained in the administration of (a) epinephrine may possess and administer epinephrine and (b) albuterol inhalers or nebulized albuterol may possess or administer an albuterol inhaler or nebulized albuterol to a student diagnosed with a condition requiring an albuterol inhaler or nebulized albuterol when the student is believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any nurse at an early childhood care and education entity, employee at the entity, or employee of a local health department who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any employee of a public institution of higher education or a private institution of higher education who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, any employee of an organization providing outdoor educational experiences or programs for youth who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within the course of his professional practice, and in accordance with policies and guidelines established by the Department of Health, such prescriber may authorize any employee of a restaurant licensed pursuant to Chapter 3 (§ 35.1-18 et seq.) of Title 35.1 to possess and administer epinephrine on the premises of the restaurant at which the employee is employed, provided that such person is trained in the administration of epinephrine.\n\t\t\tPursuant to an order issued by the prescriber within the course of his professional practice, an employee of a provider licensed by the Department of Behavioral Health and Developmental Services or a person providing services pursuant to a contract with a provider licensed by the Department of Behavioral Health and Developmental Services may possess and administer epinephrine, provided such person is authorized and trained in the administration of epinephrine.\n\t\t\tPursuant to an order or standing protocol issued by the prescriber within the course of his professional practice, any employee of a place of public accommodation, as defined in subsection A of § 2.2-3904, who is authorized by a prescriber and trained in the administration of epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize pharmacists to possess epinephrine and oxygen for administration in treatment of emergency medical conditions.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"9":{"id":278568,"text":"Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize licensed physical therapists to possess and administer topical corticosteroids, topical lidocaine, and any other Schedule VI topical drug.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"10":{"id":278569,"text":"Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize licensed athletic trainers to possess and administer topical corticosteroids, topical lidocaine, or other Schedule VI topical drugs; oxygen and IV saline for use in emergency situations; subcutaneous lidocaine for wound closure; epinephrine for use in emergency cases of anaphylactic shock; and naloxone or other opioid antagonist for overdose reversal.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"11":{"id":278570,"text":"Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, and in accordance with policies and guidelines established by the Department of Health pursuant to § 32.1-50.2, such prescriber may authorize registered nurses or licensed practical nurses under the supervision of a registered nurse to possess and administer tuberculin purified protein derivative (PPD) in the absence of a prescriber. The Department of Health’s policies and guidelines shall be consistent with applicable guidelines developed by the Centers for Disease Control and Prevention for preventing transmission of mycobacterium tuberculosis and shall be updated to incorporate any subsequently implemented standards of the Occupational Safety and Health Administration and the Department of Labor and Industry to the extent that they are inconsistent with the Department of Health’s policies and guidelines. Such standing protocols shall explicitly describe the categories of persons to whom the tuberculin test is to be administered and shall provide for appropriate medical evaluation of those in whom the test is positive. The prescriber shall ensure that the nurse implementing such standing protocols has received adequate training in the practice and principles underlying tuberculin screening.\n\t\t\tThe Health Commissioner or his designee may authorize registered nurses, acting as agents of the Department of Health, to possess and administer, at the nurse’s discretion, tuberculin purified protein derivative (PPD) to those persons in whom tuberculin skin testing is indicated based on protocols and policies established by the Department of Health.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"12":{"id":278571,"text":"Pursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize, with the consent of the parents as defined in § 22.1-1, an employee of (i) a school board, (ii) a school for students with disabilities as defined in § 22.1-319 licensed by the Board of Education, or (iii) a private school accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education who is trained in the administration of insulin and glucagon to assist with the administration of insulin or administer glucagon to a student diagnosed as having diabetes and who requires insulin injections during the school day or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia. Such authorization shall only be effective when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tPursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize the possession and administration of undesignated glucagon as set forth in subsection F of § 22.1-274.2.\n\t\t\tPursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize an employee of a public institution of higher education or a private institution of higher education who is trained in the administration of insulin and glucagon to assist with the administration of insulin or administration of glucagon to a student diagnosed as having diabetes and who requires insulin injections or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia. Such authorization shall only be effective when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tPursuant to a written order issued by the prescriber within the course of his professional practice, such prescriber may authorize an employee of a provider licensed by the Department of Behavioral Health and Developmental Services or a person providing services pursuant to a contract with a provider licensed by the Department of Behavioral Health and Developmental Services to assist with the administration of insulin or to administer glucagon to a person diagnosed as having diabetes and who requires insulin injections or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia, provided such employee or person providing services has been trained in the administration of insulin and glucagon.","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"I"},"13":{"id":278572,"text":"A prescriber may authorize, pursuant to a protocol approved by the Board of Nursing, the administration of vaccines to adults for immunization, when a practitioner with prescriptive authority is not physically present, by (i) licensed pharmacists, (ii) registered nurses, or (iii) licensed practical nurses under the supervision of a registered nurse. A prescriber acting on behalf of and in accordance with established protocols of the Department of Health may authorize the administration of vaccines to any person by a pharmacist, nurse, or designated emergency medical services provider who holds an advanced life support certificate issued by the Commissioner of Health under the direction of an operational medical director when the prescriber is not physically present. The emergency medical services provider shall provide documentation of the vaccines to be recorded in the Virginia Immunization Information System.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H","next_prefix":"J"},"14":{"id":278573,"text":"A dentist may cause Schedule VI topical drugs to be administered under his direction and supervision by either a dental hygienist or by an authorized agent of the dentist.\n\t\t\tFurther, pursuant to a written order and in accordance with a standing protocol issued by the dentist in the course of his professional practice, a dentist may authorize a dental hygienist under his general supervision, as defined in § 54.1-2722, or his remote supervision, as defined in subsection E or F of § 54.1-2722, to possess and administer topical oral fluorides, topical oral anesthetics, topical and directly applied antimicrobial agents for treatment of periodontal pocket lesions, and any other Schedule VI topical drug approved by the Board of Dentistry.\n\t\t\tIn addition, a dentist may authorize a dental hygienist under his direction to administer Schedule VI nitrous oxide and oxygen inhalation analgesia and, to persons 18 years of age or older, Schedule VI local anesthesia.","type":"section","prefixes":["J"],"prefix":"J","entire_prefix":"J","prefix_anchor":"J","level":1,"prior_prefix":"I","next_prefix":"K"},"15":{"id":278574,"text":"Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered professional nurses certified as sexual assault nurse examiners-A (SANE-A) under his supervision and when he is not physically present to possess and administer preventive medications for victims of sexual assault as recommended by the Centers for Disease Control and Prevention.","type":"section","prefixes":["K"],"prefix":"K","entire_prefix":"K","prefix_anchor":"K","level":1,"prior_prefix":"J","next_prefix":"L"},"16":{"id":278575,"text":"This section shall not prevent the administration of drugs by a person who has satisfactorily completed a training program for this purpose approved by the Board of Nursing and who administers such drugs in accordance with a prescriber’s instructions pertaining to dosage, frequency, and manner of administration, and in accordance with regulations promulgated by the Board of Pharmacy relating to security and record keeping, when the drugs administered would be normally self-administered by (i) an individual receiving services in a program licensed by the Department of Behavioral Health and Developmental Services; (ii) a resident of the Virginia Rehabilitation Center for the Blind and Vision Impaired; (iii) a resident of a facility approved by the Board or Department of Juvenile Justice for the placement of children in need of services or delinquent or alleged delinquent youth; (iv) a program participant of an adult day center licensed by the Department of Social Services; (v) a resident of any facility authorized or operated by a state or local government whose primary purpose is not to provide health care services; (vi) a resident of a private children’s residential facility, as defined in § 63.2-100 and licensed by the Department of Social Services, Department of Education, or Department of Behavioral Health and Developmental Services; or (vii) a student in a school for students with disabilities, as defined in § 22.1-319 and licensed by the Board of Education.\n\t\t\tIn addition, this section shall not prevent a person who has successfully completed a training program for the administration of drugs via percutaneous gastrostomy tube approved by the Board of Nursing and been evaluated by a registered nurse as having demonstrated competency in administration of drugs via percutaneous gastrostomy tube from administering drugs to a person receiving services from a program licensed by the Department of Behavioral Health and Developmental Services to such person via percutaneous gastrostomy tube. The continued competency of a person to administer drugs via percutaneous gastrostomy tube shall be evaluated semiannually by a registered nurse.","type":"section","prefixes":["L"],"prefix":"L","entire_prefix":"L","prefix_anchor":"L","level":1,"prior_prefix":"K","next_prefix":"M"},"17":{"id":278576,"text":"Medication aides registered by the Board of Nursing pursuant to Article 7 (§ 54.1-3041 et seq.) of Chapter 30 may administer drugs that would otherwise be self-administered to residents of any assisted living facility licensed by the Department of Social Services. A registered medication aide shall administer drugs pursuant to this section in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration; in accordance with regulations promulgated by the Board of Pharmacy relating to security and recordkeeping; in accordance with the assisted living facility’s Medication Management Plan; and in accordance with such other regulations governing their practice promulgated by the Board of Nursing.","type":"section","prefixes":["M"],"prefix":"M","entire_prefix":"M","prefix_anchor":"M","level":1,"prior_prefix":"L","next_prefix":"N"},"18":{"id":278577,"text":"Advanced medication aides registered by the Board of Nursing pursuant to Article 7 (§ 54.1-3041 et seq.) of Chapter 30 may administer drugs that would be administered by a registered medication aide pursuant to subsection M, in addition to drugs determined permissible by the Board of Nursing, in a nursing home licensed by the Department of Health. Advanced medication aides shall administer drugs pursuant to this section in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration; in accordance with regulations promulgated by the Board of Pharmacy relating to security and recordkeeping; in accordance with the licensed nursing home’s policies and procedures; and in accordance with such other regulations governing their practice promulgated by the Board of Nursing.","type":"section","prefixes":["N"],"prefix":"N","entire_prefix":"N","prefix_anchor":"N","level":1,"prior_prefix":"M","next_prefix":"O"},"19":{"id":278578,"text":"In addition, this section shall not prevent the administration of drugs by a person who administers such drugs in accordance with a physician’s instructions pertaining to dosage, frequency, and manner of administration and with written authorization of a parent, and in accordance with school board regulations relating to training, security and record keeping, when the drugs administered would be normally self-administered by a student of a Virginia public school. Training for such persons shall be accomplished through a program approved by the local school boards, in consultation with the local departments of health.","type":"section","prefixes":["O"],"prefix":"O","entire_prefix":"O","prefix_anchor":"O","level":1,"prior_prefix":"N","next_prefix":"P"},"20":{"id":278579,"text":"In addition, this section shall not prevent the administration of drugs by a person to (i) a child in a child day program as defined in § 22.1-289.02 and regulated by the Board of Education or a local government pursuant to § 15.2-914, or (ii) a student of a private school that is accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education, provided such person (a) has satisfactorily completed a training program for this purpose approved by the Board of Nursing and taught by a registered nurse, a licensed practical nurse, an advanced practice registered nurse, a physician assistant, a doctor of medicine or osteopathic medicine, or a pharmacist; (b) has obtained written authorization from a parent or guardian; (c) administers drugs only to the child identified on the prescription label in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration; and (d) administers only those drugs that were dispensed from a pharmacy and maintained in the original, labeled container that would normally be self-administered by the child or student, or administered by a parent or guardian to the child or student.","type":"section","prefixes":["P"],"prefix":"P","entire_prefix":"P","prefix_anchor":"P","level":1,"prior_prefix":"O","next_prefix":"Q"},"21":{"id":278580,"text":"In addition, this section shall not prevent the administration or dispensing of drugs and devices by persons if they are authorized by the State Health Commissioner in accordance with protocols established by the State Health Commissioner pursuant to § 32.1-42.1 when (i) the Governor has declared a disaster or a state of emergency, the United States Secretary of Health and Human Services has issued a declaration of an actual or potential bioterrorism incident or other actual or potential public health emergency, or the Board of Health has made an emergency order pursuant to § 32.1-13 for the purpose of suppressing nuisances dangerous to the public health and communicable, contagious, and infectious diseases and other dangers to the public life and health and for the limited purpose of administering vaccines as an approved countermeasure for such communicable, contagious, and infectious diseases; (ii) it is necessary to permit the provision of needed drugs or devices; and (iii) such persons have received the training necessary to safely administer or dispense the needed drugs or devices. Such persons shall administer or dispense all drugs or devices under the direction, control, and supervision of the State Health Commissioner.","type":"section","prefixes":["Q"],"prefix":"Q","entire_prefix":"Q","prefix_anchor":"Q","level":1,"prior_prefix":"P","next_prefix":"R"},"22":{"id":278581,"text":"Nothing in this title shall prohibit the administration of normally self-administered drugs by unlicensed individuals to a person in his private residence.","type":"section","prefixes":["R"],"prefix":"R","entire_prefix":"R","prefix_anchor":"R","level":1,"prior_prefix":"Q","next_prefix":"S"},"23":{"id":278582,"text":"This section shall not interfere with any prescriber issuing prescriptions in compliance with his authority and scope of practice and the provisions of this section to a Board agent for use pursuant to subsection G of § 18.2-258.1. Such prescriptions issued by such prescriber shall be deemed to be valid prescriptions.","type":"section","prefixes":["S"],"prefix":"S","entire_prefix":"S","prefix_anchor":"S","level":1,"prior_prefix":"R","next_prefix":"T"},"24":{"id":278583,"text":"Nothing in this title shall prevent or interfere with dialysis care technicians or dialysis patient care technicians who are certified by an organization approved by the Department of Health Professions or persons authorized for provisional practice pursuant to Chapter 27.01 (§ 54.1-2729.1 et seq.), in the ordinary course of their duties in a Medicare-certified renal dialysis facility, from administering heparin, topical needle site anesthetics, dialysis solutions, sterile normal saline solution, and blood volumizers, for the purpose of facilitating renal dialysis treatment, when such administration of medications occurs under the orders of a licensed physician, an advanced practice registered nurse, or a physician assistant and under the immediate and direct supervision of a licensed registered nurse. Nothing in this chapter shall be construed to prohibit a patient care dialysis technician trainee from performing dialysis care as part of and within the scope of the clinical skills instruction segment of a supervised dialysis technician training program, provided such trainee is identified as a “trainee” while working in a renal dialysis facility.\n\t\t\tThe dialysis care technician or dialysis patient care technician administering the medications shall have demonstrated competency as evidenced by holding current valid certification from an organization approved by the Department of Health Professions pursuant to Chapter 27.01 (§ 54.1-2729.1 et seq.).","type":"section","prefixes":["T"],"prefix":"T","entire_prefix":"T","prefix_anchor":"T","level":1,"prior_prefix":"S","next_prefix":"U"},"25":{"id":278584,"text":"Persons who are otherwise authorized to administer controlled substances in hospitals shall be authorized to administer influenza or pneumococcal vaccines pursuant to § 32.1-126.4.","type":"section","prefixes":["U"],"prefix":"U","entire_prefix":"U","prefix_anchor":"U","level":1,"prior_prefix":"T","next_prefix":"V"},"26":{"id":278585,"text":"Pursuant to a specific order for a patient and under his direct and immediate supervision, a prescriber may authorize the administration of controlled substances by personnel who have been properly trained to assist a doctor of medicine or osteopathic medicine, provided the method does not include intravenous, intrathecal, or epidural administration and the prescriber remains responsible for such administration.","type":"section","prefixes":["V"],"prefix":"V","entire_prefix":"V","prefix_anchor":"V","level":1,"prior_prefix":"U","next_prefix":"W"},"27":{"id":278586,"text":"A physician assistant, nurse, dental hygienist, or authorized agent of a doctor of medicine, osteopathic medicine, or dentistry may possess and administer topical fluoride varnish pursuant to an oral or written order or a standing protocol issued by a doctor of medicine, osteopathic medicine, or dentistry.","type":"section","prefixes":["W"],"prefix":"W","entire_prefix":"W","prefix_anchor":"W","level":1,"prior_prefix":"V","next_prefix":"X"},"28":{"id":278587,"text":"A prescriber, acting in accordance with guidelines developed pursuant to § 32.1-46.02, may authorize the administration of influenza vaccine to minors by a licensed pharmacist, registered nurse, licensed practical nurse under the direction and immediate supervision of a registered nurse, or emergency medical services provider who holds an advanced life support certificate issued by the Commissioner of Health when the prescriber is not physically present.","type":"section","prefixes":["X"],"prefix":"X","entire_prefix":"X","prefix_anchor":"X","level":1,"prior_prefix":"W","next_prefix":"Y"},"29":{"id":278588,"text":"Notwithstanding the provisions of § 54.1-3303, pursuant to an oral, written, or standing order issued by a prescriber or a standing order issued by the Commissioner of Health or his designee authorizing the dispensing of naloxone or other opioid antagonist used for overdose reversal in the absence of an oral or written order for a specific patient issued by a prescriber, and in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health, a pharmacist, a health care provider providing services in a hospital emergency department, and emergency medical services personnel, as that term is defined in § 32.1-111.1, may dispense naloxone or other opioid antagonist used for overdose reversal and a person to whom naloxone or other opioid antagonist has been dispensed pursuant to this subsection may possess and administer naloxone or other opioid antagonist used for overdose reversal to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose. Law-enforcement officers as defined in § 9.1-101, employees of the Department of Forensic Science, employees of the Office of the Chief Medical Examiner, employees of the Department of General Services Division of Consolidated Laboratory Services, employees of the Department of Corrections designated by the Director of the Department of Corrections or designated as probation and parole officers or as correctional officers as defined in § 53.1-1, employees of the Department of Juvenile Justice designated as probation and parole officers or as juvenile correctional officers, employees of regional jails, employees of any state agency, school nurses, local health department employees that are assigned to a public school pursuant to an agreement between the local health department and the school board, school board employees who have completed training and are certified in the administration of an opioid antagonist for overdose reversal by a program administered or authorized by the Department of Health, other school board employees or individuals contracted by a school board to provide school health services, resident assistants in a student housing facility at a public institution of higher education who have completed training in the administration of an opioid antagonist for overdose reversal pursuant to § 23.1-802.2, and firefighters may also possess and administer naloxone or other opioid antagonist used for overdose reversal and may dispense naloxone or other opioid antagonist used for overdose reversal pursuant to an oral, written, or standing order issued by a prescriber or a standing order issued by the Commissioner of Health or his designee in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health.\n\t\t\tNotwithstanding the provisions of § 54.1-3303, pursuant to an oral, written, or standing order issued by a prescriber or a standing order issued by the Commissioner of Health or his designee authorizing the dispensing of naloxone or other opioid antagonist used for overdose reversal in the absence of an oral or written order for a specific patient issued by a prescriber, and in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health, any person may possess and administer naloxone or other opioid antagonist used for overdose reversal, other than naloxone in an injectable formulation with a hypodermic needle or syringe, in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health.","type":"section","prefixes":["Y"],"prefix":"Y","entire_prefix":"Y","prefix_anchor":"Y","level":1,"prior_prefix":"X","next_prefix":"Z"},"30":{"id":278589,"text":"Notwithstanding any other law or regulation to the contrary, a person who is acting on behalf of an organization that provides services to individuals at risk of experiencing an opioid overdose or training in the administration of naloxone or other opioid antagonist for overdose reversal may dispense naloxone or other opioid antagonist, provided that such dispensing is (i) pursuant to a standing order issued by a prescriber and (ii) in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health. If the person acting on behalf of an organization dispenses naloxone or other opioid antagonist in an injectable formulation with a hypodermic needle or syringe, he shall first obtain authorization from the Department of Behavioral Health and Developmental Services to train individuals on the proper administration of naloxone or other opioid antagonist by and proper disposal of a hypodermic needle or syringe, and he shall obtain a controlled substance registration from the Board of Pharmacy. The Board of Pharmacy shall not charge a fee for the issuance of such controlled substance registration. The dispensing may occur at a site other than that of the controlled substance registration provided the entity possessing the controlled substances registration maintains records in accordance with regulations of the Board of Pharmacy. No person who dispenses naloxone or other opioid antagonist on behalf of an organization pursuant to this subsection shall charge a fee for the dispensing of naloxone or other opioid antagonist that is greater than the cost to the organization of obtaining the naloxone or other opioid antagonist dispensed. A person to whom naloxone or other opioid antagonist has been dispensed pursuant to this subsection may possess naloxone or other opioid antagonist and may administer naloxone or other opioid antagonist to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose.\n\t\t\tAA. A person who is not otherwise authorized to administer naloxone or other opioid antagonist used for overdose reversal may administer naloxone or other opioid antagonist used for overdose reversal to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose.\n\t\t\tBB. Pursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize, with the consent of the parents as defined in § 22.1-1, an employee of (i) a school board, (ii) a school for students with disabilities as defined in § 22.1-319 licensed by the Board of Education, or (iii) a private school accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education who is trained in the administration of injected medications for the treatment of adrenal crisis resulting from a condition causing adrenal insufficiency to administer such medication to a student diagnosed with a condition causing adrenal insufficiency when the student is believed to be experiencing or about to experience an adrenal crisis. Such authorization shall be effective only when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tCC. . Pursuant to a written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize, with the consent of the student’s parents as defined in § 22.1-1, an employee of (i) a school board, (ii) a school for students with disabilities as defined in § 22.1-319 licensed by the Board of Education, (iii) a private school accredited pursuant to § 22.1-19 as administered by the Virginia Council for Private Education, (iv) a local governing body, or (v) a local health department who is trained in the administration of seizure rescue medications for the treatment of seizures resulting from a condition causing seizures to administer such medications to a student diagnosed with a condition causing seizures when the student is believed to be experiencing or about to experience a seizure. Such authorization shall be effective only when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not capable of reaching the student within the amount of time necessary to effectively perform the administration of the medication.","type":"section","prefixes":["Z"],"prefix":"Z","entire_prefix":"Z","prefix_anchor":"Z","level":1,"prior_prefix":"Y"}},"ancestry":[{"id":13871,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":4,"order_by":1,"parent_id":13240,"metadata":{},"date_created":"2026-06-26 03:46:08","date_modified":"2026-06-26 03:46:08","permalink":{"id":243225,"object_type":"structure","relational_id":13871,"identifier":"1","token":"54.1\/III\/34\/1","url":"\/54.1\/III\/34\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13240,"edition_id":1,"name":"Drug Control Act","identifier":"34","label":"chapter","depth":3,"order_by":1,"parent_id":12758,"metadata":{},"date_created":"2026-06-26 03:44:30","date_modified":"2026-06-26 03:44:30","permalink":{"id":243223,"object_type":"structure","relational_id":13240,"identifier":"34","token":"54.1\/III\/34","url":"\/54.1\/III\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12758,"edition_id":1,"name":"Professions and Occupations Regulated by Boards Within the Department of Health Professions","identifier":"III","label":"subtitle","depth":2,"order_by":1,"parent_id":12754,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241105,"object_type":"structure","relational_id":12758,"identifier":"III","token":"54.1\/III","url":"\/54.1\/III\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12754,"edition_id":1,"name":"Professions and Occupations","identifier":"54.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":239313,"object_type":"structure","relational_id":12754,"identifier":"54.1","token":"54.1","url":"\/54.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":77846,"structure_id":13871,"section_number":"54.1-3400","catch_line":"Citation","url":"\/54.1-3400\/","token":"54.1\/III\/34\/1\/54.1-3400","metadata":false},{"id":59669,"structure_id":13871,"section_number":"54.1-3401","catch_line":"Definitions","url":"\/54.1-3401\/","token":"54.1\/III\/34\/1\/54.1-3401","metadata":false},{"id":73061,"structure_id":13871,"section_number":"54.1-3401.1","catch_line":"Repealed","url":"\/54.1-3401.1\/","token":"54.1\/III\/34\/1\/54.1-3401.1","metadata":false},{"id":67762,"structure_id":13871,"section_number":"54.1-3402","catch_line":"Repealed","url":"\/54.1-3402\/","token":"54.1\/III\/34\/1\/54.1-3402","metadata":false},{"id":66637,"structure_id":13871,"section_number":"54.1-3403","catch_line":"Chapter not applicable to economic poisons","url":"\/54.1-3403\/","token":"54.1\/III\/34\/1\/54.1-3403","metadata":false},{"id":64371,"structure_id":13871,"section_number":"54.1-3404","catch_line":"Inventories of controlled substances required of certain persons; 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The record of this law\u2019s original creation isn\u2019t available online. It has been modified 44 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1956, chapter 225; in 1970, chapter 650; in 1973, chapter 468; in 1976, chapters 358 and 614; in 1977, chapter 302; in 1978, chapter 224; in 1980, chapters 270 and 287; in 1983, chapters 456 and 528; in 1984, chapters 141 and 555; in 1986, chapter 81; in 1987, chapter 226; in 1988, chapter 765; in 1990, chapter 309; in 1991, chapters 141, 519, 524, and 532; in 1992, chapters 610, 760, and 793; in 1993, chapters 15, 810, 957, and 993; in 1994, chapter 53<\/a>; in 1995, chapters 88<\/a> and 529<\/a>; in 1996, chapters 152<\/a>, 158<\/a>, 183<\/a>, 406<\/a>, 408<\/a>, and 490<\/a>; in 1997, chapters 272<\/a>, 566<\/a>, 806<\/a>, and 906<\/a>; in 1998, chapter 112<\/a>; in 1999, chapter 570<\/a>; in 2000, chapters 135<\/a>, 498<\/a>, 861<\/a>, 881<\/a>, and 935<\/a>; in 2003, chapters 465<\/a>, 497<\/a>, 515<\/a>, 794<\/a>, 995<\/a>, and 1020<\/a>; in 2005, chapters 113<\/a>, 610<\/a>, and 924<\/a>; in 2006, chapters 75<\/a>, 432<\/a>, 686<\/a>, and 858<\/a>; in 2007, chapters 17<\/a>, 699<\/a>, 702<\/a>, and 783<\/a>; in 2008, chapters 85<\/a> and 694<\/a>; in 2009, chapters 48<\/a>, 110<\/a>, 506<\/a>, 813<\/a>, and 840<\/a>; in 2010, chapters 179<\/a>, 245<\/a>, and 252<\/a>; in 2011, chapter 292<\/a>; in 2012, chapters 787<\/a>, 803<\/a>, 833<\/a>, and 835<\/a>; in 2013, chapters 114<\/a>, 132<\/a>, 183<\/a>, 191<\/a>, 252<\/a>, 267<\/a>, 328<\/a>, 336<\/a>, 359<\/a>, and 617<\/a>; in 2014, chapters 88<\/a> and 491<\/a>; in 2015, chapters 302<\/a>, 387<\/a>, 502<\/a>, 503<\/a>, 514<\/a>, 725<\/a>, 732<\/a>, and 752<\/a>; in 2016, chapter 144<\/a>; in 2017, chapters 3<\/a>, 55<\/a>, 107<\/a>, 168<\/a>, 174<\/a>, 182<\/a>, 294<\/a>, 304<\/a>, and 713<\/a>; in 2018, chapters 62<\/a> and 247<\/a>; in 2019, chapters 87<\/a>, 212<\/a>, 221<\/a>, and 431<\/a>; in 2020, chapters 39<\/a>, 302<\/a>, 459<\/a>, 460<\/a>, 556<\/a>, 560<\/a>, 853<\/a>, 860<\/a>, 861<\/a>, 924<\/a>, 927<\/a>, and 1095<\/a>; in 2022, chapters 695<\/a>, 696<\/a>, 733<\/a>, and 774<\/a>; in 2023, chapters 115<\/a>, 116<\/a>, 183<\/a>, 267<\/a>, 569<\/a>, 631<\/a>, 673<\/a>, 674<\/a>, and 729<\/a>; in 2024, chapters 37<\/a>, 150<\/a>, 440<\/a>, 451<\/a>, 465<\/a>, 466<\/a>, and 519<\/a>; in 2025, chapters 59<\/a>, 65<\/a>, 277<\/a>, 341<\/a>, 370<\/a>, 386<\/a>, and 446<\/a>.<\/p>","references":[{"id":78246,"section_number":"22.1-274.2","catch_line":"Possession and administration of inhaled asthma medications, epinephrine, glucagon, and seizure rescue medications by certain students or school board employees","order_by":null,"url":"\/22.1-274.2\/"},{"id":81947,"section_number":"22.1-274.4:1","catch_line":"Opioid antagonist procurement, placement, maintenance, and administration; staff and faculty training; policies and requirements","order_by":null,"url":"\/22.1-274.4_1\/"},{"id":78903,"section_number":"22.1-274.6","catch_line":"Seizure management and action plan; training","order_by":null,"url":"\/22.1-274.6\/"},{"id":69405,"section_number":"22.1-289.023","catch_line":"Enforcement and sanctions; 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definitions","order_by":null,"url":"\/2.2-3904\/"},{"id":74111,"section_number":"22.1-1","catch_line":"(Effective July 1, 2026) Definitions","order_by":null,"url":"\/22.1-1\/"},{"id":55423,"section_number":"22.1-19","catch_line":"Accreditation of elementary, middle, and high schools; nursery schools; recognition of certain organizations; child day center regulation","order_by":null,"url":"\/22.1-19\/"},{"id":78246,"section_number":"22.1-274.2","catch_line":"Possession and administration of inhaled asthma medications, epinephrine, glucagon, and seizure rescue medications by certain students or school board employees","order_by":null,"url":"\/22.1-274.2\/"},{"id":83341,"section_number":"22.1-289.02","catch_line":"Definitions","order_by":null,"url":"\/22.1-289.02\/"},{"id":83939,"section_number":"22.1-319","catch_line":"Definitions","order_by":null,"url":"\/22.1-319\/"},{"id":84271,"section_number":"23.1-802.2","catch_line":"Resident assistant opioid antagonist administration training required","order_by":null,"url":"\/23.1-802.2\/"},{"id":74269,"section_number":"32.1-111.1","catch_line":"Definitions","order_by":null,"url":"\/32.1-111.1\/"},{"id":64338,"section_number":"32.1-13","catch_line":"Emergency orders and regulations","order_by":null,"url":"\/32.1-13\/"},{"id":77454,"section_number":"32.1-3","catch_line":"Definitions","order_by":null,"url":"\/32.1-3\/"},{"id":66908,"section_number":"32.1-42.1","catch_line":"Administration and dispensing of necessary drugs, devices and vaccines during a declared disaster or emergency","order_by":null,"url":"\/32.1-42.1\/"},{"id":73649,"section_number":"32.1-46.02","catch_line":"Administration of influenza vaccine to minors","order_by":null,"url":"\/32.1-46.02\/"},{"id":63399,"section_number":"32.1-50.2","catch_line":"Administration of tuberculin purified protein derivative by nurses; policies and guidelines","order_by":null,"url":"\/32.1-50.2\/"},{"id":81707,"section_number":"35.1-18","catch_line":"License required; name in which issued; not assignable or transferable","order_by":null,"url":"\/35.1-18\/"},{"id":85635,"section_number":"53.1-1","catch_line":"Definitions","order_by":null,"url":"\/53.1-1\/"},{"id":54903,"section_number":"54.1-2722","catch_line":"License; application; qualifications; practice of dental hygiene; report","order_by":null,"url":"\/54.1-2722\/"},{"id":70746,"section_number":"54.1-2729.1","catch_line":"Scope of chapter","order_by":null,"url":"\/54.1-2729.1\/"},{"id":70057,"section_number":"54.1-2952.1","catch_line":"Prescription of certain controlled substances and devices by licensed physician assistants","order_by":null,"url":"\/54.1-2952.1\/"},{"id":62429,"section_number":"54.1-2954","catch_line":"Respiratory therapist; definition","order_by":null,"url":"\/54.1-2954\/"},{"id":71447,"section_number":"54.1-2957.01","catch_line":"Prescription of certain controlled substances and devices by licensed advanced practice registered nurses","order_by":null,"url":"\/54.1-2957.01\/"},{"id":83986,"section_number":"54.1-2957.04","catch_line":"Licensure as a licensed certified midwife; practice as a licensed certified midwife; independent practice as a licensed certified midwife; use of title; required disclosures","order_by":null,"url":"\/54.1-2957.04\/"},{"id":58401,"section_number":"54.1-2957.7","catch_line":"Licensed midwife and practice of midwifery; definitions","order_by":null,"url":"\/54.1-2957.7\/"},{"id":59351,"section_number":"54.1-3041","catch_line":"Registration required","order_by":null,"url":"\/54.1-3041\/"},{"id":54127,"section_number":"54.1-3222","catch_line":"TPA certification; certification for treatment of diseases or abnormal conditions with therapeutic pharmaceutical agents (TPAs)","order_by":null,"url":"\/54.1-3222\/"},{"id":85347,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","order_by":null,"url":"\/54.1-3303\/"},{"id":72379,"section_number":"63.2-100","catch_line":"Definitions","order_by":null,"url":"\/63.2-100\/"},{"id":73488,"section_number":"9.1-101","catch_line":"(Effective July 1, 2026) Definitions","order_by":null,"url":"\/9.1-101\/"}],"permalink":{"id":243263,"object_type":"law","relational_id":77665,"identifier":"54.1-3408","token":"54.1\/III\/34\/1\/54.1-3408","url":"\/54.1-3408\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/54.1-3408\/","token":"54.1\/III\/34\/1\/54.1-3408","dublin_core":{"Title":"Professional use by practitioners","Type":"Text","Format":"text\/html","Identifier":"\u00a7 54.1-3408","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> A practitioner<\/span> of medicine, osteopathy, podiatry, dentistry, or veterinary medicine, a licensed advanced practice registered nurse pursuant to § 54.1-2957.01<\/a>, a licensed certified midwife pursuant to § 54.1-2957.04<\/a>, a licensed physician assistant pursuant to § 54.1-2952.1<\/a>, or a TPA-certified optometrist pursuant to Article 5 (§ 54.1-3222<\/a> et seq.) of Chapter 32 shall only prescribe, dispense<\/span>, or administer<\/span> controlled substances<\/span> in good faith for medicinal or therapeutic purposes within the course of his professional practice. A licensed midwife pursuant to § 54.1-2957.7<\/a> shall only obtain, possess, and administer<\/span> controlled substances<\/span> in good faith for medicinal or therapeutic purposes within the course of his professional practice. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The prescribing practitioner<\/span>’s order<\/span> may be on a written prescription<\/span> or pursuant to an oral prescription<\/span> as authorized by this chapter. The prescriber<\/span> may administer<\/span> drugs<\/span> and devices<\/span>, or he may cause drugs<\/span> or devices<\/span> to be administered by: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> A nurse, physician assistant, or intern under his direction and supervision; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Persons<\/span> trained to administer<\/span> drugs<\/span> and devices<\/span> to patients in state-owned or state-operated hospitals or facilities licensed as hospitals by the Board<\/span> of Health or psychiatric hospitals licensed by the Department of Behavioral Health and Developmental Services who administer<\/span> drugs<\/span> under the control and supervision of the prescriber<\/span> or a pharmacist; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Emergency medical services personnel certified and authorized to administer<\/span> drugs<\/span> and devices<\/span> pursuant to regulations of the Board<\/span> of Health who act within the scope of such certification and pursuant to an oral or written order<\/span> or standing protocol; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Persons<\/span> who are employed or engaged at a medical care facility, as defined in § 32.1-3<\/a>, who have a valid emergency medical services provider certification issued by the Board<\/span> of Health as a requirement of being employed or engaged at the medical care facility within the scope of such certification, pursuant to an oral or written order<\/span> or standing protocol to administer<\/span> drugs<\/span> and devices<\/span> at the medical care facility; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> A licensed respiratory therapist as defined in § 54.1-2954<\/a> who administers<\/span> by inhalation controlled substances<\/span> used in inhalation or respiratory therapy. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> Pursuant to an oral or written order<\/span> or standing protocol, the prescriber<\/span>, who is authorized by state or federal law<\/span> to possess and administer<\/span> radiopharmaceuticals<\/span> in the scope of his practice, may authorize a nuclear medicine technologist<\/span> to administer<\/span>, under his supervision, radiopharmaceuticals<\/span> used in the diagnosis or treatment of disease. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Pursuant to an oral or written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize registered nurses and licensed practical nurses to possess (i) epinephrine and oxygen for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.\n\t\t\tPursuant to the regulations of the Board<\/span> of Health, certain emergency medical services technicians may possess and administer<\/span> epinephrine in emergency cases of anaphylactic shock.\n\t\t\tPursuant to an order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, any school nurse, school board<\/span> employee, employee of a local governing body, or employee of a local health department who is authorized by a prescriber<\/span> and trained in the administration of epinephrine may possess and administer<\/span> epinephrine.\n\t\t\tPursuant to an order<\/span> or standing protocol that shall be issued by the local health director within the course of his professional practice, any school nurse, licensed athletic trainer under contract<\/span> with a local school division, school board<\/span> employee, employee of a local governing body, or employee of a local health department who is authorized by the local health director and trained in the administration of albuterol inhalers and valved holding chambers<\/span> or nebulized albuterol may possess or administer<\/span> an albuterol inhaler and a valved holding chamber or nebulized albuterol to a student diagnosed with a condition requiring an albuterol inhaler or nebulized albuterol when the student is believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order<\/span> or a standing protocol issued by the prescriber<\/span> within the course of his professional practice, any employee of a school for students with disabilities, as defined in § 22.1-319<\/a> and licensed by the Board<\/span> of Education, or any employee of a private school that is accredited pursuant to § 22.1-19<\/a> as administered by the Virginia Council for Private Education who is authorized by a prescriber<\/span> and trained in the administration of (a) epinephrine may possess and administer<\/span> epinephrine and (b) albuterol inhalers or nebulized albuterol may possess or administer<\/span> an albuterol inhaler or nebulized albuterol to a student diagnosed with a condition requiring an albuterol inhaler or nebulized albuterol when the student is believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order<\/span> or a standing protocol issued by the prescriber<\/span> within the course of his professional practice, any nurse at an early childhood care and education entity, employee at the entity, or employee of a local health department who is authorized by a prescriber<\/span> and trained in the administration of epinephrine may possess and administer<\/span> epinephrine.\n\t\t\tPursuant to an order<\/span> or a standing protocol issued by the prescriber<\/span> within the course of his professional practice, any employee of a public institution of higher education or a private institution of higher education who is authorized by a prescriber<\/span> and trained in the administration of epinephrine may possess and administer<\/span> epinephrine.\n\t\t\tPursuant to an order<\/span> or a standing protocol issued by the prescriber<\/span> within the course of his professional practice, any employee of an organization providing outdoor educational experiences or programs for youth who is authorized by a prescriber<\/span> and trained in the administration of epinephrine may possess and administer<\/span> epinephrine.\n\t\t\tPursuant to an order<\/span> or a standing protocol issued by the prescriber<\/span> within the course of his professional practice, and in accordance with policies and guidelines established by the Department of Health, such prescriber<\/span> may authorize any employee of a restaurant licensed pursuant to Chapter 3 (§ 35.1-18<\/a> et seq.) of Title 35.1 to possess and administer<\/span> epinephrine on the premises of the restaurant at which the employee is employed, provided that such person<\/span> is trained in the administration of epinephrine.\n\t\t\tPursuant to an order<\/span> issued by the prescriber<\/span> within the course of his professional practice, an employee of a provider licensed by the Department of Behavioral Health and Developmental Services or a person<\/span> providing services pursuant to a contract<\/span> with a provider licensed by the Department of Behavioral Health and Developmental Services may possess and administer<\/span> epinephrine, provided such person<\/span> is authorized and trained in the administration of epinephrine.\n\t\t\tPursuant to an order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, any employee of a place of public accommodation, as defined in subsection A of § 2.2-3904<\/a>, who is authorized by a prescriber<\/span> and trained in the administration of epinephrine may possess and administer<\/span> epinephrine.\n\t\t\tPursuant to an oral or written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize pharmacists to possess epinephrine and oxygen for administration in treatment of emergency medical conditions. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Pursuant to an oral or written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize licensed physical therapists to possess and administer<\/span> topical corticosteroids, topical lidocaine, and any other Schedule VI topical drug<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> Pursuant to an oral or written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize licensed athletic trainers to possess and administer<\/span> topical corticosteroids, topical lidocaine, or other Schedule VI topical drugs<\/span>; oxygen and IV saline for use in emergency situations; subcutaneous lidocaine for wound closure; epinephrine for use in emergency cases of anaphylactic shock; and naloxone or other opioid antagonist for overdose reversal. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> Pursuant to an oral or written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, and in accordance with policies and guidelines established by the Department of Health pursuant to § 32.1-50.2<\/a>, such prescriber<\/span> may authorize registered nurses or licensed practical nurses under the supervision of a registered nurse to possess and administer<\/span> tuberculin purified protein derivative (PPD) in the absence of a prescriber<\/span>. The Department of Health’s policies and guidelines shall be consistent with applicable guidelines developed by the Centers for Disease Control and Prevention for preventing transmission of mycobacterium tuberculosis and shall be updated to incorporate any subsequently implemented standards of the Occupational Safety and Health Administration and the Department of Labor and Industry to the extent that they are inconsistent with the Department of Health’s policies and guidelines. Such standing protocols shall explicitly describe the categories of persons<\/span> to whom the tuberculin test is to be administered and shall provide for appropriate medical evaluation of those in whom the test is positive. The prescriber<\/span> shall ensure that the nurse implementing such standing protocols has received adequate training in the practice and principles underlying tuberculin screening.\n\t\t\tThe Health Commissioner or his designee may authorize registered nurses, acting as agents<\/span> of the Department of Health, to possess and administer<\/span>, at the nurse’s discretion, tuberculin purified protein derivative (PPD) to those persons<\/span> in whom tuberculin skin testing is indicated based on protocols and policies established by the Department of Health. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> Pursuant to a written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize, with the consent of the parents as defined in § 22.1-1<\/a>, an employee of (i) a school board<\/span>, (ii) a school for students with disabilities as defined in § 22.1-319<\/a> licensed by the Board<\/span> of Education, or (iii) a private school accredited pursuant to § 22.1-19<\/a> as administered by the Virginia Council for Private Education who is trained in the administration of insulin and glucagon to assist with the administration of insulin or administer<\/span> glucagon to a student diagnosed as having diabetes and who requires insulin injections during the school day or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia. Such authorization shall only be effective when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tPursuant to a written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize the possession<\/span> and administration of undesignated glucagon as set forth in subsection F of § 22.1-274.2<\/a>.\n\t\t\tPursuant to a written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize an employee of a public institution of higher education or a private institution of higher education who is trained in the administration of insulin and glucagon to assist with the administration of insulin or administration of glucagon to a student diagnosed as having diabetes and who requires insulin injections or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia. Such authorization shall only be effective when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tPursuant to a written order<\/span> issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize an employee of a provider licensed by the Department of Behavioral Health and Developmental Services or a person<\/span> providing services pursuant to a contract<\/span> with a provider licensed by the Department of Behavioral Health and Developmental Services to assist with the administration of insulin or to administer<\/span> glucagon to a person<\/span> diagnosed as having diabetes and who requires insulin injections or for whom glucagon has been prescribed for the emergency treatment of hypoglycemia, provided such employee or person<\/span> providing services has been trained in the administration of insulin and glucagon. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> A prescriber<\/span> may authorize, pursuant to a protocol approved by the Board<\/span> of Nursing, the administration of vaccines to adults for immunization, when a practitioner<\/span> with prescriptive authority is not physically present, by (i) licensed pharmacists, (ii) registered nurses, or (iii) licensed practical nurses under the supervision of a registered nurse. A prescriber<\/span> acting on behalf of and in accordance with established protocols of the Department of Health may authorize the administration of vaccines to any person<\/span> by a pharmacist, nurse, or designated emergency medical services provider who holds an advanced life support certificate issued by the Commissioner of Health under the direction of an operational medical director when the prescriber<\/span> is not physically present. The emergency medical services provider shall provide documentation of the vaccines to be recorded in the Virginia Immunization Information System. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

J.<\/span> A dentist may cause Schedule VI topical drugs<\/span> to be administered under his direction and supervision by either a dental hygienist or by an authorized agent<\/span> of the dentist.\n\t\t\tFurther, pursuant to a written order<\/span> and in accordance with a standing protocol issued by the dentist in the course of his professional practice, a dentist may authorize a dental hygienist under his general supervision, as defined in § 54.1-2722<\/a>, or his remote supervision, as defined in subsection E or F of § 54.1-2722<\/a>, to possess and administer<\/span> topical oral fluorides, topical oral anesthetics, topical and directly applied antimicrobial agents<\/span> for treatment of periodontal pocket lesions, and any other Schedule VI topical drug<\/span> approved by the Board<\/span> of Dentistry.\n\t\t\tIn addition, a dentist may authorize a dental hygienist under his direction to administer<\/span> Schedule VI nitrous oxide and oxygen inhalation analgesia and, to persons<\/span> 18 years of age or older, Schedule VI local anesthesia. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

K.<\/span> Pursuant to an oral or written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize registered professional nurses certified as sexual assault<\/span> nurse examiners-A (SANE-A) under his supervision and when he is not physically present to possess and administer<\/span> preventive medications for victims of sexual assault<\/span> as recommended by the Centers for Disease Control and Prevention. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

L.<\/span> This section shall not prevent the administration of drugs<\/span> by a person<\/span> who has satisfactorily completed a training program for this purpose approved by the Board<\/span> of Nursing and who administers<\/span> such drugs<\/span> in accordance with a prescriber<\/span>’s instructions pertaining to dosage, frequency, and manner of administration, and in accordance with regulations promulgated by the Board<\/span> of Pharmacy relating to security and record keeping, when the drugs<\/span> administered would be normally self-administered by (i) an individual receiving services in a program licensed by the Department of Behavioral Health and Developmental Services; (ii) a resident of the Virginia Rehabilitation Center for the Blind and Vision Impaired; (iii) a resident of a facility approved by the Board<\/span> or Department of Juvenile Justice for the placement of children in need of services or delinquent or alleged delinquent youth; (iv) a program participant of an adult day center licensed by the Department of Social Services; (v) a resident of any facility authorized or operated by a state or local government whose primary purpose is not to provide health care services; (vi) a resident of a private children’s residential facility, as defined in § 63.2-100<\/a> and licensed by the Department of Social Services, Department of Education, or Department of Behavioral Health and Developmental Services; or (vii) a student in a school for students with disabilities, as defined in § 22.1-319<\/a> and licensed by the Board<\/span> of Education.\n\t\t\tIn addition, this section shall not prevent a person<\/span> who has successfully completed a training program for the administration of drugs<\/span> via percutaneous gastrostomy tube approved by the Board<\/span> of Nursing and been evaluated by a registered nurse as having demonstrated competency in administration of drugs<\/span> via percutaneous gastrostomy tube from administering drugs<\/span> to a person<\/span> receiving services from a program licensed by the Department of Behavioral Health and Developmental Services to such person<\/span> via percutaneous gastrostomy tube. The continued competency of a person<\/span> to administer<\/span> drugs<\/span> via percutaneous gastrostomy tube shall be evaluated semiannually by a registered nurse. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

M.<\/span> Medication aides registered by the Board<\/span> of Nursing pursuant to Article 7 (§ 54.1-3041<\/a> et seq.) of Chapter 30 may administer<\/span> drugs<\/span> that would otherwise be self-administered to residents of any assisted living facility licensed by the Department of Social Services. A registered medication aide shall administer<\/span> drugs<\/span> pursuant to this section in accordance with the prescriber<\/span>’s instructions pertaining to dosage, frequency, and manner of administration; in accordance with regulations promulgated by the Board<\/span> of Pharmacy relating to security and recordkeeping; in accordance with the assisted living facility’s Medication Management Plan; and in accordance with such other regulations governing their practice promulgated by the Board<\/span> of Nursing. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

N.<\/span> Advanced medication aides registered by the Board<\/span> of Nursing pursuant to Article 7 (§ 54.1-3041<\/a> et seq.) of Chapter 30 may administer<\/span> drugs<\/span> that would be administered by a registered medication aide pursuant to subsection M, in addition to drugs<\/span> determined permissible by the Board<\/span> of Nursing, in a nursing home licensed by the Department of Health. Advanced medication aides shall administer<\/span> drugs<\/span> pursuant to this section in accordance with the prescriber<\/span>’s instructions pertaining to dosage, frequency, and manner of administration; in accordance with regulations promulgated by the Board<\/span> of Pharmacy relating to security and recordkeeping; in accordance with the licensed nursing home’s policies and procedures; and in accordance with such other regulations governing their practice promulgated by the Board<\/span> of Nursing. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

O.<\/span> In addition, this section shall not prevent the administration of drugs<\/span> by a person<\/span> who administers<\/span> such drugs<\/span> in accordance with a physician’s instructions pertaining to dosage, frequency, and manner of administration and with written authorization of a parent, and in accordance with school board<\/span> regulations relating to training, security and record keeping, when the drugs<\/span> administered would be normally self-administered by a student of a Virginia public school. Training for such persons<\/span> shall be accomplished through a program approved by the local school boards<\/span>, in consultation with the local departments of health. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

P.<\/span> In addition, this section shall not prevent the administration of drugs<\/span> by a person<\/span> to (i) a child in a child day program as defined in § 22.1-289.02<\/a> and regulated by the Board<\/span> of Education or a local government pursuant to § 15.2-914<\/a>, or (ii) a student of a private school that is accredited pursuant to § 22.1-19<\/a> as administered by the Virginia Council for Private Education, provided such person<\/span> (a) has satisfactorily completed a training program for this purpose approved by the Board<\/span> of Nursing and taught by a registered nurse, a licensed practical nurse, an advanced practice registered nurse, a physician assistant, a doctor of medicine or osteopathic medicine, or a pharmacist; (b) has obtained written authorization from a parent or guardian; (c) administers<\/span> drugs<\/span> only to the child identified on the prescription<\/span> label<\/span> in accordance with the prescriber<\/span>’s instructions pertaining to dosage, frequency, and manner of administration; and (d) administers<\/span> only those drugs<\/span> that were dispensed from a pharmacy and maintained in the original, labeled container that would normally be self-administered by the child or student, or administered by a parent or guardian to the child or student. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

Q.<\/span> In addition, this section shall not prevent the administration or dispensing<\/span> of drugs<\/span> and devices<\/span> by persons<\/span> if they are authorized by the State Health Commissioner in accordance with protocols established by the State Health Commissioner pursuant to § 32.1-42.1<\/a> when (i) the Governor has declared a disaster or a state of emergency, the United States Secretary of Health and Human Services has issued a declaration of an actual or potential bioterrorism incident or other actual or potential public health emergency, or the Board<\/span> of Health has made an emergency order<\/span> pursuant to § 32.1-13<\/a> for the purpose of suppressing nuisances dangerous to the public health and communicable, contagious, and infectious diseases and other dangers to the public life and health and for the limited purpose of administering vaccines as an approved countermeasure for such communicable, contagious, and infectious diseases; (ii) it is necessary to permit the provision of needed drugs<\/span> or devices<\/span>; and (iii) such persons<\/span> have received the training necessary to safely administer<\/span> or dispense<\/span> the needed drugs<\/span> or devices<\/span>. Such persons<\/span> shall administer<\/span> or dispense<\/span> all drugs<\/span> or devices<\/span> under the direction, control, and supervision of the State Health Commissioner. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

R.<\/span> Nothing in this title shall prohibit the administration of normally self-administered drugs<\/span> by unlicensed individuals to a person<\/span> in his private residence. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

S.<\/span> This section shall not interfere with any prescriber<\/span> issuing prescriptions<\/span> in compliance with his authority and scope of practice and the provisions of this section to a Board<\/span> agent<\/span> for use pursuant to subsection G of § 18.2-258.1<\/a>. Such prescriptions<\/span> issued by such prescriber<\/span> shall be deemed to be valid prescriptions<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

T.<\/span> Nothing in this title shall prevent or interfere with dialysis care technicians<\/span> or dialysis patient care technicians<\/span> who are certified by an organization approved by the Department of Health Professions or persons<\/span> authorized for provisional practice pursuant to Chapter 27.01 (§ 54.1-2729.1<\/a> et seq.), in the ordinary course of their duties in a Medicare-certified renal dialysis facility, from administering heparin, topical needle site anesthetics, dialysis solutions<\/span>, sterile normal saline solution, and blood volumizers, for the purpose of facilitating renal dialysis treatment, when such administration of medications occurs under the orders<\/span> of a licensed physician, an advanced practice registered nurse, or a physician assistant and under the immediate and direct supervision of a licensed registered nurse. Nothing in this chapter shall be construed to prohibit a patient care dialysis technician trainee<\/span> from performing dialysis care as part of and within the scope of the clinical skills instruction segment of a supervised dialysis technician training program, provided such trainee<\/span> is identified as a “trainee<\/span>” while working in a renal dialysis facility.\n\t\t\tThe dialysis care technician<\/span> or dialysis patient care technician<\/span> administering the medications shall have demonstrated competency as evidenced by holding current valid certification from an organization approved by the Department of Health Professions pursuant to Chapter 27.01 (§ 54.1-2729.1<\/a> et seq.). <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

U.<\/span> Persons<\/span> who are otherwise authorized to administer<\/span> controlled substances<\/span> in hospitals shall be authorized to administer<\/span> influenza or pneumococcal vaccines pursuant to § 32.1-126.4<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

V.<\/span> Pursuant to a specific order<\/span> for a patient and under his direct and immediate supervision, a prescriber<\/span> may authorize the administration of controlled substances<\/span> by personnel who have been properly trained to assist a doctor of medicine or osteopathic medicine, provided the method does not include intravenous, intrathecal, or epidural administration and the prescriber<\/span> remains responsible for such administration. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

W.<\/span> A physician assistant, nurse, dental hygienist, or authorized agent<\/span> of a doctor of medicine, osteopathic medicine, or dentistry may possess and administer<\/span> topical fluoride varnish pursuant to an oral or written order<\/span> or a standing protocol issued by a doctor of medicine, osteopathic medicine, or dentistry. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

X.<\/span> A prescriber<\/span>, acting in accordance with guidelines developed pursuant to § 32.1-46.02<\/a>, may authorize the administration of influenza vaccine to minors<\/span> by a licensed pharmacist, registered nurse, licensed practical nurse under the direction and immediate supervision of a registered nurse, or emergency medical services provider who holds an advanced life support certificate issued by the Commissioner of Health when the prescriber<\/span> is not physically present. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

Y.<\/span> Notwithstanding the provisions of § 54.1-3303<\/a>, pursuant to an oral, written, or standing order<\/span> issued by a prescriber<\/span> or a standing order<\/span> issued by the Commissioner of Health or his designee authorizing the dispensing<\/span> of naloxone or other opioid antagonist used for overdose reversal in the absence of an oral or written order<\/span> for a specific patient issued by a prescriber<\/span>, and in accordance with protocols developed by the Board<\/span> of Pharmacy in consultation with the Board<\/span> of Medicine and the Department of Health, a pharmacist, a health care provider providing services in a hospital emergency department, and emergency medical services personnel, as that term is defined in § 32.1-111.1<\/a>, may dispense<\/span> naloxone or other opioid antagonist used for overdose reversal and a person<\/span> to whom naloxone or other opioid antagonist has been dispensed pursuant to this subsection may possess and administer<\/span> naloxone or other opioid antagonist used for overdose reversal to a person<\/span> who is believed to be experiencing or about to experience a life-threatening opioid overdose. Law<\/span>-enforcement officers as defined in § 9.1-101<\/a>, employees of the Department of Forensic Science, employees of the Office of the Chief Medical Examiner, employees of the Department of General Services Division of Consolidated Laboratory Services, employees of the Department of Corrections designated by the Director of the Department of Corrections or designated as probation<\/span> and parole<\/span> officers or as correctional officers as defined in § 53.1-1<\/a>, employees of the Department of Juvenile Justice designated as probation<\/span> and parole<\/span> officers or as juvenile correctional officers, employees of regional jails, employees of any state agency, school nurses, local health department employees that are assigned to a public school pursuant to an agreement between the local health department and the school board<\/span>, school board<\/span> employees who have completed training and are certified in the administration of an opioid antagonist for overdose reversal by a program administered or authorized by the Department of Health, other school board<\/span> employees or individuals contracted by a school board<\/span> to provide school health services, resident assistants in a student housing facility at a public institution of higher education who have completed training in the administration of an opioid antagonist for overdose reversal pursuant to § 23.1-802.2<\/a>, and firefighters may also possess and administer<\/span> naloxone or other opioid antagonist used for overdose reversal and may dispense<\/span> naloxone or other opioid antagonist used for overdose reversal pursuant to an oral, written, or standing order<\/span> issued by a prescriber<\/span> or a standing order<\/span> issued by the Commissioner of Health or his designee in accordance with protocols developed by the Board<\/span> of Pharmacy in consultation with the Board<\/span> of Medicine and the Department of Health.\n\t\t\tNotwithstanding the provisions of § 54.1-3303<\/a>, pursuant to an oral, written, or standing order<\/span> issued by a prescriber<\/span> or a standing order<\/span> issued by the Commissioner of Health or his designee authorizing the dispensing<\/span> of naloxone or other opioid antagonist used for overdose reversal in the absence of an oral or written order<\/span> for a specific patient issued by a prescriber<\/span>, and in accordance with protocols developed by the Board<\/span> of Pharmacy in consultation with the Board<\/span> of Medicine and the Department of Health, any person<\/span> may possess and administer<\/span> naloxone or other opioid antagonist used for overdose reversal, other than naloxone in an injectable formulation with a hypodermic needle or syringe, in accordance with protocols developed by the Board<\/span> of Pharmacy in consultation with the Board<\/span> of Medicine and the Department of Health. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

Z.<\/span> Notwithstanding any other law<\/span> or regulation to the contrary, a person<\/span> who is acting on behalf of an organization that provides services to individuals at risk of experiencing an opioid overdose or training in the administration of naloxone or other opioid antagonist for overdose reversal may dispense<\/span> naloxone or other opioid antagonist, provided that such dispensing<\/span> is (i) pursuant to a standing order<\/span> issued by a prescriber<\/span> and (ii) in accordance with protocols developed by the Board<\/span> of Pharmacy in consultation with the Board<\/span> of Medicine and the Department of Health. If the person<\/span> acting on behalf of an organization dispenses<\/span> naloxone or other opioid antagonist in an injectable formulation with a hypodermic needle or syringe, he shall first obtain authorization from the Department of Behavioral Health and Developmental Services to train individuals on the proper administration of naloxone or other opioid antagonist by and proper disposal of a hypodermic needle or syringe, and he shall obtain a controlled substance<\/span> registration from the Board<\/span> of Pharmacy. The Board<\/span> of Pharmacy shall not charge a fee for the issuance of such controlled substance<\/span> registration. The dispensing<\/span> may occur at a site other than that of the controlled substance<\/span> registration provided the entity possessing the controlled substances<\/span> registration maintains records in accordance with regulations of the Board<\/span> of Pharmacy. No person<\/span> who dispenses<\/span> naloxone or other opioid antagonist on behalf of an organization pursuant to this subsection shall charge a fee for the dispensing<\/span> of naloxone or other opioid antagonist that is greater than the cost to the organization of obtaining the naloxone or other opioid antagonist dispensed. A person<\/span> to whom naloxone or other opioid antagonist has been dispensed pursuant to this subsection may possess naloxone or other opioid antagonist and may administer<\/span> naloxone or other opioid antagonist to a person<\/span> who is believed to be experiencing or about to experience a life-threatening opioid overdose.\n\t\t\tAA. A person<\/span> who is not otherwise authorized to administer<\/span> naloxone or other opioid antagonist used for overdose reversal may administer<\/span> naloxone or other opioid antagonist used for overdose reversal to a person<\/span> who is believed to be experiencing or about to experience a life-threatening opioid overdose.\n\t\t\tBB. Pursuant to a written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize, with the consent of the parents as defined in § 22.1-1<\/a>, an employee of (i) a school board<\/span>, (ii) a school for students with disabilities as defined in § 22.1-319<\/a> licensed by the Board<\/span> of Education, or (iii) a private school accredited pursuant to § 22.1-19<\/a> as administered by the Virginia Council for Private Education who is trained in the administration of injected medications for the treatment of adrenal crisis resulting from a condition causing adrenal insufficiency to administer<\/span> such medication to a student diagnosed with a condition causing adrenal insufficiency when the student is believed to be experiencing or about to experience an adrenal crisis. Such authorization shall be effective only when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not present to perform the administration of the medication.\n\t\t\tCC. . Pursuant to a written order<\/span> or standing protocol issued by the prescriber<\/span> within the course of his professional practice, such prescriber<\/span> may authorize, with the consent of the student’s parents as defined in § 22.1-1<\/a>, an employee of (i) a school board<\/span>, (ii) a school for students with disabilities as defined in § 22.1-319<\/a> licensed by the Board<\/span> of Education, (iii) a private school accredited pursuant to § 22.1-19<\/a> as administered by the Virginia Council for Private Education, (iv) a local governing body, or (v) a local health department who is trained in the administration of seizure rescue medications for the treatment of seizures resulting from a condition causing seizures to administer<\/span> such medications to a student diagnosed with a condition causing seizures when the student is believed to be experiencing or about to experience a seizure. Such authorization shall be effective only when a licensed nurse, an advanced practice registered nurse, a physician, or a physician assistant is not capable of reaching the student within the amount of time necessary to effectively perform the administration of the medication. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPROFESSIONAL USE BY PRACTITIONERS (\u00a7 54.1-3408)\n\nA. A practitioner of medicine, osteopathy, podiatry, dentistry, or veterinary\nmedicine, a licensed advanced practice registered nurse pursuant to §\n54.1-2957.01, a licensed certified midwife pursuant to § 54.1-2957.04, a\nlicensed physician assistant pursuant to § 54.1-2952.1, or a TPA-certified\noptometrist pursuant to Article 5 (§ 54.1-3222 et seq.) of Chapter 32 shall\nonly prescribe, dispense, or administer controlled substances in good faith for\nmedicinal or therapeutic purposes within the course of his professional\npractice. A licensed midwife pursuant to § 54.1-2957.7 shall only obtain,\npossess, and administer controlled substances in good faith for medicinal or\ntherapeutic purposes within the course of his professional practice.\n\nB. The prescribing practitioner’s order may be on a written prescription\nor pursuant to an oral prescription as authorized by this chapter. The\nprescriber may administer drugs and devices, or he may cause drugs or devices to\nbe administered by:\n\n 1. A nurse, physician assistant, or intern under his direction and\n supervision;\n\n 2. Persons trained to administer drugs and devices to patients in state-owned\n or state-operated hospitals or facilities licensed as hospitals by the Board\n of Health or psychiatric hospitals licensed by the Department of Behavioral\n Health and Developmental Services who administer drugs under the control and\n supervision of the prescriber or a pharmacist;\n\n 3. Emergency medical services personnel certified and authorized to administer\n drugs and devices pursuant to regulations of the Board of Health who act\n within the scope of such certification and pursuant to an oral or written\n order or standing protocol;\n\n 4. Persons who are employed or engaged at a medical care facility, as defined\n in § 32.1-3, who have a valid emergency medical services provider\n certification issued by the Board of Health as a requirement of being employed\n or engaged at the medical care facility within the scope of such\n certification, pursuant to an oral or written order or standing protocol to\n administer drugs and devices at the medical care facility; or\n\n 5. A licensed respiratory therapist as defined in § 54.1-2954 who\n administers by inhalation controlled substances used in inhalation or\n respiratory therapy.\n\nC. Pursuant to an oral or written order or standing protocol, the prescriber,\nwho is authorized by state or federal law to possess and administer\nradiopharmaceuticals in the scope of his practice, may authorize a nuclear\nmedicine technologist to administer, under his supervision, radiopharmaceuticals\nused in the diagnosis or treatment of disease.\n\nD. Pursuant to an oral or written order or standing protocol issued by the\nprescriber within the course of his professional practice, such prescriber may\nauthorize registered nurses and licensed practical nurses to possess (i)\nepinephrine and oxygen for administration in treatment of emergency medical\nconditions and (ii) heparin and sterile normal saline to use for the maintenance\nof intravenous access lines.\n\t\t\tPursuant to the regulations of the Board of Health, certain emergency medical\nservices technicians may possess and administer epinephrine in emergency cases\nof anaphylactic shock.\n\t\t\tPursuant to an order or standing protocol issued by the prescriber within the\ncourse of his professional practice, any school nurse, school board employee,\nemployee of a local governing body, or employee of a local health department who\nis authorized by a prescriber and trained in the administration of epinephrine\nmay possess and administer epinephrine.\n\t\t\tPursuant to an order or standing protocol that shall be issued by the local\nhealth director within the course of his professional practice, any school\nnurse, licensed athletic trainer under contract with a local school division,\nschool board employee, employee of a local governing body, or employee of a\nlocal health department who is authorized by the local health director and\ntrained in the administration of albuterol inhalers and valved holding chambers\nor nebulized albuterol may possess or administer an albuterol inhaler and a\nvalved holding chamber or nebulized albuterol to a student diagnosed with a\ncondition requiring an albuterol inhaler or nebulized albuterol when the student\nis believed to be experiencing or about to experience an asthmatic crisis.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within\nthe course of his professional practice, any employee of a school for students\nwith disabilities, as defined in § 22.1-319 and licensed by the Board of\nEducation, or any employee of a private school that is accredited pursuant to\n§ 22.1-19 as administered by the Virginia Council for Private Education who\nis authorized by a prescriber and trained in the administration of (a)\nepinephrine may possess and administer epinephrine and (b) albuterol inhalers or\nnebulized albuterol may possess or administer an albuterol inhaler or nebulized\nalbuterol to a student diagnosed with a condition requiring an albuterol inhaler\nor nebulized albuterol when the student is believed to be experiencing or about\nto experience an asthmatic crisis.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within\nthe course of his professional practice, any nurse at an early childhood care\nand education entity, employee at the entity, or employee of a local health\ndepartment who is authorized by a prescriber and trained in the administration\nof epinephrine may possess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within\nthe course of his professional practice, any employee of a public institution of\nhigher education or a private institution of higher education who is authorized\nby a prescriber and trained in the administration of epinephrine may possess and\nadminister epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within\nthe course of his professional practice, any employee of an organization\nproviding outdoor educational experiences or programs for youth who is\nauthorized by a prescriber and trained in the administration of epinephrine may\npossess and administer epinephrine.\n\t\t\tPursuant to an order or a standing protocol issued by the prescriber within\nthe course of his professional practice, and in accordance with policies and\nguidelines established by the Department of Health, such prescriber may\nauthorize any employee of a restaurant licensed pursuant to Chapter 3 (§\n35.1-18 et seq.) of Title 35.1 to possess and administer epinephrine on the\npremises of the restaurant at which the employee is employed, provided that such\nperson is trained in the administration of epinephrine.\n\t\t\tPursuant to an order issued by the prescriber within the course of his\nprofessional practice, an employee of a provider licensed by the Department of\nBehavioral Health and Developmental Services or a person providing services\npursuant to a contract with a provider licensed by the Department of Behavioral\nHealth and Developmental Services may possess and administer epinephrine,\nprovided such person is authorized and trained in the administration of\nepinephrine.\n\t\t\tPursuant to an order or standing protocol issued by the prescriber within the\ncourse of his professional practice, any employee of a place of public\naccommodation, as defined in subsection A of § 2.2-3904, who is authorized\nby a prescriber and trained in the administration of epinephrine may possess and\nadminister epinephrine.\n\t\t\tPursuant to an oral or written order or standing protocol issued by the\nprescriber within the course of his professional practice, such prescriber may\nauthorize pharmacists to possess epinephrine and oxygen for administration in\ntreatment of emergency medical conditions.\n\nE. Pursuant to an oral or written order or standing protocol issued by the\nprescriber within the course of his professional practice, such prescriber may\nauthorize licensed physical therapists to possess and administer topical\ncorticosteroids, topical lidocaine, and any other Schedule VI topical drug.\n\nF. Pursuant to an oral or written order or standing protocol issued by the\nprescriber within the course of his professional practice, such prescriber may\nauthorize licensed athletic trainers to possess and administer topical\ncorticosteroids, topical lidocaine, or other Schedule VI topical drugs; oxygen\nand IV saline for use in emergency situations; subcutaneous lidocaine for wound\nclosure; epinephrine for use in emergency cases of anaphylactic shock; and\nnaloxone or other opioid antagonist for overdose reversal.\n\nG. Pursuant to an oral or written order or standing protocol issued by the\nprescriber within the course of his professional practice, and in accordance\nwith policies and guidelines established by the Department of Health pursuant to\n§ 32.1-50.2, such prescriber may authorize registered nurses or licensed\npractical nurses under the supervision of a registered nurse to possess and\nadminister tuberculin purified protein derivative (PPD) in the absence of a\nprescriber. The Department of Health’s policies and guidelines shall be\nconsistent with applicable guidelines developed by the Centers for Disease\nControl and Prevention for preventing transmission of mycobacterium tuberculosis\nand shall be updated to incorporate any subsequently implemented standards of\nthe Occupational Safety and Health Administration and the Department of Labor\nand Industry to the extent that they are inconsistent with the Department of\nHealth’s policies and guidelines. Such standing protocols shall explicitly\ndescribe the categories of persons to whom the tuberculin test is to be\nadministered and shall provide for appropriate medical evaluation of those in\nwhom the test is positive. The prescriber shall ensure that the nurse\nimplementing such standing protocols has received adequate training in the\npractice and principles underlying tuberculin screening.\n\t\t\tThe Health Commissioner or his designee may authorize registered nurses,\nacting as agents of the Department of Health, to possess and administer, at the\nnurse’s discretion, tuberculin purified protein derivative (PPD) to those\npersons in whom tuberculin skin testing is indicated based on protocols and\npolicies established by the Department of Health.\n\nH. Pursuant to a written order or standing protocol issued by the prescriber\nwithin the course of his professional practice, such prescriber may authorize,\nwith the consent of the parents as defined in § 22.1-1, an employee of (i)\na school board, (ii) a school for students with disabilities as defined in\n§ 22.1-319 licensed by the Board of Education, or (iii) a private school\naccredited pursuant to § 22.1-19 as administered by the Virginia Council\nfor Private Education who is trained in the administration of insulin and\nglucagon to assist with the administration of insulin or administer glucagon to\na student diagnosed as having diabetes and who requires insulin injections\nduring the school day or for whom glucagon has been prescribed for the emergency\ntreatment of hypoglycemia. Such authorization shall only be effective when a\nlicensed nurse, an advanced practice registered nurse, a physician, or a\nphysician assistant is not present to perform the administration of the\nmedication.\n\t\t\tPursuant to a written order or standing protocol issued by the prescriber\nwithin the course of his professional practice, such prescriber may authorize\nthe possession and administration of undesignated glucagon as set forth in\nsubsection F of § 22.1-274.2.\n\t\t\tPursuant to a written order or standing protocol issued by the prescriber\nwithin the course of his professional practice, such prescriber may authorize an\nemployee of a public institution of higher education or a private institution of\nhigher education who is trained in the administration of insulin and glucagon to\nassist with the administration of insulin or administration of glucagon to a\nstudent diagnosed as having diabetes and who requires insulin injections or for\nwhom glucagon has been prescribed for the emergency treatment of hypoglycemia.\nSuch authorization shall only be effective when a licensed nurse, an advanced\npractice registered nurse, a physician, or a physician assistant is not present\nto perform the administration of the medication.\n\t\t\tPursuant to a written order issued by the prescriber within the course of his\nprofessional practice, such prescriber may authorize an employee of a provider\nlicensed by the Department of Behavioral Health and Developmental Services or a\nperson providing services pursuant to a contract with a provider licensed by the\nDepartment of Behavioral Health and Developmental Services to assist with the\nadministration of insulin or to administer glucagon to a person diagnosed as\nhaving diabetes and who requires insulin injections or for whom glucagon has\nbeen prescribed for the emergency treatment of hypoglycemia, provided such\nemployee or person providing services has been trained in the administration of\ninsulin and glucagon.\n\nI. A prescriber may authorize, pursuant to a protocol approved by the Board of\nNursing, the administration of vaccines to adults for immunization, when a\npractitioner with prescriptive authority is not physically present, by (i)\nlicensed pharmacists, (ii) registered nurses, or (iii) licensed practical nurses\nunder the supervision of a registered nurse. A prescriber acting on behalf of\nand in accordance with established protocols of the Department of Health may\nauthorize the administration of vaccines to any person by a pharmacist, nurse,\nor designated emergency medical services provider who holds an advanced life\nsupport certificate issued by the Commissioner of Health under the direction of\nan operational medical director when the prescriber is not physically present.\nThe emergency medical services provider shall provide documentation of the\nvaccines to be recorded in the Virginia Immunization Information System.\n\nJ. A dentist may cause Schedule VI topical drugs to be administered under his\ndirection and supervision by either a dental hygienist or by an authorized agent\nof the dentist.\n\t\t\tFurther, pursuant to a written order and in accordance with a standing\nprotocol issued by the dentist in the course of his professional practice, a\ndentist may authorize a dental hygienist under his general supervision, as\ndefined in § 54.1-2722, or his remote supervision, as defined in subsection\nE or F of § 54.1-2722, to possess and administer topical oral fluorides,\ntopical oral anesthetics, topical and directly applied antimicrobial agents for\ntreatment of periodontal pocket lesions, and any other Schedule VI topical drug\napproved by the Board of Dentistry.\n\t\t\tIn addition, a dentist may authorize a dental hygienist under his direction\nto administer Schedule VI nitrous oxide and oxygen inhalation analgesia and, to\npersons 18 years of age or older, Schedule VI local anesthesia.\n\nK. Pursuant to an oral or written order or standing protocol issued by the\nprescriber within the course of his professional practice, such prescriber may\nauthorize registered professional nurses certified as sexual assault nurse\nexaminers-A (SANE-A) under his supervision and when he is not physically present\nto possess and administer preventive medications for victims of sexual assault\nas recommended by the Centers for Disease Control and Prevention.\n\nL. This section shall not prevent the administration of drugs by a person who\nhas satisfactorily completed a training program for this purpose approved by the\nBoard of Nursing and who administers such drugs in accordance with a\nprescriber’s instructions pertaining to dosage, frequency, and manner of\nadministration, and in accordance with regulations promulgated by the Board of\nPharmacy relating to security and record keeping, when the drugs administered\nwould be normally self-administered by (i) an individual receiving services in a\nprogram licensed by the Department of Behavioral Health and Developmental\nServices; (ii) a resident of the Virginia Rehabilitation Center for the Blind\nand Vision Impaired; (iii) a resident of a facility approved by the Board or\nDepartment of Juvenile Justice for the placement of children in need of services\nor delinquent or alleged delinquent youth; (iv) a program participant of an\nadult day center licensed by the Department of Social Services; (v) a resident\nof any facility authorized or operated by a state or local government whose\nprimary purpose is not to provide health care services; (vi) a resident of a\nprivate children’s residential facility, as defined in § 63.2-100 and\nlicensed by the Department of Social Services, Department of Education, or\nDepartment of Behavioral Health and Developmental Services; or (vii) a student\nin a school for students with disabilities, as defined in § 22.1-319 and\nlicensed by the Board of Education.\n\t\t\tIn addition, this section shall not prevent a person who has successfully\ncompleted a training program for the administration of drugs via percutaneous\ngastrostomy tube approved by the Board of Nursing and been evaluated by a\nregistered nurse as having demonstrated competency in administration of drugs\nvia percutaneous gastrostomy tube from administering drugs to a person receiving\nservices from a program licensed by the Department of Behavioral Health and\nDevelopmental Services to such person via percutaneous gastrostomy tube. The\ncontinued competency of a person to administer drugs via percutaneous\ngastrostomy tube shall be evaluated semiannually by a registered nurse.\n\nM. Medication aides registered by the Board of Nursing pursuant to Article 7\n(§ 54.1-3041 et seq.) of Chapter 30 may administer drugs that would\notherwise be self-administered to residents of any assisted living facility\nlicensed by the Department of Social Services. A registered medication aide\nshall administer drugs pursuant to this section in accordance with the\nprescriber’s instructions pertaining to dosage, frequency, and manner of\nadministration; in accordance with regulations promulgated by the Board of\nPharmacy relating to security and recordkeeping; in accordance with the assisted\nliving facility’s Medication Management Plan; and in accordance with such\nother regulations governing their practice promulgated by the Board of Nursing.\n\nN. Advanced medication aides registered by the Board of Nursing pursuant to\nArticle 7 (§ 54.1-3041 et seq.) of Chapter 30 may administer drugs that\nwould be administered by a registered medication aide pursuant to subsection M,\nin addition to drugs determined permissible by the Board of Nursing, in a\nnursing home licensed by the Department of Health. Advanced medication aides\nshall administer drugs pursuant to this section in accordance with the\nprescriber’s instructions pertaining to dosage, frequency, and manner of\nadministration; in accordance with regulations promulgated by the Board of\nPharmacy relating to security and recordkeeping; in accordance with the licensed\nnursing home’s policies and procedures; and in accordance with such other\nregulations governing their practice promulgated by the Board of Nursing.\n\nO. In addition, this section shall not prevent the administration of drugs by a\nperson who administers such drugs in accordance with a physician’s\ninstructions pertaining to dosage, frequency, and manner of administration and\nwith written authorization of a parent, and in accordance with school board\nregulations relating to training, security and record keeping, when the drugs\nadministered would be normally self-administered by a student of a Virginia\npublic school. Training for such persons shall be accomplished through a program\napproved by the local school boards, in consultation with the local departments\nof health.\n\nP. In addition, this section shall not prevent the administration of drugs by a\nperson to (i) a child in a child day program as defined in § 22.1-289.02\nand regulated by the Board of Education or a local government pursuant to §\n15.2-914, or (ii) a student of a private school that is accredited pursuant to\n§ 22.1-19 as administered by the Virginia Council for Private Education,\nprovided such person (a) has satisfactorily completed a training program for\nthis purpose approved by the Board of Nursing and taught by a registered nurse,\na licensed practical nurse, an advanced practice registered nurse, a physician\nassistant, a doctor of medicine or osteopathic medicine, or a pharmacist; (b)\nhas obtained written authorization from a parent or guardian; (c) administers\ndrugs only to the child identified on the prescription label in accordance with\nthe prescriber’s instructions pertaining to dosage, frequency, and manner\nof administration; and (d) administers only those drugs that were dispensed from\na pharmacy and maintained in the original, labeled container that would normally\nbe self-administered by the child or student, or administered by a parent or\nguardian to the child or student.\n\nQ. In addition, this section shall not prevent the administration or dispensing\nof drugs and devices by persons if they are authorized by the State Health\nCommissioner in accordance with protocols established by the State Health\nCommissioner pursuant to § 32.1-42.1 when (i) the Governor has declared a\ndisaster or a state of emergency, the United States Secretary of Health and\nHuman Services has issued a declaration of an actual or potential bioterrorism\nincident or other actual or potential public health emergency, or the Board of\nHealth has made an emergency order pursuant to § 32.1-13 for the purpose of\nsuppressing nuisances dangerous to the public health and communicable,\ncontagious, and infectious diseases and other dangers to the public life and\nhealth and for the limited purpose of administering vaccines as an approved\ncountermeasure for such communicable, contagious, and infectious diseases; (ii)\nit is necessary to permit the provision of needed drugs or devices; and (iii)\nsuch persons have received the training necessary to safely administer or\ndispense the needed drugs or devices. Such persons shall administer or dispense\nall drugs or devices under the direction, control, and supervision of the State\nHealth Commissioner.\n\nR. Nothing in this title shall prohibit the administration of normally\nself-administered drugs by unlicensed individuals to a person in his private\nresidence.\n\nS. This section shall not interfere with any prescriber issuing prescriptions in\ncompliance with his authority and scope of practice and the provisions of this\nsection to a Board agent for use pursuant to subsection G of § 18.2-258.1.\nSuch prescriptions issued by such prescriber shall be deemed to be valid\nprescriptions.\n\nT. Nothing in this title shall prevent or interfere with dialysis care\ntechnicians or dialysis patient care technicians who are certified by an\norganization approved by the Department of Health Professions or persons\nauthorized for provisional practice pursuant to Chapter 27.01 (§\n54.1-2729.1 et seq.), in the ordinary course of their duties in a\nMedicare-certified renal dialysis facility, from administering heparin, topical\nneedle site anesthetics, dialysis solutions, sterile normal saline solution, and\nblood volumizers, for the purpose of facilitating renal dialysis treatment, when\nsuch administration of medications occurs under the orders of a licensed\nphysician, an advanced practice registered nurse, or a physician assistant and\nunder the immediate and direct supervision of a licensed registered nurse.\nNothing in this chapter shall be construed to prohibit a patient care dialysis\ntechnician trainee from performing dialysis care as part of and within the scope\nof the clinical skills instruction segment of a supervised dialysis technician\ntraining program, provided such trainee is identified as a “trainee”\nwhile working in a renal dialysis facility.\n\t\t\tThe dialysis care technician or dialysis patient care technician\nadministering the medications shall have demonstrated competency as evidenced by\nholding current valid certification from an organization approved by the\nDepartment of Health Professions pursuant to Chapter 27.01 (§ 54.1-2729.1\net seq.).\n\nU. Persons who are otherwise authorized to administer controlled substances in\nhospitals shall be authorized to administer influenza or pneumococcal vaccines\npursuant to § 32.1-126.4.\n\nV. Pursuant to a specific order for a patient and under his direct and immediate\nsupervision, a prescriber may authorize the administration of controlled\nsubstances by personnel who have been properly trained to assist a doctor of\nmedicine or osteopathic medicine, provided the method does not include\nintravenous, intrathecal, or epidural administration and the prescriber remains\nresponsible for such administration.\n\nW. A physician assistant, nurse, dental hygienist, or authorized agent of a\ndoctor of medicine, osteopathic medicine, or dentistry may possess and\nadminister topical fluoride varnish pursuant to an oral or written order or a\nstanding protocol issued by a doctor of medicine, osteopathic medicine, or\ndentistry.\n\nX. A prescriber, acting in accordance with guidelines developed pursuant to\n§ 32.1-46.02, may authorize the administration of influenza vaccine to\nminors by a licensed pharmacist, registered nurse, licensed practical nurse\nunder the direction and immediate supervision of a registered nurse, or\nemergency medical services provider who holds an advanced life support\ncertificate issued by the Commissioner of Health when the prescriber is not\nphysically present.\n\nY. Notwithstanding the provisions of § 54.1-3303, pursuant to an oral,\nwritten, or standing order issued by a prescriber or a standing order issued by\nthe Commissioner of Health or his designee authorizing the dispensing of\nnaloxone or other opioid antagonist used for overdose reversal in the absence of\nan oral or written order for a specific patient issued by a prescriber, and in\naccordance with protocols developed by the Board of Pharmacy in consultation\nwith the Board of Medicine and the Department of Health, a pharmacist, a health\ncare provider providing services in a hospital emergency department, and\nemergency medical services personnel, as that term is defined in §\n32.1-111.1, may dispense naloxone or other opioid antagonist used for overdose\nreversal and a person to whom naloxone or other opioid antagonist has been\ndispensed pursuant to this subsection may possess and administer naloxone or\nother opioid antagonist used for overdose reversal to a person who is believed\nto be experiencing or about to experience a life-threatening opioid overdose.\nLaw-enforcement officers as defined in § 9.1-101, employees of the\nDepartment of Forensic Science, employees of the Office of the Chief Medical\nExaminer, employees of the Department of General Services Division of\nConsolidated Laboratory Services, employees of the Department of Corrections\ndesignated by the Director of the Department of Corrections or designated as\nprobation and parole officers or as correctional officers as defined in §\n53.1-1, employees of the Department of Juvenile Justice designated as probation\nand parole officers or as juvenile correctional officers, employees of regional\njails, employees of any state agency, school nurses, local health department\nemployees that are assigned to a public school pursuant to an agreement between\nthe local health department and the school board, school board employees who\nhave completed training and are certified in the administration of an opioid\nantagonist for overdose reversal by a program administered or authorized by the\nDepartment of Health, other school board employees or individuals contracted by\na school board to provide school health services, resident assistants in a\nstudent housing facility at a public institution of higher education who have\ncompleted training in the administration of an opioid antagonist for overdose\nreversal pursuant to § 23.1-802.2, and firefighters may also possess and\nadminister naloxone or other opioid antagonist used for overdose reversal and\nmay dispense naloxone or other opioid antagonist used for overdose reversal\npursuant to an oral, written, or standing order issued by a prescriber or a\nstanding order issued by the Commissioner of Health or his designee in\naccordance with protocols developed by the Board of Pharmacy in consultation\nwith the Board of Medicine and the Department of Health.\n\t\t\tNotwithstanding the provisions of § 54.1-3303, pursuant to an oral,\nwritten, or standing order issued by a prescriber or a standing order issued by\nthe Commissioner of Health or his designee authorizing the dispensing of\nnaloxone or other opioid antagonist used for overdose reversal in the absence of\nan oral or written order for a specific patient issued by a prescriber, and in\naccordance with protocols developed by the Board of Pharmacy in consultation\nwith the Board of Medicine and the Department of Health, any person may possess\nand administer naloxone or other opioid antagonist used for overdose reversal,\nother than naloxone in an injectable formulation with a hypodermic needle or\nsyringe, in accordance with protocols developed by the Board of Pharmacy in\nconsultation with the Board of Medicine and the Department of Health.\n\nZ. Notwithstanding any other law or regulation to the contrary, a person who is\nacting on behalf of an organization that provides services to individuals at\nrisk of experiencing an opioid overdose or training in the administration of\nnaloxone or other opioid antagonist for overdose reversal may dispense naloxone\nor other opioid antagonist, provided that such dispensing is (i) pursuant to a\nstanding order issued by a prescriber and (ii) in accordance with protocols\ndeveloped by the Board of Pharmacy in consultation with the Board of Medicine\nand the Department of Health. If the person acting on behalf of an organization\ndispenses naloxone or other opioid antagonist in an injectable formulation with\na hypodermic needle or syringe, he shall first obtain authorization from the\nDepartment of Behavioral Health and Developmental Services to train individuals\non the proper administration of naloxone or other opioid antagonist by and\nproper disposal of a hypodermic needle or syringe, and he shall obtain a\ncontrolled substance registration from the Board of Pharmacy. The Board of\nPharmacy shall not charge a fee for the issuance of such controlled substance\nregistration. The dispensing may occur at a site other than that of the\ncontrolled substance registration provided the entity possessing the controlled\nsubstances registration maintains records in accordance with regulations of the\nBoard of Pharmacy. No person who dispenses naloxone or other opioid antagonist\non behalf of an organization pursuant to this subsection shall charge a fee for\nthe dispensing of naloxone or other opioid antagonist that is greater than the\ncost to the organization of obtaining the naloxone or other opioid antagonist\ndispensed. A person to whom naloxone or other opioid antagonist has been\ndispensed pursuant to this subsection may possess naloxone or other opioid\nantagonist and may administer naloxone or other opioid antagonist to a person\nwho is believed to be experiencing or about to experience a life-threatening\nopioid overdose.\n\t\t\tAA. A person who is not otherwise authorized to administer naloxone or other\nopioid antagonist used for overdose reversal may administer naloxone or other\nopioid antagonist used for overdose reversal to a person who is believed to be\nexperiencing or about to experience a life-threatening opioid overdose.\n\t\t\tBB. Pursuant to a written order or standing protocol issued by the prescriber\nwithin the course of his professional practice, such prescriber may authorize,\nwith the consent of the parents as defined in § 22.1-1, an employee of (i)\na school board, (ii) a school for students with disabilities as defined in\n§ 22.1-319 licensed by the Board of Education, or (iii) a private school\naccredited pursuant to § 22.1-19 as administered by the Virginia Council\nfor Private Education who is trained in the administration of injected\nmedications for the treatment of adrenal crisis resulting from a condition\ncausing adrenal insufficiency to administer such medication to a student\ndiagnosed with a condition causing adrenal insufficiency when the student is\nbelieved to be experiencing or about to experience an adrenal crisis. Such\nauthorization shall be effective only when a licensed nurse, an advanced\npractice registered nurse, a physician, or a physician assistant is not present\nto perform the administration of the medication.\n\t\t\tCC. . Pursuant to a written order or standing protocol issued by the\nprescriber within the course of his professional practice, such prescriber may\nauthorize, with the consent of the student’s parents as defined in §\n22.1-1, an employee of (i) a school board, (ii) a school for students with\ndisabilities as defined in § 22.1-319 licensed by the Board of Education,\n(iii) a private school accredited pursuant to § 22.1-19 as administered by\nthe Virginia Council for Private Education, (iv) a local governing body, or (v)\na local health department who is trained in the administration of seizure rescue\nmedications for the treatment of seizures resulting from a condition causing\nseizures to administer such medications to a student diagnosed with a condition\ncausing seizures when the student is believed to be experiencing or about to\nexperience a seizure. Such authorization shall be effective only when a licensed\nnurse, an advanced practice registered nurse, a physician, or a physician\nassistant is not capable of reaching the student within the amount of time\nnecessary to effectively perform the administration of the medication.\n\nHISTORY: Code 1950, \u00a7 54-497; 1956, c. 225; 1970, c. 650, \u00a7 54-524.65; 1973,\nc. 468; 1976, cc. 358, 614; 1977, c. 302; 1978, c. 224; 1980, cc. 270, 287;\n1983, cc. 456, 528; 1984, cc. 141, 555; 1986, c. 81; 1987, c. 226; 1988, c. 765;\n1990, c. 309; 1991, cc. 141, 519, 524, 532; 1992, cc. 610, 760, 793; 1993, cc.\n15, 810, 957, 993; 1994, c. 53; 1995, cc. 88, 529; 1996, cc. 152, 158, 183, 406,\n408, 490; 1997, cc. 272, 566, 806, 906; 1998, c. 112; 1999, c. 570; 2000, cc.\n135, 498, 861, 881, 935; 2003, cc. 465, 497, 515, 794, 995, 1020; 2005, cc. 113,\n610, 924; 2006, cc. 75, 432, 686, 858; 2007, cc. 17, 699, 702, 783; 2008, cc.\n85, 694; 2009, cc. 48, 110, 506, 813, 840; 2010, cc. 179, 245, 252; 2011, c.\n292; 2012, cc. 787, 803, 833, 835; 2013, cc. 114, 132, 183, 191, 252, 267, 328,\n336, 359, 617; 2014, cc. 88, 491; 2015, cc. 302, 387, 502, 503, 514, 725, 732,\n752; 2016, c. 144; 2017, cc. 3, 55, 107, 168, 174, 182, 294, 304, 713; 2018, cc.\n62, 247; 2019, cc. 87, 212, 221, 431; 2020, cc. 39, 302, 459, 460, 556, 560,\n853, 860, 861, 924, 927, 1095; 2021, Sp. Sess. I, cc. 181, 200, 201, 508; 2022,\ncc. 695, 696, 733, 774; 2023, cc. 115, 116, 183, 267, 569, 631, 673, 674, 729;\n2024, cc. 37, 150, 440, 451, 465, 466, 519; 2025, cc. 59, 65, 277, 341, 370,\n386, 446.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}