Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up

Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Thread: Controlled substances Post: RE: Controlled substances Author: Vondra Wesley Posted Date: February 9, 2019 8:17 PM Status: Published Overall Rating: 1 2 3 4 5 I do agree that these laws have the potential to assist in combating the abuse of prescription medications. But there remain those that can convince some doctors beyond a shadow of doubt that they really do need them. There must be a form of discipline within the prescribing physicians to acknowledge when a patient is indeed in need of these medications and be observant of the patient’s behavior. The number of the request being made and to offer another means of pain alleviation and this should also be the practice of Physicians who give long-term care to patients that suffer from on-going pain management issues. This should also serve to be in the practice of a Pharmacist and Pharmacy Technician. When a Technician is inputting prescription request into the system, they have access to acknowledge if this is an on-going habit of the patient or the prescriber and if it is, they should notify the Pharmacist in such a way as unbeknown to the patient. Also, I have noticed that some areas are now offering amnesty programs for abusers to turn in the drugs they have or have been abusing as well as receive free treatment and counseling. Wouldn’t this be great if all abusers would resort to these programs and stick with the procedures and regimens recommended? Help stop drug-abuse Post: Help stop drug-abuse Author: Vondra Wesley Posted Date: February 8, 2019 2:09 AM Status: Published Overall Rating: 1 2 3 4 5 The current laws and regulations surrounding controlled substance prescriptions are adequate due to the prevalent epidemic surrounding the abuse of prescription medications that are currently prescribed to treat pain especially. This epidemic mostly encases our elderly,  people with mental health conditions and now even our children of various ages. It was stated that college students were big on abusing these drugs, but now we see it in younger children as well. This has posed a severe health safety hazard, and numerous people have succumbed to accidental overdoses or trying to get higher than when they had taken the drugs before. Some of the younger ones have become curious and decided to explore the effects of these drugs, and many have died. There have been circumstances at which parents didn’t actually realize how dangerous these medications were and didn’t properly put them away from young hands. Children are curious and will explore. When there’s not a child safety cap on a bottle, sometimes the medication looks like candy to them. In the back of their little minds, they actually think that their parents are trying to keep the goodies away from them and ingest them anyway. Another known fact is that some medications may not immediately cause harm, but can actually trigger an addiction. The mind and body will tell a person they need more and more until there’s a severe effect of addiction or death. Many people that are addicted to drugs also make regular visits to the emergency rooms portraying chronic pain symptoms to get a prescription to obtain these medications to satisfy their addiction. There is also a rise in patients that aren’t addicted but will portray the role to receive prescriptions for these medications to sell to abusers for money.  These are some of the reasons I agree with these laws. There has to be a way of monitoring and regulating the accessibility of these medications that enhance a substantial risk of addiction to these medications. Too many people are dying unnecessarily and from every age, ethnicity, and profession. Everyone needs education on the types of drugs they receive, side effects, hazards and potential for addiction. In my opinion, I don’t feel that these laws will hinder people from getting the medication that they may need, but they’re ensuring the overall safety and protection of the patients. Doctors are to be skilled and qualified to know if their patient actually needs medication or not. There are other options such as pain management, biofeedback, and other natural alternatives to ensure comfort. As for the role of a Pharmacist or Pharmacy Technician, it suits well to be observant of a patients behavior and their medical profile before filling a controlled substance prescription.                        (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328297/, 2019) In closing, I currently work in a hospital sometimes in the role of a patient sitter. In this role, I oversee for the safety of patients mainly being bought in under The Baker Act and the majority of these patients were drug abusers or overdose victims. Some made it, and some didn’t. They were over various ages, but none of these circumstances are pleasant to witness. Comments Feedback to Learner 2/12/19 12:35 PM Vondra: Great job in answering the discussion forum question regarding controlled substance regulations and also responding to your peers! These laws are in place to help deter fraud and abuse but may make it more difficult for certain patients such as the elderly to physically get the prescriptions. Nice job with your posts! ______________________________________________________________________________ PTCB- https://ptcb.org/ The Pharmacy Technician Certification Exam is administered year-round by Pearson VUE (Pearson Professional Centers) nationwide. Pearson VUE has more than 1,400 centers nationwide including more than 100 military on-base sites. The cost of the Certified Pharmacy Technician certification is $129.00 and must be taken within 90-days upon board approval of the application. There is currently no limit to an infinite number of exam attempts, but candidates are encouraged to prepare appropriately for each attempt by increasing their knowledge. Candidates who fail the PTCE must wait for 60-days from the date of the most recent attempt to apply for the second and third attempts, and six months after that. Each time an attempt is made to retake the PTCE a fee of $129.00 must be paid. The amount of time allocated to take the PTCE is two hours, and the test consists of ninety multiple choice questions (80 questions are scored, and 10 questions are unscored). Due to the complexity of the scoring process, PTCB uses a scaled scoring system since there are different forms of the PTCE administered every year and these forms may fluctuate slightly in difficulty. The passing scale score at which one may pass is 1400(with a range of 1000-1600). Practicing Certified Pharmacy Technicians are required to renew their certification every two years at the cost of $40.00 application fee. For late renewal recertification, there is an additional charge of $25.00 and a $10.00 reprocessing fee. Upon recertification Continuing Education (CE’s) are required to maintain an active certification status and must be Pharmacy Technician-specific. For recertification, the PTCB requires twenty hours continuing education including one hour in the subject of Pharmacy Law and one hour in the subject of Patient Safety or twenty hours Continuing education, including two hours of Pharmacy Law and one hour of Patient Safety (whichever set is requested). A max of twenty hours may be earned by completing a relevant three academic credit hour college course with a grade average of “C” or better. As of Jan. 1, 2018, The PTCB no longer accepts in service Continuing Education (CE) hours and the records of Continuing Education hours earned. During each recertification period, Continuing Education must be maintained for at least one year after the certification cycle ends. (“Home”, 2019) FLORIDA REQUIREMENTS FOR REGISTERED PHARMACY TECHNICIANS https://floridaspharmacy.gov/ To practice in the role of a pharmacy technician in the State of Florida, you are required to register with the Florida Board of Pharmacy. To register with the Florida Board of Pharmacy, an applicant must submit: Pharmacy Technician Registration Application (form DH-MQA-PH1183), Social Security form, proof of Board Approved Pharmacy Technician Training Program completion. Official transcripts from official educational providers will be accepted. Employer-based training programs can be verified online at www.flhealthsource.gov. Failure to submit evidence of an appropriate Pharmacy training program will result in an insufficiency letter being sent to you and will delay your application process. All sections of the application must be completed. If you answer “yes” to any of the criminal record inquiries on the application, you must submit a reply giving all certified official court copies and details of any supportive documents for the board to review. If an item is not applicable, indicate with N/A. N/A is not an adequate answer for yes or no questions and could delay the processing. Failure to submit a completed application will result in a delay in processing. If you provide untruthful information, the board may deny your application for registration. The application accompanied with a non-refundable application fee of $50.00 and an initial registration fee of $50.00 and an unlicensed application fee of $5.00 for a total of $105.00. Money order or Certified check should be made payable to The Florida Department of Health. Upon receipt of your application and supporting documentation your file will be reviewed, and written notification will be sent regarding the status of your application. If your file is incomplete, a deficiency letter will be sent to notify you of any remaining requirements. The actual copy of your license should arrive within seven days of the issue date. In the State of Florida Licensees, registrants and permit holders with the Florida Board of Pharmacy are under obligation to renew their licenses every two years (biennially) to maintain the right to practice. The Department of Health, Division of Medical Quality Assurance, will now evaluate your continuing education histories in the electronic tracking system at the time of renewal. It will happen automatically when you renew your license. If you choose to renew BEFORE your license expires, your fees will be $55.00. Continuing Education (CE) Requirements- General Hours 18 hours (General hours can be either ACPE or Board approved, four of the twenty must be live), Medication Errors two hours (Medication Errors Must be Board Approved). SPECIAL NOTE: First-Time Biennium Renewal: If you are renewing your license for the first time and the renewal occurs less than twelve months after the original licensure date you are only required to complete one hour in HIV/AIDS and two medication errors. If your renewal occurs twelve months or more after your initial licensure date, you are required to complete 9 (2 must be live)  general hours of registered pharmacy technician continuing education, 1-hour HIV/AIDS and two medication errors. The state in which I will be working is Florida and Florida does not require for a person to be certified. Applying to take the PTCB in Florida is not considered to be enrollment in a Board-approved training program. You are not allowed to work as a pharmacy technician except you are registered or enrolled in a Board-approved training program. If you desire to work while waiting to take the PTCB, you must be enrolled in a Board-approved training program. According to the State of Florida, the ratio at which a Pharmacist can supervise Pharmacy Technicians is 3 to 1. (Pharmacy, 2019) The four areas that I can identify from the PTCE blueprint that I feel I could use more improvement on and study more about before taking the exam are all related to compounding. The dosage calculations that are used in compounding, sterile compounding process, determining product stability in compounding, batch preparation. In these areas, I know that I need to study a bit harder with practice lessons. But overall this program has been more of a refresher for me since I have experienced working in both hospital and retail and pharmacy settings. But my overall preference would be to Not work in a compounding environment. Even though it is a beneficial life-sustaining practice, it is hazardous and complicated, especially when compounding for cancer treatments or patient administration. CALCULATIONS Pharmacology for Technicians- 1.4* Strengths/dose, dosage forms, physical appearance, routes of administration, and duration of drug therapy. Sterile and Non-Sterile Compounding- 3.3* Documentation (e.g., batch preparation, compounding record), 3.4* Determine product stability (e.g., beyond use dating, signs of incompatibility), 3.6* Sterile compounding processes, 3.7* Non-sterile compounding processes. Medication Order Entry and Fill Process- Order entry process, 6.2* Intake, interpretation, and data entry, 6.3* Calculate doses required, 6.6* Packaging requirements (e.g., type of bags, syringes, glass, PVC, child-resistant, light-resistant). Pharmacy Inventory Management- 7.3* Ordering and receiving processes (e.g., maintain par levels, rotate stock). Pharmacy Billing and Reimbursement- 8.2* Third party resolution (e.g., prior authorization, rejected claims, plan limitations). (“Home”, 2019) Feedback to Learner 2/12/19 3:27 PM Vondra: Great job in answering the questions regarding PTCB and Board of Pharmacy! Your answers are complete and informative. Keep up the good work!
Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Pharmacology for Technicians- Pharmacology is a very important part of your future practice, and drug knowledge is essential for performing your job well. Pharmacy Law and Regulations- Pharmacy is governed by many laws and regulations, and this section includes controlled substance laws, DEA and FDA regulations, privacy laws and record keeping. Sterile and Non-sterile Compounding- Pharmacy technicians compound parenteral medications, creams, ointments, suppositories, oral suspensions. Medication Safety- One of the most important parts of working in any pharmacy is error prevention.• This section covers known error prevention strategies, as well as knowledge of error-prone medications. Pharmacy Quality Assurance- Pharmacies are required to have established policies and procedures in place for quality assurance.• This section will cover areas such as NDC numbers, infection control, and product recalls. Medication Order Entry and Fill Process- This section is at the heart of the pharmacy technician’s job, and covers all parts of the prescription filling process, including calculations. Pharmacy Inventory Management- Pharmacies usually have vast drug inventories, and the pharmacy technician plays a big part. Pharmacy Billing and Reimbursement- Pharmacy payment is complex and varies based on the setting.• Pharmacy technicians are involved in all areas of billing, making this another essential skill.• This section counts for 8.75% of the exam and includes Medicare, Medicaid, other third party payers, handling insurance claims, and patient assistance programs. Pharmacy Information System Usage and Application- Technology plays a big part in a pharmacy’s operations, and pharmacy technicians are responsible for many aspects of pharmacy information systems. SECTION IX – VALID PRESCRIPTION REQUIREMENTS To dispense controlled substances, a pharmacist must know the requirements for a valid prescription which are described in this section. A prescription is an order for medication which is dispensed to or for an ultimate user. A prescription is not an order for medication which is dispensed for immediate administration to the ultimate user (i.e., an order to dispense a drug to an inpatient for immediate administration in a hospital is not a prescription). A prescription for a controlled substance must be dated and signed on the date when issued. The prescription must include the patient’s full name and address, and the practitioner’s full name, address, and DEA registration number. The prescription must also include: Drug name Strength Dosage form Quantity prescribed Directions for use Number of refills authorized (if any) A prescription must be written in ink or indelible pencil or typewritten and must be manually signed by the practitioner on the date when issued. An individual (i.e., secretary or nurse) may be designated by the practitioner to prepare prescriptions for the practitioner’s signature. The practitioner is responsible for ensuring the prescription conforms to all requirements of the law and regulations, both federal and state. Who May Issue A prescription for a controlled substance may only be issued by a physician, dentist, podiatrist, veterinarian, mid-level practitioner, or other registered practitioner who is: Authorized to prescribe controlled substances by the jurisdiction in which the practitioner is licensed to practice, and Registered with DEA or exempted from registration (e.g., Public Health Service, Federal Bureau of Prisons, military practitioners), or An agent or employee of a hospital or other institution acting in the normal course of business or employment under the registration of the hospital or other institution which is registered in lieu of the individual practitioner being registered, provided that additional requirements as set forth in the C.F.R. are met. Purpose of Issue To be valid, a prescription for a controlled substance must be issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice. The practitioner is responsible for the proper prescribing and dispensing of controlled substances. A prescription may not be issued in order for an individual practitioner to obtain controlled substances for supplying the individual practitioner for the purpose of general dispensing to patients. Pharmacies receive payments from a variety of sources. Payments will vary based on the pharmacy setting and the type of patients served and prescriptions filled. Let’s take a look at the variety of payment types by setting: Community (Retail) Pharmacy Community pharmacies receive payments for prescriptions drugs and durable medical supplies by billing the patient’s insurance plan, or charging the patient cash if they do not have any insurance coverage. Insurance types range from employer-sponsored plans and private insurance (HMOs and PPOs) to state and federal programs such as Medicaid and Medicare. For Medicare patients, most drugs are covered under Medicare Part D. Medical supplies such as diabetic testing strips and certain drugs (some nebulizer medications, anti-rejection or chemotherapy drugs) are paid for by Medicare Part B. Every insurance plan has a formulary and patients either pay a copay or coinsurance. Many patients also have a deductible to meet every year, and will pay for the cost of drugs out of pocket until the deductible is met. Nearly every health insurance plan contracts out the pharmacy benefits portion to a Pharmacy Benefits Manager (PBM). These PBMs manage the prescription billing and are to whom the pharmacy actually submits prescription claims. Examples of PBM companies include, MedImpact, Prime Therapeutics and Express Scripts. It is important to note that the pharmacy does not set the patient’s copay or coinsurance; that is set up in the specifics of the patient’s individual health plan. Pharmacies bill prescriptions electronically to insurance companies; the claim is adjudicated instantly and the patient’s copay prints out on the prescription label. This can sometimes be confusing to patients as they may not understand the process. Pharmacy staff can help patients by explaining the adjudication process and directing them to contact their insurance company directly for an explanation of plan benefits. Most insurance cards have help desk phone numbers on the back of the card. Hospital Pharmacy Billing for hospital pharmacy services is done quite differently than other settings. Drugs used during a patient’s hospital stay are not billed the same way as outpatient prescriptions. The billing is combined with the rest of the charges the patient incurs while in the hospital and is taken care of by the hospital’s billing department. Pharmacy staff have very little interaction with the patient’s specific insurance plans and therefore do not have to handle insurance rejections. Long-term Care Pharmacy Long-term care pharmacies frequently bill insurance companies and Medicare and Medicaid just as community pharmacies do. However, since nursing home stays are sometimes billed to Medicare Part A, the pharmacy will dispense and bill prescriptions for those patients a little differently. Most Part A patients will only receive a short amount of medications at a time, such as a weeks’ supply. The Process from Start to Finish Pharmacy Technicians are involved in the prescription order process from start to finish. In a community pharmacy, this starts with the intake of the prescription or refill request from the patient and ends with ringing up the sale of the prescription. In hospital pharmacy it starts with receiving the medication order for the patient from the physician and ends with delivery of the product to the nursing unit for eventual administration to the patient. In long-term care pharmacy, the process is similar to hospital pharmacy with respect to the initial medication order intake and delivery process. There are several critical steps where Pharmacy Technicians play important roles. Those steps, while varying slightly based upon the setting, have some commonalities: Data Entry At this step, technicians are creating or updating the patient profile and entering the prescription order. The data entry step also involves calculations of drug doses, quantities and days’ supply, proper selection of the correct medication, and input of all other required prescription order elements, including correct directions. In a community pharmacy and often in a long-term care pharmacy this will involve billing the patient’s insurance plan and handling any insurance rejections. Prescription Order Filling This will vary considerably depending on the order to be prepared and the pharmacy setting. In any setting, it will require accurate selection of the drug to be dispensed, the correct quantity, selection of proper container for dispensing, and application of proper labels. In a long-term care setting, this often involves filling tablets and capsules into unit-of use blister packs (sometimes called punchpaks). These are intended to allow for safe and accurate administration to the patient by avoiding nursing staff having to take pills from a prescription bottle. In a community pharmacy setting, this involves preparing the prescription for the patient to administer it themselves. Proper directions, auxiliary warning labels and patient information leaflets are a part of this dispensing process. In a hospital pharmacy setting, this may involve filling unit-dose medications into a cart for delivery to a nursing unit. It will also involve sterile parenteral compounding. Labeling requirements for medications are different for hospital inpatients since the drugs are administered by nursing staff. Compounding An exciting part of the Pharmacy Technician’s job is compounding. Most pharmacies, regardless of the setting, do some type of compounding. Years ago when the pharmacy industry had just begun, all medications were individually compounded by the pharmacist. If you recall from your study of the history of pharmacy, mass production of pharmaceuticals developed as a result of increasing demand from injuries sustained during the major World Wars. Today, pharmaceutical manufacturers produce most of the medications pharmacies dispense. There is still a need for compounding, however, especially in hospital pharmacies. Reasons for Compounding There are many reasons why a patient would need a compounded medication: The most obvious is that the product does not come in a dosage form that the patient can take. Another would be a patient that cannot swallow capsules may need to have that medication compounded into an oral suspension. Perhaps the physician may want to order a cream in a strength that isn’t available. For example, the physician may want 2% strength instead of the commercially available 1% strength. Sometimes pharmacies compound medications to save the patient money. Compounding generic omeprazole suspension instead of dispensing Prevacid solu-tabs could be a cost-saving example here. Hospital pharmacies need to compound sterile parenteral medications to meet the needs of acutely ill inpatients. Total parenteral nutrition must be made to exact specifications depending on the patient’s nutritional needs. Chemotherapy follows similar preparation requirements. It is important to remember that patient safety is paramount when performing compounding procedures. Strict sterility guidelines must be followed each and every time in order to avoid contamination. While this is important in any setting, in the hospital environment it is particularly critical. Contamination of sterile IV products could result in patient harm, including infection and death. Important Aspects of Compounding How well do you remember these important aspects of compounding? Personal Protective Equipment Personal Protective Equipment (PPE) must be put on in proper order prior to compounding. The purpose of PPE is to protect you from coming in to contact with any hazardous substances and also to maintain a sterile environment to prevent compounded products from becoming contaminated. As a reminder, the proper order for putting on PPE is: Shoe covers Hair cover Face mask Aseptic hand washing Gown Shelf-life and Beyond-use Dates No pharmaceutical product has an indefinite shelf-life. All compounded products, both sterile and non-sterile, have beyond-use dates. Once a product has reached its beyond-use date, it must be discarded. The stability of a compounded product starts to diminish after the expiration date, and may result in a loss of effectiveness or degradation of the ingredients, both of which have the potential to cause patient harm. Remember that sterile compounding is regulated by USP 795 and non-sterile by USP 797. Specific guidelines are included in those resources. Pharmacies will maintain a compounding formula for each pharmaceutical product they compound, whether sterile or non-sterile. Think of this as the “recipe” for making the product. Sterile compounded products have beyond -use dates that are based upon risk categories. Examples of how to calculate a beyond-use date for various CSPs: An immediate-use CSP was compounded at 4:00 PM on May 3rd of this year and stored at room temperature. When will it expire? It will expire at 5:00 PM, 1-hour after being compounded. A high-risk category CSP was compounded at 12:00 PM on May 1st of this year and stored in the refrigerator. When will it expire? It will expire at 12:00 PM on May 4th of this year (3-days after being compounded). A medium-risk CSP was compounded at 8:00 AM on April 1st of this year and stored in the freezer. When will it expire? It will expire at 8:00 AM on May 16th of this year (45-days after being compounded). A low-risk CSP was compounded at 2:00 PM on April 2nd of this year and was stored in the refrigerator. When will it expire? It will expire at 2:00 PM on April 16th of this year (14-days after being compounded). Automated systems are now used in a variety of pharmacy practice settings. Automation types are very diverse and range from simple counter-top tablet counting units, all the way to robotic systems that prepare sterile parenteral admixtures. Examples of Pharmacy Automation Community pharmacies often use automated systems that count, package and label prescription drugs, and prepare them for final pharmacist verification. One example of this is a system made by McKesson called ScriptPro. For more information on how the ScriptPro system works, click here: http://www.scriptpro.com/ Hospital pharmacies may employ a few different types of automation. In the hospital pharmacy itself, they may use an automated IV admixture system. One example is RIVA. Here is a video that explains how a RIVA system works: RIVA Robotic IV Automation Hospitals may also use a type of automation called an AMDS (Automated Medication Dispensing System). These systems are placed in nursing units on the hospital floors or in the emergency department. These units often look like cabinets and have drawers of differing sizes. The pharmacy is responsible for stocking the units with drugs. Two examples are Pyxis and Omnicell. Pharmacy Technicians Responsibilities with Automated Systems Pharmacy Technicians have many responsibilities with automated systems. The technician is responsible for stocking the system, cleaning and maintenance. Depending on the type of system, the technician may also scan prescriptions and input patient information. As pharmacist’s roles continue to expand, technicians will also take on additional duties in the pharmacy. Using automation to help with the manual aspects of filling prescription will allow technicians and pharmacist to have more time to spend with patients and complete other pharmacy tasks. uch of the focus during your training is on hospital and community pharmacy. These two settings generally account for the majority of Pharmacy Technician jobs. However, there are many other fulfilling settings for you to work. Let’s discuss a few: Long-term Care Pharmacy A traditional long-term care pharmacy is generally a closed-door pharmacy, meaning that they are not open to the general public as a community retail pharmacy is. Prescriptions are packaged in unit-dose punch-paks or other unit-dose dispensing systems and are delivered to the nursing facility’s pharmacy services. These pharmacies service nursing homes, group homes, assisted living facilities and sometimes even recovery centers and jails. Veteran’s Administration VA pharmacies strictly serve Veterans and, depending on the facility, may service both inpatients and outpatients. The setting here is quite diverse. Similar to hospital pharmacies, VA pharmacies have specific formularies and the pharmacy will automatically substitute the formulary alternative when necessary. Mail-order Pharmacy Mail-order pharmacies are becoming more and more popular as insurance company plans change to offer incentives for patients to use mail-order service. These are generally large facilities but otherwise operate much like a community pharmacy. The obvious difference is that patients do not come to the pharmacy to pick up medications. Depending on the type of mail-order pharmacy the prescriptions may be shipped anywhere in the country. Many large PBMs operate mail order pharmacies such as Express Scripts and Medco. Specialty Compounding One unique specialization is a compounding pharmacy. Some specialize in compounding parenteral medications for home IV infusion. Others may specialize in bioidentical hormones. In these settings, the Pharmacy Technician may not dispense many “traditional” prescriptions but will have the opportunity to do a lot of sterile and non-sterile compounding. __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Running head: INVENTORY MANAGEMENT 0 Inventory Management Vondra Wesley Rasmussen College Author Note This paper is being submitted on February 27, 2019, for Stanley Sangar’s Pharmacy Technician Capstone course. Inventory Management Rejected Insurance Claims -There are various reasons for insurance claims to be rejected and it is very imperative to have these issues correctly adjusted to maintain an accurate inventory count and positive customer service. The Pharmacy Technician must review why the claim was rejected and research a possible solution for the issue: DAW (dispense as written) rejections occur whenever the insurance may not want to pay for a brand medication because of the price. Most insurance companies would rather pay for the generic over the brand version of a drug because the generic is much cheaper. It is required for the prescriber to put on the prescription a DAW code and this will let the insurance company know that this is what he or she has requested for the patient and that it’s medically necessary. Example: Insurances refuses to pay for the brand, Technician processes order for generics but gives patient brand medication (Brand is more expensive), the patient will receive a lower price, but the Pharmacy will lose money, and the inventory will not be correct since the order received approval for generics and patient given the brand. In the inventory count, it will show a discrepancy in the actual amount of brand on the shelf compared to what’s on the report. Days’ Supply. Majority of insurance companies only pay for thirty days of medication at a time, and unless the technician or patient calls the insurance company and verifies the reason for more than thirty days, it will not receive approval. The technician must input the correct dispense amount under the approved amount of the insurance company, and any overage must be put in as another form of payment. If improperly done and the patient is given more under the claim, this will cause an inventory shortage. For example: Pharmacy has 200 Lipitor 10mg @ 1.75each tablet in stock. Jane Doe has an on-going prescription for Lipitor 10mg 1 daily, qty 30. Ms. Doe is requesting 90 tablets. The insurance company only approves 30 tablets. The Technician processes the prescription for 30 tablets but gives the patient 90 tablets. The pharmacy inventory will show up as 60 tablets short and $105.00 short, which is a loss to the pharmacy assets as well as a loss if four other patients came in and needed Lipitor 10mg 1 tablet daily qty 30. The Pharmacy would be ten short, therefore also losing a sale. DAW SOLUTION- First the Technician should be familiar with the various DAW codes and their values to be able to resolve the issue. In this context, we see a DAW was sent back to the Pharmacy because there was no specification as to who requested for the prescription to be filled as a brand drug. The Technician should review the prescription and verify whether the healthcare provider requested a brand or the patient. If the Physician requested brand, the DAW code should be entered as DAW 1, if the patient requested DAW 2 and resubmitted. If approved by the insurance, process the claim. If not approved, refer to the Pharmacist to contact the Physician about changing the prescription. DAYS SUPPLY SOLUTION- Review the prescription, making a note of the strength of prescribed medication (determine if it’s one single dose or more), administration orders and how many days is prescribed and perform the proper calculations. Your final answer will be your days’ supply: Lipitor 10mg, one tablet PO daily x 30 days, six refills. Patient requests 90 days’ supply (3 months). Technician inputs the prescription with the request of 90 days’ supply. Insurance company rejects (only will cover 30 days). Consult with Pharmacist about speaking with the insurance company for the patient to get an exception by providing reasoning for a request or speak to the customer concerning contacting their provider about writing a new prescription indicating a 90 days’ supply. After input of the new prescription, submit it to insurance. If approved continue filling the order, if not have the patient consult with their provider about making contact with their insurance company to request an exception. But as with any issue that relates to a patient and their medication, always consult the Pharmacist on the proper way to resolve any problems. Managing the inventory is a critical responsibility for the Technician to maintain at all times to ensure that the Pharmacy is always in stock to provide the proper care of the community, safety, and profit of the pharmacy. Adequate stocking of the inventory will eliminate a stressful issue whereas having a customer come in with a prescription request and can’t receive the medications they may need. Not only is that poor customer service, but can also contribute to the loss of customers and profits. Removing and sending back medications due to expiration dates is another way that provides safety for the patients and some manufacturers will give credit back to the Pharmacy. By following an on hand, ledger will help eliminate overstock. With the new technology available, it helps to prevent shortages and overages by recording what’s on hand and what has been dispensed. Some systems are pre-programmed to order whenever a medication reaches a certain level down automatically. Time management and completing each day required tasks is an essential element to be practiced in any work environment and can increase productivity, less stress, additional time to accomplish other tasks. Proper time management ensures an efficient and adequate workflow. When the proper time management skills exist, it creates an atmosphere of a sense of completion and optimum patient care and provides opportunities to assist and learn other areas of the work environment or to lend a helping hand to co-workers or anyone else needing assistance. References
Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Running head: PHARMACY SOFTWARE AND CUSTOMER SERVICE 0 Pharmacy Software and Customer Service Vondra Wesley Rasmussen College Author Note This paper is being submitted on February 22, 2019, for Stanley Sangar’s Pharmacy Technician Capstone course. Pharmacy Software and Customer Service EPICOR EAGLE N SERIES- A Pharmacy Retail Software System fully combined with built in multichannel sales, a point-of-sale system, and inventory and merchandising management. Ideal for small and midsize businesses. (“Epicor® Eagle N Series Pricing, Demo, Reviews, Features”, 2019) Benefits- Customer service friendly, integrated accounting and real-time analytics, powerful mobile tools and online solutions, keeps data in a date/time order for easy, credit card user requests verification, minimization of Inventory searches. Cons- Customization on invoices is limited, limited software compatibility, extra training to cashier to explain the pricing and promotions to customers, less suitable for companies that do not have a large volume of sales/inventory. (Software et al., 2019) SCRIPTPRO- A all-inclusive, unified platform of robotics-enabled systems to enhance retail and ambulatory pharmacy procedures, encouraging safe and effectual medication use and adherence, as well as support for specialized pharmacy services, high-risk/high cost medications, 340B administration, home-based patient medication adherence, and third- party financial management. (“ScriptPro – Reviews, Pricing, Free Demo and Alternatives”, 2019) Benefits: works with lightning speed and extreme accuracy, Prescription Management, Compounding, Prescription Processing, Signature Capture, Windows compatible. Cons: Medication errors if loaded with wrong medication with longer detection timing, breakdowns or malfunctions, software issues and power outages. (Error?, Assaad & Houston, 2019) PIONEER RX- A pharmacy managing solution that helps self-governing pharmacies direct their business by supporting their daily activities. It can be installed either on-premise or in the cloud. Retail. (“PioneerRx – Top Pharmacy Software System – Save + Revitalize Independent Pharmacy”, 2019) Benefits- User-Driven Features for Pharmacist and Technicians, integrated Rx Syncing and easy search features, enables you to better participate in your patients’ wellness, rapid data entry, assists with increasing profits and revenues by promoting labs and immunizations, integrated point of sale, direct access to pricing and patient information. pharmacy software data is duplicated to Cloud and meets HIPAA requirements and minimizes downtime in the event of an emergency. Cons- Missing “Total Price” for prescriptions ready for pickup at the bottom of the patient Rx Profile, need faster scanner, no emergency supply feature, determining claim overrides to use on the secondary insurance rejections. (“Pharmacy Software Reviews | Software Reviews”, 2019) For my research I used the Software Company’s website and for the benefits and Cons of each I researched the blogs and product reviews of different Pharmacies and also a case file involving robotic software usage in Pharmacy. References Epicor® Eagle N Series Pricing, Demo, Reviews, Features. (2019). Retrieved from https://selecthub.com/erp-software/epicor-eagle/ Software, E., it!, E., DiMarco, D., system, E., Bettencourt, J., & Epicor not sufficient anymore, n. et al. (2019). Epicor Eagle N Series Reviews & Ratings | TrustRadius. Retrieved from https://www.trustradius.com/products/epicor-eagle-n-series/reviews#2 ScriptPro – Reviews, Pricing, Free Demo and Alternatives. (2019). Retrieved from https://www.softwaresuggest.com/us/scriptpro Error?, W., Assaad, G., & Houston, T. (2019). The Dangers of Using a Pharmacy Dispensing Robot to Fill a Prescription. Retrieved from http://www.pharmacyerrorlawfirm.com/blog/advantages-and-disadvantages-of-pharmacy-robots.cfm PioneerRx – Top Pharmacy Software System – Save + Revitalize Independent Pharmacy. (2019). Retrieved from https://www.pioneerrx.com/Web/ Pharmacy Software Reviews | Software Reviews. (2019). Retrieved from http://www.pharmacysoftwarereviews.com/Software/PioneerRx_Pharmacy_Software/Reviews?PageTo=3
Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Running head: STERILE AND NON-STERILE COMPOUNDING 0 Sterile and Non-Sterile Compounding Vondra Wesley Rasmussen College Author Note This paper is being submitted on March 3,2019, for Stanley Sangar’s Pharmacy Technician Capstone course. Sterile and Non-Sterile Compounding The U.S. Pharmacopeia Convention (also called the USP) is a pharmacopeia (a compendium of drug information) was established in 1820 which is a nonprofit organization that owns the trademark and copyright. The United States Pharmacopeia is published annually and ensures the quality and safety of medications and foods. (“United States Pharmacopeia,” 2019). USP <797> helps to guarantee patients receive quality formulations that are contaminant free and are consistent in anticipated Identity, strength, and potency. It defines various requirements, as well as responsibilities of compounding personnel, training, environmental monitoring, storage and testing of finished preparations. Compounding creates available access to medication for patients who may not be able to use commercially available preparations due to dosing requirements, allergies or rare illnesses. Medications that are necessary to be sterile include those administered through injection, intravenous infusion (IV), intraocular (injection in the eye) or intrathecal (injection in the spine). USP develops principles for preparing compounded sterile drugs to help ensure patient benefit and reduce risks such as contamination, infection or incorrect dosing. (“Compounding Standards | USP”, 2019) Even though it was established in the US, its regulations are being practiced all over the world. The guidelines set by USP as well as the changes and updates on medication and food regulations that arise every five years is crucial to the pharmacy industry and the health of patients. Some guidelines will require pharmacies to make changes in their business management and to invest in advanced equipment, in the long run, will be beneficial to all parties involved (doctor, pharmacy, patients). One example is USP 797 that requires a pharmacy to acquire new technology to prepare sterile medication in facilities that encase an Anteroom for the staff to prepare themselves and supplies for sterile preparation techniques and a clean room for the compounding of sterile medication with an ISO Class 5 air quality environment certification. These requirements will ensure that quality medication is being produced and will prevent contaminations that will be detrimental to the patient’s health. (“How will new USP regulations impact the pharmacy? | Solid State Technology”, 2019) Consider this scenario: You receive a prescription for tramadol 5 mg/ml suspension. The compounding formula states the needed ingredients are: tramadol 50 mg tablets, ora-sweet syrup, and ora-plus suspension. You need to make 140 ml of suspension. Answer the following: List the compounding equipment you would need to prepare this product, and list what you would use each item for. Mortar and triturate – I will use these instruments to crush the tramadol 50 mg tablets into a fine powder. Graduated cylinder – This is where I will transfer all the ingredients coming from the mortar. Stirring Rod- I will use this to ensure that all ingredients are well mixed. (13 Sterile Compounding, n.d.) Your choices for bottles to dispense the suspension in are 2 oz, 4 oz, and 6 oz. Which size will you choose? I would use a 6 oz. bottle as per the USP medication packaging guidelines with a child safety cap. (Pharmacy Calculation, 2017) COMPOUND RECORD- Name of the Pharmacy, Name, strength, and dosage form of the compounded sterile preparation (CSP), Master Formulation Record reference for the CSP, when used, Date and time of preparation of the CSP, Assigned internal identification number (e.g., prescription or lot number). Signature or initials of individuals involved in each step (e.g., technician or pharmacist). Name, vendor or manufacturer, lot number, and expiration date of each ingredient and container-closure system. Weight or measurement of each element, documentation of the calculations made to determine and verify quantities and concentrations of components, if appropriate. Documentation of quality control procedures in agreement with the SOP (e.g., filter integrity, pH, and visual inspection). Any deviations from the Master Formulation Record, if used, and any problems or errors experienced during the compounding of the CSP. Total quantity compounded, Assigned Beyond Use Date, duplicate container label if prepared in a batch. (Compound Record and Master Formula Record, n.d.) Most of the medication compounded by community pharmacies are nonsterile medications like ointments that are typically prescribed in small quantities for a short treatment period. While compound medications processed in a hospital pharmacy is generally made for inpatient and emergency patients, and it usually consists of sterile medications that require facilities such as a clean room. Some hospital pharmacies also outsource compound medication to community pharmacies with existing facilities to save on the cost of maintaining their facility and storing the medication per patient basis. Hospital pharmacies have the advantage of providing the correct compound medication since they have direct access to patient records and any changes in the patient’s condition that will also alter the course of treatment. Hospital Setting- Oral liquids, topicals or suppositories; the conversion of one dosage form into another; the preparation of selected dosage forms from bulk chemicals; the development of intravenous admixtures or parenteral nutrition solutions; the preparation of radioactive isotopes; or the preparation of cassettes, syringes and other devices for drug administration in the home setting. Some of the most frequently compounded products include lotions, ointments, creams, gels, suppositories, intravenously administered fluids, and medications, total parenteral nutrition products, oral suspensions, and Troches. Some therapies, such as hyaluronidase injection (used to increase dispersion and absorption of other drugs injected under the skin). (“Pharmacy and the value of compounding today,” 2019) Retail Pharmacy Setting- Omeprazole or lansoprazole liquids (similar active ingredients to Prilosec or Prevacid). A combination of two or more commercially available creams, ointments, lotions, or other topical medications. Some typical examples are diaper rash creams or other skin treatments. Various types of prescription mouthwash, sometimes referred to as “Magic Swizzle” (this will often include an antacid, lidocaine, and diphenhydramine—the active ingredient in Benadryl). (Shye, 2015) Cleaning A Horizontal Laminar Flow Hood: First, gather all the cleaning supplies needed in cleaning the horizontal laminar flow hood. To ensure that the container of the 70% alcohol is free of dust and other contaminants the pharmacy technician must first wipe or spray the container with a cleaning agent. The technician must then proceed with hand washing followed by wearing a sterile gown. The cleaning process begins with the pharma wipes being folded into four and sprayed with alcohol. Start wiping the top of the booth, beginning on side nearest to the HEPA filter towards the outer edge of the hood. To make sure that all surface is covered use long overlapping sweeping motions from right to left. Then proceed with wiping the lens cover using another side of the pharma wipes. Follow the same movement used to clean the top portion. Then continue with cleaning the sides starting with the right side. The direction of wiping must be from top to bottom with same sweeping motion use on the top part of the hood. Perform the same process on the left side using another clean side of the pharma wipes. Once done with cleaning both sides, use another clean part of the pharma wipes to clean the suspension rod. Only wipe the rod once starting on the left side going to the right. And lastly, clean the work surface beginning on the back going to the front. Wipe the work surface, in the same manner starting from the back toward the edge. Once done the technician must go back to the anteroom to complete the hood cleaning checklist and then remove the sterile gown. (Durant, 2015) Laminar Flow Hood And A Vertical Laminar Flow Hood: Horizontal laminar flow hood is commonly utilized between the two since its less expensive and it is ideal for compounding most sterile products. The air flows from back to front in a horizontal motion across the work surface. It can remove 99.97% of all particles that are 0.3 microns or larger. Vertical laminar flow hood, on the other hand, directs the laminar flow downward. It is considered as the safest making it ideal in preparing hazardous types of medication such as anti-cancer drugs as it protects the pharmacist from exposure to airborne drug particles. Vertical LAFW is also more expensive than horizontal LAFW. (“Horizontal vs Vertical Laminar Flow Hoods”, 2014). References United States Pharmacopeia. (2019). Retrieved from https://en.wikipedia.org/wiki/United_States_Pharmacopeia Compounding Standards | USP. (2019). Retrieved from https://www.usp.org/compounding How will new USP regulations impact the pharmacy? | Solid State Technology. (2019). Retrieved from https://electroiq.com/2004/03/how-will-new-usp-regulations-impact-the-pharmacy/ Paradigm Publishing, LLC. 13 Sterile Compounding [eBook]. Retrieved from http://resources.emcp.com/EPC_Books/EPC_Sterile_Compounding/ Paradigm Publishing, Inc. (2017). Pharmacy Calculation [eBook] (6th ed.). Retrieved from https://paradigm.bookshelf.emcp.com/lectern/book/Pharm_Calc_6e Compound Record and Master Formula Record. [eBook]. Retrieved from https://pharmacy.ky.gov/Documents/COMPOUND%20RECORD.pdf Pharmacy and the value of compounding today. (2019). Retrieved from http://www.hospitalpharmacyeurope.com/featured-articles/pharmacy-and-value-compounding-today Shye, R. (2015). What are Compounded Medications? [Blog]. Retrieved from https://www.goodrx.com/blog/what-are-compounded-medications/ Durant, K. (2015). Cleaning the Horizontal Laminar Flow Hood [Video]. Retrieved from http://www.slideshare.net/Kdurant36/cleaning-the-horizontal-laminar-flow-hood Horizontal vs Vertical Laminar Flow Hoods. (2014). [Blog]. Retrieved from https://www.terrauniversal.com/blog/all-terra-blogs/horizontal-vs-vertical-laminar-flow-hoods/ Standard Formulations. (2019). Retrieved from http://www.mipedscompounds.org/sites/default/files/standard-formulations/Tramadol_0.pdf COMPOUNDING RECORD Formula Number: 555555555 Product Drug Name and Strength Use/Dosage Form Date Tramadol 5mg/ml Suspension 3/03/2019 ———————————————————————————————- LOT BUD Quantity Control/Rx # 1234567891 3/06/2019 140ml 7777777-1049 ——————————————————————————————————————— INGREDIENTS BREAKDOWN INGREDIENT NDC QTY LOT EXP Tramadol 50mg tablets 1444444444 12 7777777777 8/2020 Ora-Plus Suspension xxxxxxxx qs ad 70ml xxxxxxxxxx 8/2025 Ora-Sweet Syrup xxxxxxxx qs ad 70ml xxxxxxxxxx 8/2025 ______________________________________________________________________ DIRECTIONS: 1.Triturate tablets to a fine powder in a mortar and pestle. 2.Levigate with a small amount of base solution to form a paste. 3.Add base solution in increasing amounts while mixing thoroughly. 4.Transfer contents of the mortar to a graduated cylinder. 5.Rinse the mortar and pestle with base solution and pour into graduated cylinder. 6.Add base solution to the graduated cylinder to achieve the total volume 140ml. 7.Transfer contents of the graduated cylinder into an appropriate size plastic amber (6oz) bottle with Child Safety Cap 8.Shake well to mix. (“Standard Formulations”, 2019)
Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Running head: STATE LAW REQUIREMENTS State Law Requirements Vondra Wesley Rasmussen College Author Note This paper is being submitted on February 16, 2019, for Stanley Sangar’s Pharmacy Technician Capstone course. State Law Requirements The well-being and safety of individual patients and the community are at the center of everyday professional practice and must be your first and continuing concern regardless of your profession. Your actions or behavior has an impact on patient care or public safety. It is required for you to provide a good standard of practice and care to those for whom you are providing professional services. Your purposes should be to promote a healthier lifestyle among the community and individuals, safeguard the well-being of all patients. Acquire the required information to discover a person’s needs and provide appropriate treatment and care. If necessary, refer patients to other health or social care professionals, or other pertinent organizations. Ensure safe access to medicines and reassure their usage. Make an effort to explain to patients how to properly use their medications. Be pleased with the integrity and quality of products supplied to the community. Uphold accurate and adequate records including all relevant information in a clear and understandable form. Confirm you have access to the facilities, equipment, and materials necessary to provide services in accordance with professionally accepted standards. Practice regular audits and risk assessments to improve the quality of services you provide to minimize risks to the patient and public safety. Use your professional decision in the interests of patients and the community. Practice balancing the necessities of individuals within society as one. Take into account the targets, guidelines and financial constraints, but do not allow them to alter your ability to make a professional, informed decision on the appropriateness of care for patients in specific circumstances. Always act and take into account the best interests of everyone. Make use of all available sources, healthcare professionals or coworkers. If you feel their difference in opinion can jeopardize the safety of others, be ready to compare your views based on facts against theirs. Use your professional decision in the interests of patients and the community. Practice balancing the necessities of individuals within society as one. Take into account the targets, guidelines and financial constraints, but do not allow them to alter your ability to make a professional, informed decision on the appropriateness of care for patients in specific circumstances. Always act and take into account the best interests of everyone. Make use of all available sources, healthcare professionals or coworkers. If you feel their difference in opinion can jeopardize the safety of others, be ready to compare your views based on facts against theirs. Your professional judgment should not be based on personal or profitable interests, targets or similar measures. All decisions and recommendations for services or products should be based upon research done on requested services or products that contain the utmost safety and integrity for the patients and the community. Always take notice of whether or not the benefits outweigh the risks. Patient safety should still be first. In case of an emergency, resolve to assist in the best possible action to ensure safety for all. Showing respect for others- is fundamental and appropriate in all professional relationships, relationships with patients, their caretakers or providers, coworkers and other individuals that you come into contact with during your professional practice. Respecting the different ethnicity of others is essential. You must recognize diversity and respect the cultural differences, values, and beliefs of others. Development and usage of your professional knowledge and skills should benefit those who seek your professional services, uphold good professional relationships with others, and act in a way that encourages confidence and trust in the pharmacy professions. The Code of Ethics- is the Society’s core guidance on the conduct, practice and professional performance of professionals in all aspects of the healthcare industry. It is designed to confirm our responsibilities under The Pharmacists, and Pharmacy Technicians Order 2006 and other applicable laws. The principles of the Code guide provide support to the work you do and the decisions you make. They also inform the general public of the ideals of behavior that are expected from the pharmacy profession. The Code is originated on seven principles that express the values central to the identity of the pharmacy professions. The seven principles and their supporting descriptions summarize what it means to be a registered pharmacist or pharmacy technician. Using these principles as part of your professional life will ensure patient safety and public confidence in the profession. Status of the Code of Ethics- Your professional and personal conduct will be judged against the Code. You must abide by its principles irrespective of the job you do. Inappropriate behavior, whether directly or indirectly connected to your professional practice, or failure to comply with the laws identified in the Code, could put your registration at risk. Make the care of patients your first concern – Show respect for others, Treat others politely and considerately. Honor and protect the dignity and privacy of others by always following and practicing the HIPPA Guidelines, Use your professional judgment in the interests of patients and the public. Never allow your views about a person’s lifestyle, beliefs, race, gender, age, sexuality, disability or another perceived status to prejudice their treatment or care. (If you have an objection to providing a particular professional service, ensure that appropriate persons or authorities are informed of this and the patients are referred to alternative sources of the service they require, either by you or by one of your colleagues). Acquire consent for the professional services, treatment or care you provide and the patient information you need to use. The data obtained in the course of professional practice should only be used for the purposes for which it was given. Use all reasonable steps to ensure appropriate levels of privacy for patient consultations. Encourage and practice proper professional boundaries in the relationships you have with patients and other individuals that you come into contact with during your professional practice, especially when dealing with at-risk individuals. Encourage patients to be active in decisions about their care- Patients have a right to be actively involved in decisions about their treatment and care. They should be encouraged to work in partnership with you and other members of the professional team to manage their health care needs. A successful partnership requires effective communication and the ability to identify the individual needs of patients. When possible, work in cooperation with patients, their caregivers, and other health care professionals to manage the patient’s treatment and care. Clarify the options available and assist individuals in making an informed decision about whether or not they wish to use a particular service or treatment option. Listen to patients and attempt to communicate effectively with them. Ensure that, whenever possible, reasonable steps are taken to meet the particular language and communication needs of the patient. Take all reasonable steps to share information that patients or their caregivers want or need in a way that they can understand, and make sure that the information you provide is relevant and up to date. Ensure that information is properly shared with other health care professionals involved in the care of the patient. Respect a patient’s right to refuse to receive treatment, care or other professional services. Consider and, whenever possible take steps to address factors that may prevent or discourage individuals from obtaining or taking their treatment. (“Code of Ethics for Pharmacists and Pharmacy Technicians – CKM PHARMA”, 2019) Develop your professional knowledge and competence – Proper management of keeping your knowledge, skills, and performance up to date will ensure they are of high quality, and relevant to your field of practice throughout your working life. Your knowledge will all be evidence-based and relevant to your role and responsibilities. Appropriately apply your knowledge and skills to your professional responsibilities. Observe the limits of your professional competence; practice in those areas in which you are competent and refer to others when necessary. Take on and maintain up-to-date records of continuing professional development corresponding to your field of practice. Reply constructively to the outcomes of assessments, appraisals, and reviews of your professional performance and assume further training where necessary. Practice if you are fit and competent to do so. Promptly state to the Society, your employer and other relevant authorities any circumstances that may call into question. Your fitness to practice or bring the professions into discredit, including ill health that impairs your ability to practice, criminal convictions and findings by other regulatory bodies or organizations. (“Code of Ethics | Alberta College of Pharmacy”, 2019) Be honest and trustworthy- Be honest and trustworthy to patient, coworkers and the community because they place their trust in you as a pharmacy professional. You must behave a way that validates this trust and maintains the status of the profession. Maintain public trust and confidence in the professions by acting with honesty and integrity. Do not abuse your professional position for personal gain or exploit the weakness or lack of knowledge of others. Avoid conflicts of interest by announcing any personal or professional interests to those who may be affected. Do not accept gifts, incentives, hospitality or referrals that may affect, or be perceived to disturb your professional judgment. Be accurate and fair about the teaching of others and the sharing of publications or materials of information to ensure that you do not mislead or make claims that cannot be justified. Observe accepted standards of personal and professional conduct. Complied with legal requirements, mandatory professional standards and accepted best practice guidance. Honor commitments, agreements, and arrangements for the provision of professional services. Respond honestly, openly and courteously to complaints and criticism. Take responsibility for your working practices- Team working is the main element of every professional practice and requires respect, co-operation, and communication with colleagues from your profession. When working as part of a team, you continue to be accountable for your own decisions, behavior, or any work done under your supervision. Communication and effective work with your coworkers from your own and other professions enable services to the best interests of patients and the community. Ensure that both you and those you employ or supervise have sufficient language skills to provide the requested services. The sharing of relevant knowledge, skills, and expertise with others and support colleagues and trainees assist in developing their professional competence. Take responsibility for all work done by you or those under your supervision. Ensure that individuals to whom you assign tasks are to be competent and fit to practice and have started, or are in the process of starting the training required for their duties. Be appreciative that appropriate standard operating procedures exist and receive adherence, and that clear lines of accountability and verifiable audit trails are in place. Confirm that you can comply with your legal and professional obligations and that your workload or working conditions do not compromise patient and public safety. Be sure that your actions do not prevent others from complying with their legal and professional obligations, or present a risk to the patient and public safety. Ensure that all professional activities are undertaken by you, or under your control, are covered by professional security arrangements. Be pleased that there is an effective complaints procedure where you work and follow it at all times. Raise concerns if policies, systems, working conditions, or the actions, professional performance or health of others may compromise patient or public safety. Take appropriate action if something goes wrong or if others report concerns to you. Co-operate with investigations into your or another health care professional’s practices and procedures and abide by actions you give or any restrictions placed on your practice. (“Code of Ethics for Pharmacists and Pharmacy Technicians – CKM PHARMA”, 2019) The Pharmacy Laws state that All people are to be treated and respected the same. No matter their diversity and cultural differences, values, and beliefs, choice of relationships or language, origins or anything that differentiates us one from another. It is solely based upon the Human Rights Act that states everybody should be treated equally and with dignity and respect. At which no one should receive a denial of any services that are created to serve the various communities as a whole. No one is to be looked upon, degraded or treated inhumanly in any way. As far as about the Pharmacy Practice this is a crucial factor to be practiced because everybody deserves to receive the proper healthcare they may need without the fear of being denied or rejected because of their indifference. A Pharmacy is a place that’s established for all with no form of discrimination allowed. With these laws in effect and being practiced, the proper care and safety of each patient can and will be achieved. No one deserves to be denied treatment, services or proper care. Good customer service and interaction is not just an avenue for business, but it is a proper way of life. Those who are caught or reported for breaking these laws could put their registration, license, and job in jeopardy. Rude, disrespectful or disorderly customers can or will mostly be asked to leave the business establishment. 64B16-27.420 Pharmacy Technician – Delegable Tasks- A pharmacy technician may only assist a pharmacist in executing or carrying out the practice of the profession of pharmacy, but shall never themselves engage in the practice of the profession of pharmacy as defined in Chapter 465, F.S. Therefore, pharmacy technicians may only perform delegable tasks as identified and defined pursuant to this rule. Delegable Tasks – Delegable tasks are those tasks that are performed in an agreement to a pharmacist’s direction, without the practice of the pharmacy technician’s own judgment and discretion, and which do not require the pharmacy technician to implement the independent professional judgment that is the foundation of the practice of the profession of pharmacy. The following tasks are delegable: Data entry; The initiation of communication to confirm the patient’s name, medication, strength, quantity, directions, number of refills, and date of last refill; The initiation of communication with a prescribing practitioner or their agents to obtain clarification on missing or illegible dates, prescriber name, brand or generic preference, quantity, license numbers or DEA registration numbers. The acceptance of authorization to dispense medications pursuant to a prescribing practitioner’s authorization to fill an existing prescription that has no refills remaining (refill authorization). Labeling of preparations and prescriptions; Retrieval of prescription files, patient files and profiles, and other similar records pertaining to the practice of pharmacy; The counting, weighing, measuring, and pouring of prescription medication or stock legend drugs and controlled substances, including the filling of an automated medication system; The receiving, in a permitted nuclear pharmacy, of diagnostic orders only; Participation in a monitoring program to remove deteriorated pharmaceuticals to a quarantine area. Organizing of or participating in continuous quality improvement related events, meetings, or presentations. While under the direct supervision of the pharmacist, performance of any other mechanical, technical or administrative tasks which do not themselves constitute practice of the profession of pharmacy. (https://www.flrules.org/gateway/ruleNo.asp?id=64 B16-27.420, n.d.) References Code of Ethics for Pharmacists and Pharmacy Technicians – CKM PHARMA. (2019). Retrieved from https://www.ckmpharma.com/code-of-ethics-for-pharmacists-and-pharmacy-technicians/ Code of Ethics | Alberta College of Pharmacy. (2019). Retrieved from https://abpharmacy.ca/code-ethics https://www.flrules.org/gateway/ruleNo.asp?id=64 B16-27.420.
Final Policy and Procedure SubmissionIt is time to synthesize the elements of your Policy and Procedure into a document. Your document should be a 3-4-page paper, written in APA format, which draws up
Running head: PROGRAM REFLECTION AND INDUSTRY TRENDS AND CHALLENGES 0 Program Reflection and Industry Trends and Challenges Vondra Wesley Rasmussen College Author Note This paper is being submitted on February 20, 2019, for Stanley Sangar’s Pharmacy Technician Capstone course. Program Reflection and Industry Trends and Challenges How medications are prescribed, dispensed, and administered in the United States are quickly changing in management and the sharing of patient information electronically, instead of paper records and traditional phone and fax methods. Electronic Prior Authorization- ePA will create a valuable asset for pharmacies by removing many prior authorization requests from their work queues. The new ePA standard will add precision and reliability across the health care range and the state regulatory process, reduce costs, improve access, and improve outcomes by removing delays in treatment or prescription rejection and freeing up valuable time, which will allow pharmacists to focus on patients and income-generating activities. Medication Therapy Management: MTM services include complete medication reviews, reconciliation, drug usage review, the ordering, review of lab tests, immunizations, drug dosage adjustments, and identification of gaps in Healthcare. The Pharmacist practicing MTM encourages patients to get involved in their health care decisions, improve medication obedience especially in patients suffering from chronic diseases. New tools, such as telehealth and mobile health applications, to deliver personalized care and monitor outcomes and patient compliance. Enabling decreases costs and improving the quality of care and patient safety. Waging the War Against Substance Abuse: Electronic prescribing of controlled substances (EPCS) and prescription drug monitoring programs (PDMPs) are currently used in pharmacies, and their use will promote the ability of clinicians identify substance abuse through medication history checks, which will show all classifications of medications that were paid for through the patient’s insurance. E-prescribing systems and pharmacy systems flag potentially deadly prescription errors and drug interactions related to opioid use, thus preventing accidental deaths and overdoses. Refill request observation can be used to help flag abuse and diversion. Examination the PDMP database before filling a controlled substance prescription is highly encouraged. The Rise of Specialty Prescribing: Specialty medications requests are due to several factors: increasing numbers of elderly and chronically ill patients needing specialty medications, the need for the development of “orphan drugs” for rare diseases or conditions. New specialty therapies, an increase in effective drugs for such conditions as hepatitis C and cancer. IV administration data; patient demographics and clinical information; order-specific clinical information; and instructions related to the delivery of the medication. Real-Time Pharmacy Benefit: Assists to improve accuracy and clarity to the group-level formulary and benefit standard, potentially curb costs and resolve debates, and improve health care by increasing formulary compliance and medication adherence. Improve the current process of relating an eligibility response with transferred data files, which have limitations due to the inactivity of the update process and the different quantity and quality of the data. Actual benefit verification will significantly improve the scope, accuracy, and effectiveness of formulary data available to the prescriber at the point of care. EHR will allow the prescriber to view other decision factors, such as co-pay amounts for individual patients at the point of prescribing. This will help with formulary compliance and medication adherence. (“Five Technology Trends: Changing Pharmacy Practice Today and Tomorrow,” 2019)Pharmacy Technicians Future: Pharmacy technicians’ roles are growing and escalating due to an increased demand for prescription medications and related pharmacy services. Pharmacy techs already support pharmacists in areas of medication reconciliation, medication therapy management, immunization delivery, indigent care programs, investigational drug programs, sterile and non-sterile compounding, pharmacist-managed chronic care clinics, tech-check-tech programs, point-of-care testing services, quality assurance and quality improvement initiatives, patient safety initiatives, informatics and health information technology and tele-pharmacy, among many other roles. Pharmacy technicians will take on more roles to help increase the business of independent community pharmacy by gathering patient data, scheduling appointments, complete vital sign readings, or perform non-health related business tasks, such as marketing and front-end sales. Working with pharmacy automation systems and helping to resolve patient insurance issues. Even though the implication of these changes will allow the Pharmacist more time to focus and perform on those roles and responsibilities that require patient-related clinical judgment, it is encouraged that the Technician is subject to rigorous standards before assuming increased roles and responsibilities in the pharmacy. “This will ensure they provide the highest quality health care to improve patient outcomes and protect the public’s health in the process.” (“Transforming Technicians: Insights into the Expanding Roles of Pharmacy Technicians – PBA Health,” 2019) Challenges: Affordability- to be able to provide adequate care at the lowest cost, Nonadherence- Patients receive prescriptions, and either don’t take them or don’t refill them because they find them to be too expensive or they feel asymptomatic. Pharmacist reimbursement- pharmacists are not being compensated for services beyond dispensing drugs even though they are providing required functions, such as medication management, patient education, and counseling; reducing polypharmacy; promoting adherence; and giving wellness and prevention screenings. (ModernMedicine Network, 2017) Possible Solutions: Affordability- The decrease of prices on medications and services, increasing the availability of generic medicines at more rapid time frame, increased discount and requiring approval by insurances on medicines purchased at a higher days’ supply. Nonadherence- Increased patient education on the importance of the need to comply with the recommendation of their healthcare provider, assisting patients with obtaining generics, discounts and drug manufacturers cost-saving programs. If applicable, a reference to OTC medications. Pharmacist reimbursement- Upgrading Pharmacist to provider status since they are providing counseling, medication management therapy, recommendations, and immunizations. Future-Complexities- Higher wage requests, increased knowledge requirements for both Pharmacist and Technicians, more complex and costly equipment. Base higher wage requests upon performance, knowledge and productivity and adherence to all company policies and procedures. Offer incentives and sponsorship along with open discussion relating to promotions within company for the advancement of knowledge through continuing education. Research ways in order to increase revenues through sales, additional services both in-house and in the community and discounts or incentives to increase clientele and by providing exemplary customer service. References Five Technology Trends: Changing Pharmacy Practice Today and Tomorrow. (2019). Retrieved from https://www.pharmacytimes.com/publications/directions-in-pharmacy/2015/august2015/five-technology-trends-changing-pharmacy-practice-today-and-tomorrow Transforming Technicians: Insights Into the Expanding Roles of Pharmacy Technicians – PBA Health. (2019). Retrieved from https://www.pbahealth.com/transforming-technicians-insights-into-the-expanding-roles-of-pharmacy-technicians/ ModernMedicine Network. (2017). The top three pharmacy challenges. Retrieved from https://www.managedhealthcareexecutive.com/mhe-articles/top-three-pharmacy-challenges-2018