Accuracy checking of dispensed medications by a pharmacy technician: a hospital case study
Centaine L. Snoswell A B C F , Melynda Flor A , Cameron Tessier A , Sunita Ratanjee A , Andrew Hale A B D , Andrew Matthews E , Lisa Nissen D and Ian Coombes A B DA Pharmacy Department, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia. Email: Ian.Coombes@health.qld.gov.au
B School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, Qld 4102, Australia.
C Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Brisbane, Qld 4102, Australia.
D School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Qld 4059, Australia. Email: l.nissen@qut.edu.au
E Society of Hospital Pharmacists of Australia, PO Box 1774, Collingwood, Vic. 3066, Australia.
F Corresponding author. Email: c.snoswell@uq.edu.au
Australian Health Review 44(3) 410-414 https://doi.org/10.1071/AH18267
Submitted: 7 January 2019 Accepted: 21 July 2019 Published: 27 November 2019
Abstract
Medication order accuracy checking is an integral and time-consuming component of the current Australian pharmacist’s role. However, the pharmacy profession internationally has moved towards separating the checking task into two parts: a clinical check performed by the registered pharmacist and a technical accuracy check delegated to an appropriately trained pharmacy technician. This case study demonstrates that in an Australian hospital pharmacy context, appropriately trained pharmacy technicians have the potential to be more proficient and time efficient than pharmacists when undertaking accuracy checking of dispensed medications.
What is known about the topic? International data have shown that appropriately trained pharmacy technicians can be more precise than pharmacists when performing accuracy checking.
What does this paper add? This paper reports the findings of an Australian case study reallocating the accuracy checking task to trained pharmacy technicians and evaluating the time efficiency data, which has not previously been reported.
What are the implications for practitioners? These findings provide support for the potential to safely delegate checking tasks to an appropriately trained accuracy checking pharmacy technician.
References
[1] Australian Commission on Safety and Quality in Health Care (ACSQHC). National safety and quality health service standards, 2nd edn. Sydney: ACSQHS; 2017.[2] Passfield J, Nielsen I, Brebner N, Johnstone C. Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks. Aust Health Rev 2018; 42 656–60.
| Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks.Crossref | GoogleScholarGoogle Scholar | 28735602PubMed |
[3] NHS Pharmacy Education & Development Committee. Nationally recognised competency framework for pharmacy technicians: the assessment of medicines management skills. 2013. Available at: http://www.nhspedc.nhs.uk/Docs/SupportStaff/ACPT%20Nationally%20Recognised%20Competency%20Framework%20v12%202013%20Under%20review.pdf [verified 27 September 2019].
[4] Adams AJ, Martin SJ, Stolpe SF. Tech-check-tech: a review of the evidence on its safety and benefits. Am J Health Syst Pharm 2011; 68 1824–33.
| Tech-check-tech: a review of the evidence on its safety and benefits.Crossref | GoogleScholarGoogle Scholar | 21930641PubMed |
[5] PACT Advisory Group. New Zealand framework for pharmacy accuracy checking technicians. 2017. Available at: https://www.psnz.org.nz/Folder?Action=View%20File&Folder_id=162&File=NZ%20PACT%20Framework%20%20Version%203.0%20FINAL.pdf [verified 27 September 2019].
[6] Koehler T, Brown A. A global picture of pharmacy technician and other pharmacy support workforce cadres. Res Social Adm Pharm 2017; 13 271–9.
| 28190479PubMed |
[7] Taylor G. Clinical pharmacy COSP – standards of practice for clinical pharmacy services. J Pharm Pract Res 2013; 43 91–3.
| Clinical pharmacy COSP – standards of practice for clinical pharmacy services.Crossref | GoogleScholarGoogle Scholar |
[8] Ness JE, Sullivan SD, Stergachis A. Accuracy of technicians and pharmacists in identifying dispensing errors. Am J Hosp Pharm 1994; 51 354–7.
| Accuracy of technicians and pharmacists in identifying dispensing errors.Crossref | GoogleScholarGoogle Scholar | 8160687PubMed |
[9] Hickman L, Poole SG, Hopkins RE, Walters D, Dooley MJ. Comparing the accuracy of medication order verification between pharmacists and a tech check tech model: a prospective randomised observational study. Res Social Adm Pharm 2018; 14 931–935.
| 29169856PubMed |
[10] Society of Hospital Pharmacists of Australia. Exploring the role of hospital pharmacy technicians and assistants to enhance the delivery of patient centred care: a White Paper on the findings and outcomes of the ‘Pharmacy Technician and Assistant Role Redesign within Australian Hospitals (Redesign) Project’. 2016. Available at: https://www.shpa.org.au/sites/default/files/uploaded-content/website-content/final_tech_redesign_white_paper_november_revision.pdf [verified 16 October 2019].
[11] Pharmacy Board of Australia. Guidelines for dispensing of medicines. 2015. Available at: https://www.pharmacyboard.gov.au/Codes-Guidelines.aspx [verified 16 October 2019].
[12] Jenkins A, Eckel SF. Analyzing methods for improved management of workflow in an outpatient pharmacy setting. Am J Health Syst Pharm 2012; 69 966–71.
| Analyzing methods for improved management of workflow in an outpatient pharmacy setting.Crossref | GoogleScholarGoogle Scholar | 22610029PubMed |
[13] Kalman MK, Witkowski DE, Ogawa GS. Increasing pharmacy productivity by expanding the role of pharmacy technicians. Am J Hosp Pharm 1992; 49 84–9.
| Increasing pharmacy productivity by expanding the role of pharmacy technicians.Crossref | GoogleScholarGoogle Scholar | 1570872PubMed |
[14] Risk Assessment and Treatment Governance and Risk Chief Risk Officer. Risk assessment and treatment. 2017. Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0026/397313/qh-gdl-070-1-1.pdf [verified 16 October 2019].
[15] Snoswell CL. A meta-analysis of pharmacists and pharmacy technicians’ accuracy checking proficiency. Res Social Adm Pharm 2019; In press
| 31431337PubMed |
[16] Foo GTT, Tan CH, Hing WC, Wu TS. Identifying and quantifying weaknesses in the Closed Loop Medication Management System in reducing medication errors using a direct observational approach at an academic medical centre. J Pharm Pract Res 2017; 47 212–20.
| Identifying and quantifying weaknesses in the Closed Loop Medication Management System in reducing medication errors using a direct observational approach at an academic medical centre.Crossref | GoogleScholarGoogle Scholar |
[17] Gursanscky J, Young J, Griffett K, Liew D, Smallwood D. Benefit of targeted, pharmacist-led education for junior doctors in reducing prescription writing errors – a controlled trial. J Pharm Pract Res 2018; 48 26–35.
| Benefit of targeted, pharmacist-led education for junior doctors in reducing prescription writing errors – a controlled trial.Crossref | GoogleScholarGoogle Scholar |
[18] Jackson S, Martin G, Bergin J, Clark B, Stupans I, Yeates G, Nissen L, Marty S, Gysslink P, Matthews A. An advanced pharmacy practice framework for Australia. Pharmacy (Basel) 2015; 3 13–26.
| An advanced pharmacy practice framework for Australia.Crossref | GoogleScholarGoogle Scholar | 28975900PubMed |
