community pharmacy chapter 15. chapter review community pharmacy regulations organization customer...

COMMUNITY PHARMACY

CHAPTER 15

CHAPTER REVIEW

• Community Pharmacy• Regulations• Organization• Customer Service• Processing the Prescriptions• Preparing the Prescription• Customer Pick-up• Using a Cash Register• Other Duties• Review

• The practice of providing prescription services to the public.

• Almost 2/3 of all prescriptions drugs in the US are dispensed by community pharmacies.

• One of the key characteristics of community pharmacy is the close interaction with patients.

COMMUNITY PHARMACY

TYPES OF COMMUNITY PHARMACIES

• Independent Pharmacies – individually owned local pharmacies

• Food Store Pharmacies– A&P, Giant Eagle, Kroger, Pathmark and others

• Chain Pharmacies – CVS, Walgreens, Rite-Aid and others

• Mass Merchandiser Pharmacies– Wal-Mart, Kmart, Costco, Target and others

• Disease State Management (DSM)

• Medication Therapy Management (MTM)

• Other Clinical services and Programs

RAPIDLY GROWING ASPECTS OF COMMUNITY PHARMACY

• One-on-one pharmacist/patient consultation sessions– General medication advice and information– Diabetes education and monitoring– Asthma and Chronic Obstructive Pulmonary

Disease (COPD) education and monitoring– Anticoagualtion education and monitoring– Weight loss programs– Smoking cessation programs– Cholesterol reductions programs

DSM

• Tailored to provisions of Medicare Part D – 5 Core elements• Medication therapy review (MTR)• Personal medication record (PMR)• Medication-related action plan (MAP)• Intervention and/or referral• Documentation and follow-up

MTM

• Walk in clinics staffed with nurse practitioners– Treatment for a limited number of conditions such

as colds and minor injuries• Pharmacist or nurse vaccination programs– Influenza– Herpes zoster– Pnuemococcal

CLINICAL SERVICES AND PROGRAMS

HOW TECHNICIANS HELP WITH PHARMACY CLINICAL SERVICES &

PROGRAMS

• Coordinating billing• Scheduling appointments• Taking patient information

• Omnibus Budget and Reconciliation Act (OBRA)

• Health Insurance Portability and Accountability Act (HIPPA)

• Medicare Prescription Drug Improvement and Modernization Act (Medicare Part D)

• Combat Methamphetamine Epidemic Act (CMEA)

REGULATIONS: FEDERAL REGULATIONS AFFECTING COMMUNITY PHARMACY

• Counseling • Pharmacy technician certification• Pharmacist to pharmacy technician ratios• Scope of pharmacy technician practice• Record keeping• Required equipment in a pharmacy and work

area requirements• Scope of medication compounding

REGULATIONS: WHAT STATES REGULATE

• Transaction windows for pick-up and drop-off of prescriptions• Pharmacist counselling area• Drug Storage areas– Tablets and capsules– Syrups and suspensions– Creams, ointments and other topicals– Eye ad ear drops– Rectal and vaginal preparations– Injectibles– Inhalers and nebulized medications – Locked storage for controlled substances– Refrigerated medications

ORGANIZATION

• Compounding area– sink

• Prescription counter for preparing prescriptions– Counting trays– Vials– Labels

• Prescription bins or shelves– Completed prescriptions arranged by customer’s

last name

ORGANIZATION CONT.

• Presenting in a calm, courteous, professional manner– Listening carefully– Making eye contact– Repeating what the customer said– Calling patients by name

• Knowing when to involve the pharmacist• Dealing with customer complaints– Positive responses vs. negative responses

CUSTOMER SERVICE

• Prescription In-Take– Patient drop off– Faxed prescriptions– E-prescriptions or electronically transferred

prescriptions– Telephone prescription orders

PROCESSING PRESCRIPTIONS

• Patient name• Date of birth• Current address• Telephone numbers• Allergy information• Insurance information

ENTERING PATIENT PROFILE INFORMATION

• Correct drug and strength• Drug quantity• Directions for use (the sig)• Number of refills• Dispense as Written (DAW) code• Physician name, address, phone, and DEA

number

ENTERING PRESCRIPTION INFORMATION

• The prescription number• Availability of refills• Timeliness for refill

PROCESSING REFILL PRESCRIPTIONS

• By prescription number• By class– General prescriptions (non-controlled substances)– Class III, IV, V controlled substances– Class II controlled substances

Filing Hard Copy Prescriptions

• Generating a label• Retrieving the correct medication from stock• Counting or measuring– Using counting trays– Automated filling and measuring devices

• Selecting a container– Safety caps– Easy open caps

• Affixing the prescription label and auxiliary labels

PREPARING PRESCRIPTIONS FOR DISPENSING

• The final step of the prescription filling process before the prescription is bagged for patient pick up

PHARMACIST FINAL CHECK

• Alphabetized prescription bins• Signature logs

CUSTOMER PICK-UP

• Scanning a price• Handling payments– Cash– Checks– Credit cards– Gift cards– Coupons

USING A CASH REGISTER

• Transmitting drug orders to a drug wholesaler

• Receiving drug orders from a drug wholesaler

ORDERING STOCK

• Assisting customers with where to find over-the-counter products

• Keeping the pharmacy clean, neat and in working order– Cleaning counting trays and countertops – Keeping disposable supplies stocked

• Bags, vials and bottles, labels, paper, cash register receipts

– Facing stock bottles– Pulling soon to expire stock from shelves

OTHER GENERAL DUTIES OF A PHARMACY TECHNICIAN

• Regular trash• Trash containing protected health information– Shredding or sending out for shredding

SEPARATION OF TRASH