Pharmacists, Interns, and Ancillary Personnel PharP 582, Spring 2005 Definitions Practitioner – person duly authorized by law to prescribe drugs or devices Pharmacist – person duly licensed by Board to engage in the practice of pharmacy Dispense – interpretation of order, and selection, measuring, compounding, labeling or packaging necessary to prepare for delivery Administer – direct application of a drug or device by injection, inhalation, ingestion or any other means, to body of patient or research subject Practice of Pharmacy Interpreting prescription orders Compounding, dispensing, labeling, administering and distributing of drugs and devices Monitoring of drug therapy and use Initiating or modifying drug therapy in accordance with written protocols approved for his or her practice by a practitioner authorized to prescribe Participating in DUR and drug product selection Proper and safe storage, distribution, record keeping Providing of information on legend drugs … therapeutic values, hazards, and uses MONITORING OF THERAPY – WAC 246-863-110 Collecting and reviewing patient drug histories Measuring and reviewing routine patient vital signs including, but not limited to, pulse, temperature, blood pressure, and respiration. Ordering and evaluating the results of laboratory tests relating to drug therapy – blood chemistries and cell counts – drug levels in blood, urine, tissue or other body fluids – culture and sensitivity tests – when performed in accordance with policies and procedures or protocols applicable to the practice setting, – which have been developed by the pharmacist and prescribing practitioners – which include appropriate mechanisms for reporting to the prescriber monitoring activities and results. It is unlawful to practice without a license. Criminal charges filed against Shahid Shiekh, a registered counselor from Bellevue Gave hundreds of flu shots, although he is not a nurse, physician, or pharmacist Charged with using outdated flu vaccine from the 2002 formula. Pharmacists’ responsibilities that may not be delegated Receipt of a verbal Rx Providing patient Consultation with the pt information as required Consultation with Dr. by WAC 246-869-120 Extemporaneous Signing of documents or compounding of the Rx registry books Interpretation of data in Professional the patient record communications with Ultimate responsibility other health care for verification of the Rx professionals Pharmacists License 18 years of age Good moral and professional character; not impaired by use of alcohol, drugs or controlled substances or by mental or physical disability Bachelors or Doctor of Pharmacy from accredited school or college Met internship requirements Passed examinations (NAPLEX, MPJE) Completion of 7 hours of HIV/AIDS education License may be renewed subject to completion of continuing professional education requirements and timely payment of fees Board may refuse to issue license to an otherwise qualified applicant who … Has engaged in fraud, misrepresentation or deceit in procuring a license Has violated laws relating to drugs, controlled substances, cosmetics, or non prescription drugs, or the rules of the Board of Pharmacy, or has been convicted of a felony. Fees for Pharmacist’s License Original license -- $130 Annual renewal fee -- $135 Renewals occur on the pharmacist’s birthday – Initial licenses issued within 90 days of the birthday do not expire until the following year Late renewal penalty -- $67.50 – Note; between the time the license expires and the renewal fee and late penalty fee are received by the Board, the pharmacist is not eligible to practice pharmacy. – Renewal fees may be paid up to 90 days prior to the expiration of the license Interns Student enrolled in accredited college of pharmacy Making timely progress towards graduation Engages in practice of pharmacy under supervision of a licensed pharmacist preceptor – Notifies Board prior to starting at site – Preceptor oversight – May be supervised by non-preceptor RPh in the temporary absence of preceptor – Submits final report within 30 days after finishing at site, and at least 30 days prior to taking licensure exam Timely pays the $20 annual fee for an intern permit Preceptors Actively practicing in a Class “A” pharmacy. Been in active practice for at least 12 months prior to becoming a preceptor Completion of a Board-approved preceptor training program every 5 years Supervise only one intern at any given time Required internship hours 1,500 hours prior to licensing Earned after completing the first term in a pharmacy program 1,200 hours credit given for clinical experiences during the PharmD program Board will document hours in excess of 1,500 for reporting to other states with larger requirements RCW 18.64A – Pharmacy Assistants Pharmacist defined in this section but not intern Ancillary personnel – Technicians – Assistants Training programs for pharmacy technicians Duties of technicians and assistants Limitations Disciplinary actions Pharmacy Application to use Ancillary Personnel Pharmacy or pharmacist responsible Ancillary Personnel -- Duties Technicians – Assist in performing manipulative, nondiscretionary functions associated with the practice of pharmacy – Under supervision of a licensed pharmacist Assistants – Typing, filing, refiling, bookkeeping, pricing, stocking,delivery, nonprofessional phone inquiries,documentation of third party reimbursements – May not enter data into the computer system Pharmacy Technician Training Education and training required for technicians, as established by Board rules Licensed pharmacist shall supervise training of technicians Training to consist of instruction and/or practical training May include requirements for completion of examinations Pharmacist-to-technician ratios specified in the statute 1:1 is standard Institutional practice – Hospitals (70.41); Mental health institutions (71.12); Residential Habitation Centers (71A.20); Nursing homes (74.42) – Inpatient medication preparation, 1:3 – Outpatient medication preparation, 1:1 Board may modify ratio by rule – Pharmacy desiring higher ratio must submit a utilization plan – Board may approve pilot projects Board of Pharmacy Rules: WAC 246-901– Ancillary Personnel “Consultation” – Between pharmacist and patient, agent, or provider in which pharmacist uses professional judgment to provide advice about drug therapy “Verification” by pharmacist – Review of order – Examination of profile – Approved order, taking into account pertinent drug and disease information to assure correctness of the drug order for a specific patient. – Must generate audit trail that identifies pharmacist “Immediate Supervision” – Visual or physical proximity to a licensed pharmacist to assure patient safety. Only pharmacists, interns, and technicians may … Enter a new medication order into the pharmacy computer system Retrieve the drug product to fill a prescription Technician Education and Training Education or training required – Formal academic program – On-the-job training – High school diploma or G.E.D. required to enter training Application submitted to Board Completion of certifying exam may be required Foreign applicants have special requirements Special training requirements – Unit dose checking: must demonstrate 99% accuracy in checking medications – IV Admixtures: 100% accuracy for a sample of preparations IV admixtures Technicians may prepare IV admixtures Licensed pharmacist must check each parenteral drug prepared by technician Interns may not check technician-prepared admixtures Unit-dose Checking (Tech-Check- Tech) May check unit doses of another technician or intern in institutional settings No more than 48 hour supply may be included in the checked cassettes Meds must check the drug before administration Interns may check technician-prepared unit dose medications Pharmacy Assistants may … Perform all duties not reserved to pharmacists or technicians Package and label drugs for subsequent use Count, pour, and label for individual prescriptions Replace the container on the shelf (but not retrieve it from the shelf) Must be under general supervision of a pharmacist Pharmacy Assistant Registration No formal training, age, or educational requirements Apply to board on registration forms provided Maintain current mailing address with board Renew every two years on birth date No individual fee; included in pharmacy utilization fee No limit on ratio of pharmacists to assistants Identification of ancillary personnel If working in the pharmacy and having contact with patients; Must wear badges or tags clearly identifying them as technicians or assistants Utilization Plan Manner in which technicians will be utilized – Job description – Task analyses – Number of positions Specialized functions – Criteria for selection of technicians for specialized functions – Methods of training Assistants – Job title or function of each assistant Pharmacist-to-technician ratios Standard ratio – 1:3 pharmacist:technician ratio set by board rule for each licensed pharmacy – Pharmacist supervising must be actively practicing pharmacy (not the CEO in the office) Inpatient pharmacies – Ratio may include pharmacists outside of the central pharmacy Pharmacy services plan – May use more than 3:1 techs to pharmacists subject to board- approved plan Access to pharmacies restricted … Differential hours Lay person may not converse with a pharmacist who is compounding a prescription Prescription department must be located so that public won’t have free access to area where drugs, etc., are stored, compounded, or dispensed. Licensure Examinations NAPLEX – North American Pharmacy Licensure Examination – All 50 states now use NAPLEX CA after January 2004 – Normally, may take in your home state and transfer scores to other states at same time FL accepts score transfers after January 2005 Pre-NAPLEX available on NABP web site – $50 per attempt – Maximum of 3 attempts Law Exams All states require some form of law exam for licensure and many prepare their own exam – Idaho – California MPJE – Multistate Pharmacy Jurisprudence Exam – Computer adaptive covering both federal and state law – Take once for each state you wish to be licensed in – AK, AZ, HI, MT, NV, OR, WA, WY use MPJE License Transfer If already licensed by examination in one state, may transfer license to another state without retaking NAPLEX – NABP has electronic system for transferring license information to the new state – Somewhat more expensive than retaking NAPLEX Most states, including WA, won’t allow transfer of a “transferred” license – must maintain at least one license by examination Federal pharmacists Indian Health Service, PHS, armed forces, VA Must be licensed in at least one state or territory Do not need to be licensed in the state where stationed Cannot practice part-time outside of the installation unless licensed in that state Roles requiring special training or experience “Qualified by education, training, or experience” – Directors of hospital pharmacies – Pharmacists-in-charge of home IV therapy pharmacies Nuclear pharmacists – 6 months of on-the-job training under supervision of qualified nuclear pharmacist in a licensed nuclear pharmacy – Completion of a nuclear pharmacy training program in an accredited college of pharmacy Miscellaneous requirements Criminal background checks required for providers of services to children or vulnerable adults Pharmacists required to report – Child abuse or neglect – Abuse of vulnerable adults Social Security Numbers are required to be submitted to DOH to obtain a license The pharmacist’s current license (or photocopy) must be displayed to the public in each pharmacy in which he or she is practicing.
Pages to are hidden for
"Pharmacists, Interns, and Ancillary Personnel"Please download to view full document