pharmacy technician career environments retail pharmacy retail pharmacy, also know as community...
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Post on 22-Dec-2015
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- Pharmacy Technician Career Environments Retail Pharmacy Retail pharmacy, also know as community based pharmacy or community pharmacy, is a very common environment in which pharmacy technicians are employed. These pharmacies provide prescription services and an outlet for the sales of commonly purchased good and services. Retail pharmacies consists of independent pharmacies and chain pharmacies. In general, the major benefit of retail pharmacies is accessibility. Often the patient will go to see the pharmacist at a retail store first before seeking medical attention for which they may have limited access to or no insurance to help cover the costs.
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- Independent Pharmacy Owned as a sole proprietorship by one or a few owners. Provide prescription filling along with other ancillary services (surgical supplies, vitamins, hallmark) Often provide personal services Major benefit: familiarity of the pharmacists with the customers Disadvantage: may not have the pricing power of larger chain stores.
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- Chain Drug Stores National franchises like Walgreens, CVS, Rite Aid, and Duane Reade (east coast) have many stores around the US and/or in a regional area Offer convenience with many stores operating 24/7 Major advantages: pricing power, convenience, and accessibility. Disadvantages: lack of personalized service between pharmacist and patient.
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- Retail Staff Supervising pharmacist: a full time pharmacist who is in charge of the legal and administrative aspect of the pharmacy Store Manager: a person, who may or may not be a pharmacist, that is in charge of the operation of the store in general Typically the store is divided into front end and back end. Front end deals with OTC issues and other non medication issues a customer may have Back end contains the pharmacy Stores the legend medications Stores other restricted meds and higher priced devices Blood glucose strips, blood pressure monitors, Plan B, and products that contain pseudoephedrine. Combat Methamphetamine epidemic act of 2005 requires removal of pseudoephedrine products from the public area and mandates record keeping with the per transaction limit of 3.6 grams per patient.
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- In addition to other areas of the pharmacy, HIPAA mandates that pharmacies have a counseling area for a patient counseling. Area can be a part of the pharmacy but must be relatively private.
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- Regulatory Agencies State Boards of Pharmacy regulates the practice of pharmacy which in NYS are contained in the education law of the board of regents article 137, the public health law article 33 for controlled substances, and the NYSRR title 10 among others. SBOP conducts inspections of pharmacy facilities. Centers for Medicare and Medicaid Services: CMS regulates the federal programs of Medicare and Medicaid along others. CMS conducts inspections to ensure compliance with federal regulations. Third Party Payers: Third party insurance companies also may conduct inspects of pharmacy establishments to determine if contractual agreements are kept between insurance payer and the pharmacy.
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- The Prescription The pharmacy technician is often the first person to examine the patients prescription for completeness and other issues. Due to this it is very important that a pharmacy technicians understands the basic elements of the prescription to save time and to ensure customer satisfaction. This is probably the technicians primary function in the retail setting.
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- The Elements of the Prescription Patients name, address, and age. Prescribers name, address and phone. Date it was written Name, strength, and quantity of drug Directions for use Signature of the prescriber. Route of administration Product selection permitted (if brand or generic permitted)
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- Probably the most important element on the prescription is the signature of the prescriber. Whether electronic or hard copy the signature must be there for the prescription to be valid. In NYS, according to article 137 of the education law 6802 electronic prescriptions are allowed in NYS. An electronic prescription is a prescription that is created and generated by the prescriber and sent electronically (E prescribing). Prescriptions for controlled substances are not permitted to be electronically generated. Section 6810 states that in addition to the signature, the stamped or imprint name of the prescriber must be on the prescription
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- In NYS, the pharmacist is permitted to clarify and enter data on the prescription to include all information with the exception of the signature. If a prescription is filled without the signature the pharmacist will be guilty of professional misconduct under Part 29.7 of the board of regents. In addition, the date cant be added on an Rx for a controlled substance If the patients information and/or the prescribers information is readily retrievable in the pharmacy computerized records, the physical presence of this information on the prescription is not necessary (NYS) The face of the prescription must be signed or initialed by the pharmacist with the date filled; refills must be documented on the back with the date filled along with the Pharmacists initials. Records of refills may be stored electronically (NYS) Remember, CII cant be refilled. CIII can be refilled 5 times or 6 months CIV and CV for 11 refills or one year.
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- Prescription Elements Continued Other elements on the prescription may include Prescribers license number and registration number Prescribers DEA number (required to write a controlled substance prescription) Prescribers NPI or national providers identification number.
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- DEA Numbers Any entity handling controlled substances in the US from prescribing, dispensing and manufacturing requires registration with the DEA of the US Department of Justice. Consists of two letters A or B followed by the first letter of the prescribers last name following by a seven digit number. One way to determine if a DEA is fraudulent is the calculate the sum of digits 1,3, and 5 and add it to twice the sum of 2,4,and 6. The result will have a digit which should match the check digit of the DEA number, the last digit
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- NPI numbers The NPI is a ten digit number that was created by HIPAA act of 1996. The NPI is a unique identifier that is used by CMS to identify healthcare providers for the purposes of administrative issues and reimbursements. Often other third party payers utilize this number to file claims and payments to pharmacies. Often an adjudication is denied because of lack of prescribers NPI. The NPI for various providers can be found at: https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forwa rd=static.npistart
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- Who can write prescriptions? MD NP DO DVM DPM Ophthalmologists DDS PA Physicians assistants can in general write for prescriptions so long as their primary supervising physician name, address, and registration number is on the prescription. Often the PA will use his/her physicians prescription blank so long as the PA signs the Rx and stamps his/her name on it with his registration number. Physician Assistants, as of 2007, can write for prescriptions for CII and other scheduled drugs. In this case he/she would use his own Rx blanks with their own DEA numbers.
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- NYS Official Prescription Program Public Health Law 21 requires all prescriptions for controlled drugs and other legend drugs to be issued on an official NYS prescription which contains all required information on it with the NYS seal, and a serialized number on the lower right hand corner. Issued in an attempt to discourage doctor shopping and to monitor prescription drug usage patterns in the state. When using electronic prescribing official Rx not required.
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- Filing Prescriptions Most states require hard copy Rx to be stored for a 5 year period. Further federal regulations require that controlled substance Rxs be filed in such a way as to be easily retrievable by law enforcement. Option 1: three separate cabinets for CII, CIII-CV, and other legend Rxs. Option 2: two drawer system: CII-CV with CIII-CV marked with a C in the lower right corner in one drawer and all other prescription in second drawer.
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- Prescription Transfers A refill may be transferred from one pharmacy to another either in the same state or different states. A pharmacist is to handle Rx transfers. Some states allow transfer of all of patients Rx refills. In NY only one transfer at a time is allowed.
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- Other Technician duties Handling Deliveries Inventory management Record keeping Stock rotation and others Remember, counseling is the pharmacists duties. One area where technician can offer advise is in the use of medical devices like blood pressure monitors, glucose testing equipment, etc.
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- Health System Pharmacy Pharmacy setting where patients reside at the facility where the pharmacy is located Includes acute care hospitals Long term care facilities-provides skilled nursing services to patients in need of long term rehabilitative services Hospices-facilities that provide end of life palliative care to terminally ill patients. Nursing Homes-facilities that provide skilled nursing care to elderly people who can no longer care for themselves due to chronic illness Correctional Facilities-prisons
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