Well, I feel like a seasoned pharmacist at least. I've been here, there, and everywhere, and I'm pretty sure none of the staff I worked with had any idea I am still as fresh as a daisy to the world as a US pharmacist.
I've increased in confidence on the QA screen of the computer system, and have been trying to work out why various things don't always add up. For example I often see prescription images that have zero refills dated 6 months ago, and yet the rx has been filled 6 times since then and still has further refills available. It's most often related to the correct info not being visible on the QA screen, and has to be searched out on the actual patients record. It's onerous enough to just assume that there was an e-script somewhere along the line, and that the refills are valid, they just aren't obviously valid. I'm still debating whether to search each one out or trust the system.
The other thing I've come across quite a bit is prescriptions where there's an annoying line something like "this prescription is not valid unless the number of items is included", and then the number of items is NOT included. Seems to get passed a lot of pharmacists, until it gets to me. I spoke with one seasoned pharmacist who takes the view that the responsibility for the correction is solely on the shoulders of the first pharmacist that QA'd it, and that subsequently it could be argued that there was the possibility that the correction was made but that no image was added. I'm of the view currently that seeing is believing, and I'm not happy with the possibility that the board of pharmacy grab only the first pharmacist and let the rest off just because, so I'm making phone calls for new presciptions (as phone rx's), and deleting any refills on the original, and leaving little notes in the computer in case any audit by the board pulls any of these out for check. At least I'd be confidant they can't find me at fault.
And the final common error I keep coming across is when there are mistakes on CIII, CIV or CV controlled drugs prescriptions. Errors come in many shapes and sizes, but they are more risky when on controlled medication prescriptions, so I'm chasing these more zealously. For example, if the "this prescription is not valid unless the number of items is included" is not included on a CII then of course the patient will have to take it back to the MD to be changed, as you can't currently make ANY changes to a CII rx, whatever, ever, ever - but on a CIII-CV rx, these can be changed by a phone call, even though it would be more pleasing to annoy the prescriber by repeatedly sending every patient back until they got the message that this is IMPORTANT! However, I sent one poor sod too many back this week, and he was sharp enough to call the Doctor first, who then phoned a new rx in, and then super sharp enough to realize that if it could be phoned in then the original could have been amended by phone (some people really are annoyingly clever), so I'm not taking the risk again - I'll just make the phone calls, and eat the annoyance.
Well, one day left before a well-deserved break for the holidays. I hope everyone has a wonderful and relaxed few days, and I'll be back for more updates in the new year.
Oh, and if you've noticed the new waiver at the bottom of every page of all of my blogs, that's because the good people at the NABP® have been following my various blogs too, and wanted to be sure to let everyone know they aren't sponsoring, endorsing or authorizing me - well, fair enough, I'm just proud to bits they've even noticed me :-)
Happy 2010 everyone.
Steven C
No comments:
Post a Comment