Download Professional Competency #4: Manage Drug Distribution

Professional Competency #4:
Manage Drug Distribution
Competency Unit
Pharmacists manage drug distribution by performing or supervising
the functions of acquisition, storage, preparation, and distribution of
drugs to ensure the safety, accuracy and quality of supplied products.
Situations in Which All Registered Pharmacists Must Fulfil this
Competency:
Pharmacists take responsibility for the actual functions or delegation
of the functions, of the preparation and distribution of
pharmaceuticals in response to a prescription for an individual
patient. This includes the compounding or preparation (or
supervision of) of common dosage forms such as powders, ointments,
creams and oral solutions and referral of the patient to an appropriate
pharmacy or other provider of less common dosage forms such as
sterile products, chemotherapy or suppositories. Pharmacists
undertake this competency in all settings that utilize common drug
distribution systems.
Competency Element
Required Performance Indicators
4.1 A pharmacist must
perform, supervise and/ or
review drug preparation and
distribution activities.
Fulfil established drug distribution policies and
procedures9.
Examples of activities that might prove fulfilment of
Required Performance Indicator
Appropriately identify and perform professional
functions associated with drug distribution, including:
– providing assistance with the selection of
unscheduled* non-prescription drugs when
requested;
– offering assistance with the selection of
Schedule III* drugs when appropriate;
– providing professional information and advice
regarding selection and use of Schedule II* drugs;
– completing professional functions outlined in
Competency #1 when providing pharmaceutical
care as part of the drug distribution process;
– identifying and resolving problems related to
professional functions, delegated drug preparation
or distribution functions that may prevent the
patient from attaining the desired effects of the
medication such as:
• interpretation of prescription medication orders;
• bioequivalency & interchangeability of multisource drugs;
• ability to pay (drug plan or formulary issues);
• pharmaceutical calculations;
• selection of ingredients;
• acquisition and supply of pharmaceuticals;
• compounding or preparation;
• product packaging, storage, handling, stability
and expiration.
– ensuring accuracy and quality of delegated
distribution functions, including maintenance of
records of drug distribution
– ensuring safe and proper disposal of drugs and
non-prescription medications
– correcting dispensing errors as soon as detected,
contacting the patient and patient’s prescriber as
required to correct the error and manage
subsequent problems with the patient’s health,
and
– reporting adverse drug reactions that have caused
a problem with a patient’s health
9.
The preface to this document states that all activities undertaken by pharmacists are in accordance with all relevant laws and regulations.
* According to NAPRA’s National Model Drug Schedules
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Model Standards of Practice for Canadian Pharmacists
— Continued
Competency Element
Required Performance Indicators
Examples of activities that might prove fulfilment of
Required Performance Indicators
4.1 (Continued)
Appropriately delegate technical and nonprofessional preparation and distribution functions
as necessary and as according to provincial
regulations, while maintaining responsibility for the
accuracy and quality of these functions.
The pharmacist appropriately delegates pre-packaging of unit
dose medications; repackaging of medications; data entry
into computer; selection, counting, transfer, labelling of Rx
products; billing; and compounding according to standard
formulae.
Ensure that patients have access to all required,
appropriate medications that are prescribed in
accordance with relevant policies and that are
available in Canada.
The pharmacist locates stock of uncommon drugs; refers the
patient to a different pharmacy that can prepare specialty
products; contacts the prescriber for a change in prescription
for a drug not available or not readily available.
Optional Performance Indicator reflecting
advanced or exemplary practice:
Use formal processes to identify and resolve
systematic problems in drug preparation and/or
distribution.
4.2 A pharmacist must ensure
that problems identified with
individual prescriptions are
addressed within appropriate
time frames.
Routinely identify and address problems with
individual prescriptions that require immediate
management.
Examples of activities that might prove fulfilment of
Optional Performance Indicator:
The pharmacist compiles and analyses drug error reports
to identify patterns and develops projects to investigate /
correct these problems.
The pharmacist immediately calls the patient when it is
discovered that a wrong medication was dispensed;
immediately informs the patient’s physician if a higher
strength of a medication was dispensed and the patient
received a dose.
Consistently attempt to resolve problems that have
been identified by pharmacists or technicians from
previous shifts.
4.3 A pharmacist must manage
situations involving drug
diversion or inappropriate use.
Systematically identify and communicate problem
prescriptions to subsequent pharmacists.
The pharmacist flags concerns with specific prescriptions;
completes a summary of issues that need to be addressed at
shift change.
Identify and address situations that have the
potential to create distribution problems.
The pharmacist addresses a lack of documentation regarding
checking of filling of dosettes; pre-packaging / advanced
preparation of unlabelled syringes by allied health
professionals.
Identify issues in the preparation or distribution of
individual prescriptions that may represent a
systematic problem
The pharmacist recognizes that if a technician dispenses a
prescription before a pharmacist has checked it, this may
represent the lack of a consistent plan for checking of
prescriptions.
Accurately identify situations involving potential drug
diversion or inappropriate use.
The pharmacist identifies double doctoring; polypharmacy;
excess prescription quantities; overly frequent refills; forged or
altered prescriptions.
Investigate, document and report such situations
were appropriate.
The pharmacist contacts the doctor to confirm authenticity of
prescription or prescription quantity; reviews stolen triplicate
prescription reports, pharmacy alerts and fan outs; initiates
fan outs as appropriate; contacts police where appropriate.
Optional Performance Indicators reflecting
advanced or exemplary practice:
Develop and utilize expertise in management of
drug misuse and abuse.
Examples of activity that might prove fulfilment of
Optional Performance Indicator:
The pharmacist provides information to a patient caught
in a cycle of abuse so they can obtain professional help.
Complete analyses of patient profiles /
prescription records to identify areas of drug
diversion or misuse.
— Continued
Model Standards of Practice for Canadian Pharmacists
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Optional Advanced Role:
Possible Performance Indicators
Examples of activities that might prove fulfilment of
Possible Performance Indicators
Compounding / Specialty
Preparations
Maintain ready access to appropriate facilities,
equipment and ingredients required for specialty
compounding / preparation.
The pharmacist has laminar flow hoods installed for sterile
preparation; purchases moulds for suppositories;
establishes appropriate, designated compounding areas;
maintains an inventory of products necessary for home IV
antibiotic or specialty compounding.
Establish and routinely utilize programs to test,
report and assure the quality of compounded
preparations.
The pharmacist obtains any specific certification suggested
for specialty compounding.
Maintain a ‘library’ of resources required to support
quality specialty compounding.
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Model Standards of Practice for Canadian Pharmacists