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Chapter 8 Prescription Processing

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Presentation on theme: "Chapter 8 Prescription Processing"— Presentation transcript:

1 Chapter 8 Prescription Processing
Copyright © 2004 by Elsevier Inc.  All rights reserved.

2 Introduction Filling a prescription: most common and important duty of a technician Transcribing doctor’s orders: frustrating Clarification is needed at times Pharmacist makes the call

3 Processing a Script: A Step-by-Step Approach
Five basic steps for filling a prescription Taking in the prescription Translating the prescription Entering information in database Filling the script Patient counseling

4 Taking the Prescription
Prescription arrives by various methods Written order Hand carried Faxed Called in

5 Taking the Prescription
Computer generated prescriptions becoming more common May be provided to patients on discharge from hospitals or physician’s office

6 Prescription Information-Outpatient
Ensure correct information is listed on prescription Allergy information for new patient needed

7 Important Patient Information
Patient Information Provider's Information Name Name Phone number and address Phone number and address Insurance information, Provider's license number if applicable Age or date of birth Provider's DEA number if applicable Name of medication Strength Dosage form

8 Important Patient Information (continued)
Provider's Information Route Quantity Route of administration Sig Refill information Provider's signature Date written "Brand necessary" if brand name drug is desired

9 Prescription Information-Outpatient
Medical record number needed if patient is member of HMO DEA number is necessary for controlled substance Controlled drug written in ink or indelible pencil

10 Prescription Information-Inpatient
Information required different than outpatient Doctor’s license and DEA number on file at hospital Dosing 24-hour period

11 Prescription Information-Inpatient
Doctor writes for daily dose Antibiotics have automatic stop date

12 Translation of an Order
Look at whole order if difficult to decipher If in doubt, ask another person or pharmacist

13 When to Ask for Help When handwriting is poor, assistance is needed
Filling scripts under pressure can lead to “guessing” See example 8.1 on page 117

14 Entering the Information into the Database-Outpatient
After doctor’s order is read, enter into computer Check computerized label against prescription after it is filled Two labels generated: one for the vial; other for back of original prescription Pharmacist initial needed on both labels

15 Entering the Information into the Database-Inpatient
Pharmacist enters new prescriptions in computer, not technicians Multiple orders on patient sent during stay Computers alert to drug interactions Pharmacist calls physician to change order

16 Filling the Script After label preparation, match with original order and fill 10 steps to prevent errors (See list on page 119)

17 Checking the Label Against the Script
Label checked many times before it reaches patient Hold original script next to label to check for errors or discrepancies Look at names of drug, strength, dosage form, sig (directions)

18 Pulling the Correct Medication
Take label to shelf when getting medication from the shelf Label helps you not to forget Can compare label with information on the bottle

19 Counting and Filling the Medication
Check label and script against bottle for accuracy Counting trays still used Digital counters and automated machines Baker cells used in larger pharmacies

20 Prescription Lid and Auxiliary Label
Appropriate lid applied after medication is filled Problem for elderly patient–safety lid Elderly lose dexterity and strength Older patients do not want safety lids Can replace with snap-on lid

21 Applying the Label Professionalism is needed when applying label
Do not place torn or crooked label on bottle Label not to cover lot and expiration date on full bottle prescriptions Auxiliary labels must be easily read

22 Applying the Label Computer systems print label and information on one sheet Law requires certain information to be on label See list on page 121 for required label information

23 Technician’s Initials
Technicians should initial all orders filled by them Pharmacist gives final check-off and knows who filled it by initials Pharmacist can notify or ask technician if errors or questions occur Pharmacist must always sign off after completion

24 Auxiliary Labels Auxiliary labels usually printed with prescription label Drug classification, interactions, and side effects need to be known for auxiliary labels if not computerized

25 The Pharmacist’s Final Inspection
Passing the filled vial, along with medication container from shelf, and original prescription to the pharmacist is the last step in filling scripts Filling one prescription at a time is important to avoid errors Mark newly opened stock bottle with an X (do not cover NDC number or expiration date)

26 Computer Dispensing Systems
Two major versions of dispensing systems: One for filling outpatient prescriptions Those used in hospitals

27 Outpatient Dispensing Systems
Three primary reasons for using dispensing systems: Cut down on errors Increase productivity Inventory control Disadvantage–high cost

28 Inpatient Dispensing Systems
Hospitals need medications around the clock Computerized dispensing systems cut down on staffing needs; gives doctors and nurses access Control narcotics and track their movement

29 Inpatient Dispensing Systems
Robot dispensing machine incorporated into hospital pharmacies Dispenses unit-dose medications Fills with 99% accuracy

30 The Rights of a Patient Right dose Right medication Right route
Right time Right price Right dosage form Right patient

31 Pharmacist Consultations: When and Who Needs Them
First-time prescriptions flagged and pharmacist is alerted Patient needs consultation with new script Federal law–all new or changed prescriptions need consultation OBRA 1990

32 Miscellaneous Orders Technicians, clerks, and pharmacy interns fill refills and transfer prescriptions over the phone Technicians may phone and receive authorization for a prescription refill

33 Zero Refill Recorders Additional phone lines set up in pharmacies for refill Patient should allow two days to get proper authorization from prescriber

34 Transfers Previously filled prescriptions transferred by pharmacist from one pharmacy to another Boards of Pharmacy prefer transfer only one time Federal law states only narcotics be transferred one time

35 Filing Prescriptions Hard copy prescriptions manually filed
Hard copy filed for future reference Prescription kept on file for three years Prescription numbers used

36 Filing Prescriptions All controlled substances stamped with a red “C” 1 inch down on right hand side of prescription label for easy location All Scheduled II medications must be filed separately

37 Medication Pick-Up Patients can wait for prescriptions
Have it delivered Pick up another day by self or relative All third-party prescriptions must have a signature of the person receiving medication Check all ID before releasing medication for controlled substances

38 Billing No third-party coverage–patient charged full price
Each type of insurance has limitations

39 Changing Trends “Meat and potatoes” of pharmacy is interpreting, transcribing, producing a label, filling, and checking scripts OBRA 1990 requires consultation with patients Pharmacist moved away from filling counter and technician placed in front line

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