Transcript Chapter 2 Law and Ethics of Pharmacy Teresa Hopper

Chapter 8
Prescription Processing
Copyright © 2004 by Elsevier Inc. All rights reserved.
Introduction
• Clarification is needed at times
• Pharmacist makes the call
Copyright © 2004 by Elsevier Inc. All rights reserved.
Processing a Script:
A Step-by-Step Approach
– Patient drops off prescription
– Pharmacy tech checks to make sure that
the patient is on file. If not, a patient
information sheet must be filled out.
– Pharmacy tech checks the prescriptions
for completeness
– Pharmacy tech checks to ensure
medication is in stock
– Pharmacy tech enters the prescription
into the computer
Copyright © 2004 by Elsevier Inc. All rights reserved.
Taking the Prescription
• Prescription arrives by various methods
• Written order
• Hand carried
• Faxed
• Called in
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Taking the Prescription
• Computer generated prescriptions
becoming more common
• May be provided to patients on
discharge from hospitals or
physician’s office
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Patient Information Sheet
• Allergy information for new patient
needed
• Contact information
• Insurance information
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On the Rx
Patient Information
Provider's Information
Name
Name
Phone number and address
Phone number and address
Insurance information,
if applicable
Provider's license number
Age or date of birth
Provider's DEA number
if applicable
Name of medication
Strength
Dosage form
Copyright © 2004 by Elsevier Inc. All rights reserved.
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
Copyright © 2004 by Elsevier Inc. All rights reserved.
Prescription Information
• DEA number is necessary for
controlled substance
• Controlled drug written in ink or
indelible pencil
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Translation of an Order
• Look at whole order if difficult to
decipher
• If in doubt, ask another person
or pharmacist
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Entering the Information into
the Database-Inpatient
• Computers alert to drug interactions
• DUR (drug utilization review) warns of
possible problems the pharmacist will
have to address.
– checks for drug interactions and drug
allergies
– Pharmacist calls physician to
change order if necessary
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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)
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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
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Finding the Right Stock Bottle
• NDC (National Drug Code): is a unique
eleven digit number that identifies each
medication.
– 1st five digits identify the manufacturer
– Next four identify the drug product
– Final two digits represent package size
and packaging
Copyright © 2004 by Elsevier Inc. All rights reserved.
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
Copyright © 2004 by Elsevier Inc. All rights reserved.
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
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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
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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
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Package Insert
• Is drug information that is dispensed
with each prescription medication.
• The information sheet includes
indications, interactions, and possible
side effects.
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The Rights of a Patient
• Right dose
• Right medication
• Right route
• Right time
• Right price
• Right dosage form
• Right patient
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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
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Billing
• No third-party coverage–patient
charged full price
• Each type of insurance has limitations
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Preventing Forgery
• Prescription pad may colored paper or
water marking to prevent photocopying
prescriptions
• Alert the pharmacist if you suspect
forgery
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