Transcript Receive a Prescription Order (Dari)

Receive a Prescription Order
(Dari)
EO 003.02
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Purpose of Lesson
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The pharmacy technician student will
learn how to:
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(1) Screen prescriptions for
completeness and authenticity.
(2) Complete the proper patient
prescription intake procedure.
This topic will be taught using a lecture
format and students will be given a
chance to practice these skills during
an in-class assignment as well as
during a skills lab.
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Overview of Lesson
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(1) Outpatient vs. Inpatient
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(2) Essential components of an
outpatient prescription.
(3) Essential components of an
inpatient medication order
(MoD form 58).
(4) Stepwise approach to
outpatient prescription
intake.
(6) In-class assignment
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Outpatient vs. Inpatient
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An outpatient is a patient who is
hospitalized for 24 hours or less. It is a
patient who visits a hospital, clinic, or
facility for diagnosis or treatment.
An inpatient is admitted to the
hospital and stays overnight or for a
longer amount of time, usually several
days or weeks.
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Outpatient vs. Inpatient Prescriptions
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Hospital pharmacies provide
services for both outpatients and
inpatients.
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Outpatient prescriptions are usually
brought to the pharmacy to by the
patient or a family member of the
patient.
Inpatient prescriptions will be
brought to the pharmacy by a nurse
from the ward on which the patient is
staying.
Outpatient and inpatient prescriptions
look different and also have different
information requirements.
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Outpatient Prescriptions
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Outpatient Prescriptions
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Information required on the
prescription:
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(1)
(2)
(3)
(4)
(5)
Hospital/facility name
Patient’s name
Patient’s gender and date of birth
Patient’s father’s name
Patient medical condition (if
known)
(6) Date the prescription was written
(7) Drug name
(8) Drug strength and dose to be
administered
(9) Instructions for use, including
route of administration, frequency
and duration of use.
(10) Quantity to be dispensed
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Outpatient Prescriptions
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(11) Doctor’s signature
(12) Doctor’s name
(13) Doctor’s address and contact
information.
(14) Doctor’s license/registration
number
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Instructor lead discussion
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The instructor will take 10 minutes to discuss the question
on the following slide with the class.
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Discussion Topic
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Why are the following pieces of
information important to have
on the prescription?
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• Doctor’s contact information
• Date the prescription was
written
• Medical condition
• Patient’s gender and date of
birth.
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Possible Responses
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Doctor’s contact information:
• If there is a problem with the
prescription (i.e. the prescription is
incomplete, drug not on the
formulary etc) the pharmacist may
need to contact the doctor.
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Date the prescription was written:
• It is important to know when the
prescription was written. Do you
think it would be appropriate to fill
a prescription that was written 10
months ago? Likely not, the patient
should be re-evaluated by a
physician.
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Possible Responses
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Patient’s medical condition:
• Allows the pharmacist to evaluate
if the choice of medication is
appropriate and if it is being dosed
appropriately.
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Patient’s gender and date of birth:
• Gender is important to know for
the pharmacist to evaluated if the
medication is appropriate and if
there is specific information the
patient should know (i.e. issues
with pregnancy, side effects etc).
• Date of birth is important to know
if you are dealing with a child or an
adult, which affects how
medication is dosed.
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Inpatient Prescriptions: Medication
Orders and MoD Form 58
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What is a medication order?
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Medication order refers to a written
request on a physician’s order form (in
the patient’s chart) or a transcribed
verbal or telephone order in an
inpatient setting (ward).
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Medication orders are then transcribed
onto the MoD Form 58 for all the
patients on the ward.
This is usually done by the nurse and is
approved by the physician prior to the
MoD Form 58 being brought to the
pharmacy for filling.
In the pharmacy the pharmacist on
duty will review the MoD Form 58 and
sign off prior to the medications being
filled.
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Role of the clinical pharmacist on the ward
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One of the major roles for a clinical
pharmacist working on a ward is to
review medication orders for
completeness, accuracy and therapeutic
use (i.e. dose, route of administration,
indication etc.)
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Form 58
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Form 58
Drug
Strength
Amount of
Drug
Required
for Each
Patient
Patient
Total of
Each Drug
Required
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Differences between inpatient and outpatient
prescriptions
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Each outpatient prescription is for a
single patient. It can have multiple
medications on one form but the
medications are all for the same
patient.
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MoD form 58 (an inpatient
prescription) can have orders for
multiple patients and multiple
medications on the same form.
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Stepwise procedure for outpatient
prescription intake
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Step #1
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Greet the patient and introduce
yourself:
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• This makes the patient feel
more comfortable and welcome.
• Be sure to identify yourself as
a pharmacy technician.
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Step #2
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Verify patient identity
including:
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(1) Name
(2) Date of birth
(3) Gender
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Step #3
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Ask the patient if they have
any medication allergies that
they are aware of.
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What is an allergy?
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Review from anatomy and
physiology:
•
•
•
•
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Undesirable over-reaction of
the immune system to normally
harmless substances such as
medications.
The immune system ‘thinks’
the medication is a ‘foreign
invader’.
Reactions can be damaging and
uncomfortable.
Symptoms can include:
- itchy rash
- difficulty breathing
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Medication intolerance vs. Medication allergy
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Often patients will confuse an
intolerance with an allergy.
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An intolerance refers to a normal side
effect experienced when taking a
medication (i.e. stomach irritation with
an antibiotic).
A true medication allergy is
characterized by breathing problems or
a full body rash.
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Step #3 Continued
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Ask the patient if they have
any medication allergies that
they are aware of.
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• Regardless, if a patient
identifies themselves as
having an allergy you must
get a pharmacist to speak
with the patient before
proceeding.
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Step #4
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Verify the medical
condition/diagnosis for
which the patient is taking
the medication.
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• If there is an inconsistency
between what is written on the
prescription and what the
patient says, do not proceed
and refer the issue to the
pharmacist on duty.
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Step #5
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Confirm the name of the
medication with the patient.
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Note: not all patients will
remember the name of the
medication that has been
prescribed for them and that’s
okay.
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Step #6
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Ask the patient if they have
taken this medication
before.
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• If they have not taken this
medication before, the patient
may wish to speak with the on
duty pharmacist regarding
side effects and any concerns
or questions they may have.
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Step #7
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Now that you have verified all the
appropriate information with the
patient you should screen the
prescription for completeness and
authenticity.
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• Ensure all 14 components of the
outpatient prescription are complete
• Check for signs of counterfeit
prescriptions (see next slide).
• If any information is missing or the
prescription appears to be counterfeit
refer to the pharmacist on duty.
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Counterfeit Prescriptions
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•
Look for:
– Use of two colours of ink. This
may indicate changes made after it
was written.
– Unknown prescriber.
– Incorrect registration number
– Drug names misspelled
– Quantity does not match direction
requirements
– Not written on an official
prescription form.
– No Sig Code
– Quantities changed by crossing out
•
In all these instances the
Pharmacist will have to investigate.
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IMPORTANT: Be sure to keep the patient
informed of any issues encountered throughout
the intake process.
This will help ensure they understand any time
delays in receiving their medication.
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Step #8
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Inform the patient of the
approximate wait time until
their prescription will be
ready. Be sure to tell them:
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• Where they can wait in the
meantime.
• If you will get them when
their medication is ready or if
they should check back at the
pharmacy.
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Step #10
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Fill the prescription
(will be covered in EO 003.03)
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1. Greet the patient/
introduce yourself
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2. Verify patient identity
-Age, gender, date of birth.
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Yes
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3. Ask if the patient has any
allergies
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Doesn’t
match with
the
prescription
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4. Confirm the medical
condition/diagnosis
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5. Confirm the name of the
medication
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None
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Matches
with the
prescription
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Continue to the next
step in the process
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Refer to the on duty
pharmacist
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No
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6. Ask if they have taken the
medication before
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Yes
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7. Ensure the prescription is
complete/authentic
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8. Inform the patient of the wait
time.
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In-class Assignment
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Identify the missing piece(s) of information with the
following prescriptions and determine whether you
need to refer the issue to a pharmacist or if it is
something you can just ask the patient.
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1.
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2.
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3.
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4.
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5.
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Answers
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1.
The doctor’s
signature is
missing
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This is an issue that you should refer to the on duty pharmacist. They can
contact the physician to obtain the signature.
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2.
The name of
the drug is
missing
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This is an issue that you should refer to the on duty pharmacist. They can
contact the physician to obtain the correct information.
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3.
The date the
prescription
was written is
missing
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This is an issue that you should refer to the on duty pharmacist. They can
contact the physician to obtain the correct information.
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4.
The diagnosis
is missing
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You can ask the patient what condition they are being treated for. Once
you obtain that information you can then discuss it with the on duty
pharmacist.
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5.
The gender
and date of
birth is missing
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You can ask the patient for the date of birth and fill it in along with
gender, then take the prescription to the on duty pharmacist.
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