Pharmacy TEchnician Assessment (PTA) · The Pharmacy Technician Assessment (PTA) is a competency assessment of a technician candidate performed in the workplace by an approved licensed

PHARMACY TECHNICIAN ASSESSMENT (PTA)

WORKBOOK

23 JUNE 2014

Nova Scotia College of Pharmacists Pharmacy Technician Assessment Workbook 23June 2014

Page | 1

TABLE OF CONTENTS

1. Introduction ............................................................................................................................................. 2

2. Program Activities

Exercise #1: Documentation of Drug Distribution Processes ................................................................. 5

Exercise #2: Verbal Prescriptions and Prescription Transfers ............................................................... 7

Exercise #3: Technical Check ................................................................................................................ 9

Exercise #4: Product Release .............................................................................................................. 11

Exercise #5: Professional Collaboration ............................................................................................... 13

Exercise #6: Communication and Education ........................................................................................ 15

3. Appendices

Appendix A: Instructions for Checking the Accuracy and Quality of the Final Product ........................ 17

Appendix B: Prescription Daily Tracking Log ....................................................................................... 21

NSCP CONTACT INFORMATION

Nova Scotia College of Pharmacists

1559 Brunswick Street, Suite 200

Halifax, NS B3J 2G1

Fax: 902.422.0885

Melissa Rhodes

Manager of Registrations

[email protected]

902.422.8528 Ext 1

Sue Sampson

Project Director/Lead Pharmacy Technician Regulation

[email protected]

902.422.8528 Ext 8


Page | 2

1. INTRODUCTION

One of the qualifications for registration and licensing as a pharmacy technician with the Nova Scotia

College of Pharmacists (NSCP) is “successful completion of an assessment of the applicant's basic

competencies in a direct patient care practice setting approved by the Council”1. The Pharmacy

Technician Assessment (PTA) is a competency assessment of a technician candidate performed in the

workplace by an approved licensed pharmacy technician or pharmacist preceptor.

The pharmacy technician candidate will complete activities that fall within the registered pharmacy

technician’s scope of practice in Nova Scotia and are based on competencies set forth in the NAPRA

Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice (2014)2. The

pharmacy technician candidate is required to complete all activities and/or demonstrate the skill(s) to the

satisfaction of the preceptor, regardless of the practice setting where completion of the PTA is taking

place.

RELEVANT COMPETENCIES

Competency 1: Ethical, Legal, and Professional Responsibilities

1.5 Document activities of practice in compliance with federal and provincial/territorial

legislation, standards, and policies.

1.5.1 Maintain complete, accurate and secure patient records.

Competency 3: Product Distribution

3.1 Receive, interpret and process a prescription.

3.1.1 Transcribe verbal orders and ensure their accuracy.

3.1.2 Transfer a prescription and receive a transferred prescription.

3.4 Verify the technical aspects of the prescription to ensure accuracy and quality of

products.

3.4.1 Identify when an independent double check should be performed.

3.4.2 Check the product and its prescription label against the prescription using a systematic

approach.

3.5 Collaborate with the pharmacist in the release of the product.

3.5.1 Determine whether the legal and professional requirements for a product to be released to

the patient have been met.

3.5.2 Identify when the patient requires further consultation or education from the pharmacist.

1 NSCP Registration, Licensing & Professional Accountability Regulations s.8(1)(f) 2 http://napra.ca/Content_Files/Files/Comp_for_Cdn_PHARMTECHS_at_EntrytoPractice_March2014.pdf

http://napra.ca/Content_Files/Files/Comp_for_Cdn_PHARMTECHS_at_EntrytoPractice_March2014.pdf


Page | 3

Competency 7: Communication and Education

7.1 Establish and maintain effective communication.

7.1.1 Demonstrate proficiency in written and verbal English or French.

7.1.2 Demonstrate appropriate verbal and non-verbal communication skills, including listening

skills.

7.1.4 Select appropriate communication and education techniques for use with the patient and

other health professionals.

7.1.5 Conduct interpersonal interactions, including conflict management, in a professional

manner.

7.1.6 Communicate with sensitivity, respect and empathy.

7.2 Use safe, effective and consistent communication systems.

7.2.1 Use communication techniques that maximize safety and understanding, including

repeating back verbal orders, using recognized terminology and avoiding unnecessary or unsafe

abbreviations.

7.2.2 Record and store information in a consistent manner for efficient access and retrieval by

relevant personnel.

7.2.3 Select appropriate technology to facilitate communication.

Competency 8: Intra and Inter-Professional Collaboration

8.1 Create and maintain collaborative professional relationships.

8.1.1 Create and maintain collaborative professional relationships.

8.1.2 Contribute to the effectiveness of working relationships in collaborative teams.

8.2 Contribute to the effectiveness of working relationships in collaborative teams.

8.2.1 Interact respectability with other members of the team by accepting accountability for

themselves and managing disagreements and conflict.

Important:

PTA participants cannot perform any of the activities alone since they are not yet licensed to do

so. Pharmacy technician candidates must clearly identify themselves as such during all

professional interactions and must always be under the direct supervision of a licensed registrant

of the NSCP.


Page | 4

BEFORE YOU BEGIN THE PTA

Both the pharmacy technician candidate and the preceptor must review the PTA Workbook

supplementary document Pharmacy Technician Assessment (PTA) Program Information for Pharmacy

Technician Candidates and Preceptors prior to beginning the program. This document contains important

information, including:

PTA goals

Prerequisites

Application submission

Preceptor eligibility and responsibilities

Pharmacy technician candidate responsibilities

Site criteria

Conflict of Interest considerations

Competency assessment and grading

Length of PTA

Completion of PTA and submission of final documents

HOW TO COMPLETE THIS WORKBOOK

The workbook consists of a six exercises, each containing one or two related activities that must be

completed by the pharmacy technician candidate. The exercises and activities may be completed in an

order.

In completing the various activities, the pharmacy technician must include relevant notes, observations,

summaries and answers to specific questions included as part of the activity. The preceptor is expected

to review these notes for completeness.

For each exercise, the preceptor must provide an assessment of the pharmacy technician`s ability to

complete the activities and/or demonstrate the targeted skill(s). Once this has been done to the

satisfaction of the preceptor, he or she signs and dates the associated exercise page in the workbook,

including any relevant comments or observations.

COMPLETION OF THE PTA

Once all exercises and associated activities have been completed to the preceptor`s satisfaction, the PTA

Declaration of Completion must be completed and signed by both the pharmacy technician candidate and

preceptor and submitted to the NSCP within ten days of completion of the PTA.

The preceptor is asked to complete and submit the PTA Preceptor Program Evaluation.

The pharmacy technician candidate must submit the completed PTA Workbook, all Prescription Daily

Tracking Logs, and the PTA Pharmacy Technician Candidate Program Evaluation to the NSCP within ten

days of completion of the PTA.


Page | 5

2. PROGRAM ACTIVITIES

EXERCISE 1: DOCUMENTATION OF DRUG DISTRIBUTION PROCESSES

Activities

For accountability purposes, it is important that the various aspects of the drug distribution process are well documented. It must be clear who has taken the responsibility for what aspect of the drug distribution process including: receiving a (verbal) prescription, entering the prescription into the pharmacy computer system, preparing the prescription (including all steps involved in compliance or unit dose packaging), assessing the prescription for therapeutic appropriateness, verification of the technical accuracy of the completed prescription, patient counselling, and any follow up monitoring activities.

1. Note how documentation at your practice site is auditable and traceable for the various aspects of drug distribution. Could any changes be made to improve the process?

2. Summarize your findings.

Preceptor Comments and Assessment (use back of page if needed)

I confirm that the candidate has completed the above activities and/or demonstrated the skill(s) to my satisfaction.

Date: Preceptor`s signature:

Suggested Resources

NAPRA Model Standards of Practice for Canadian Pharmacy Technicians NSCP Pharmacy Practice Regulations NSCP Standards of Practice: General Practice (Pharmacists)

Relevant Competencies 1.5


Page | 6

EXERCISE 1: DOCUMENTATION OF DRUG DISTRIBUTION PROCESSES

CANDIDATE NOTES / DOCUMENTATION


Page | 7

EXERCISE 2: VERBAL PRESCRIPTIONS AND PRESCRIPTION TRANSFERS

Activities1

1. Receive and accurately transcribe at least two verbal orders from a prescriber, making sure to record all information as required by legislation. Use communication techniques that maximize safety and understanding, including repeating back information to the prescriber, using recognized terminology and avoiding unnecessary abbreviations.

2. Under the supervision of your preceptor, receive from a pharmacy or transfer to another pharmacy a total of five verbal or faxed prescriptions.

a. Summarize your experience with each of the transfers. b. Were any issues encountered during the process and how were they be addressed? c. Can a pharmacy refuse to transfer a prescription? d. What are the legal requirements for transferring a prescription?



Date: Preceptor`s Signature:

Suggested Resources

Canada’s Food and Drug Regulations NSCP Pharmacy Practice Regulations NSCP Transfer of Prescriptions Policy NAPRA Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice NAPRA Model Standards of Practice for Canadian Pharmacy Technicians

Relevant Competencies 3.1, 7.1, 7.2

1 If the technology or site poses restrictions on these activities, the preceptor could use other strategies (e.g. roll play).


Page | 8

EXERCISE 2: VERBAL PRESCRIPTIONS AND PRESCRIPTION TRANSFER



Page | 9

EXERCISE 3: TECHNICAL CHECK

Important: Before beginning this activity, the pharmacy technician candidate and the preceptor must review Instructions for Checking Accuracy and Quality of Final Product (Appendix B)

Activities

1. The pharmacy technician candidate must demonstrate competency in his or her ability to accurately perform a check of the technical accuracy of completed prescriptions/orders prepared for release to patients, under normal working conditions. In order to meet this competency, the candidate must accurately perform 500 technical checks in a row without making an error. The candidate must record ALL checked prescriptions (including those where an error is made) on the PTA Prescription Daily Tracking Log (Appendix C).

A maximum of 50 prescription checks will be counted in any one day.

A new tracking log must be used each day to record prescriptions checked and any errors

identified.

No errors are permitted during the technical checking process. If an error occurs, the

preceptor must inform the participant and discuss the error made. The checking process must

then be reset to zero, regardless of how many of the targeted 500 consecutive checks have

been completed.

All prescriptions checked by the pharmacy technician candidate must be second

checked by the preceptor or delegate (other pharmacist or registered pharmacy

technician) for technical accuracy.

Remember that no product can be released to the patient until the pharmacist has

assessed the appropriateness of therapy




Suggested Resources

PTA Instructions for Checking Accuracy and Quality of Final Product (Appendix A)

PTA Prescription Daily Tracking Log (Appendix B)

NSCP Prescription Labels Policy

NAPRA Model Standards of Practice for Canadian Pharmacy Technicians



Page | 10

EXERCISE 3: TECHNICAL CHECK



Page | 11

EXERCISE 4: PRODUCT RELEASE

Activities

1. Discuss the following with your preceptor:

a. What does the legislation state with respect to the responsibility of the pharmacist to:

Ensure the appropriateness of therapy?

Counsel the patient?

Monitoring the initial and ongoing appropriateness of a patient’s drug therapy?

b. What processes are in place at the practice site to confirm that the pharmacist has reviewed

the prescription and patient record to determine appropriateness of therapy and that the

requirements for counselling as set out in the Pharmacy Practice Regulations have been met?

c. What processes are in place to ensure that the prescriptions are released to the correct

customer or agent?

2. Summarize your findings.




Suggested Resources

NSCP Pharmacy Practice Regulations NSCP Releasing Medications to Patients and their Agents Policy NAPRA Model Standards of Practice for Canadian Pharmacy Technicians

NSCP Standards of Practice: General Practice (Pharmacists)



Page | 12

EXERCISE 4: PRODUCT RELEASE



Page | 13

EXERCISE 5: PROFESSIONAL COLLABORATION

Activities

1. Reflect on a positive situation that occurred in your workplace when the relationship between you

and another health care professional was collaborative. What effective communication skills were

demonstrated?

2. Reflect on a situation where the interaction was not ideal between you and a patient or other health

care provider and consider:

a. What may have contributed to the situation?

b. What changes could have been made or issues addressed that may have resulted in a better

interaction?




Suggested Resources

NAPRA Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice NAPRA Model Standards of Practice for Canadian Pharmacy Technicians

Relevant Competencies 8.1, 8.2


Page | 14

EXERCISE 5: PROFESSIONAL COLLABORATION



Page | 15

EXERCISE 6: COMMUNICATION AND EDUCATION

Activities

1. Prepare and deliver a 5-10 minute presentation to your preceptor, staff, or other group that helps to

promote understanding of the role of the registered pharmacy technician and its relationship to the

roles of other health care providers. Consider including information such as requirements to

become a registered pharmacy technician, scope of practice, how the role of the pharmacy

technician complements and supports the pharmacist’s role, etc.

2. Demonstrate the proper use of a device (to be chosen by your preceptor) to a patient, staff, or your preceptor. What special advice or precautions specific to the device should be mentioned during this demonstration?




Suggested Resources

NAPRA Model Standards of Practice for Canadian Pharmacy Technicians

Relevant Competencies 7.1, 7.2


Page | 16

EXERCISE 6: COMMUNICATION AND EDUCATION



Page | 17

3. APPENDICES

APPENDIX A: INSTRUCTIONS FOR CHECKING ACCURACY AND QUALITY OF

THE FINAL PRODUCT

1. Pharmacy technician candidate orientation and review

Prior to beginning this exercise, the preceptor must have a conversation with the pharmacy technician

candidate to highlight the expectations of the candidate with respect to the checking process.

There should be a clear understanding between the preceptor and candidate regarding:

a. What are considered prescriptions or products.

b. What will be considered to be an error in the filling process (and therefore reportable as an

error).

c. The procedure that will be followed in the event that the candidate misses identifying an error

made in the filling process.

2. Activity

This activity assesses the pharmacy technician candidate’s competency in accurately performing the

technical check of products or prescriptions prepared for release to a patient. Best practice for

checking the technical accuracy of prepared prescriptions is an independent double check1, however

situations may arise in practice whereby this may not be possible or practical; and in such situations

all technical aspects of filling a prescription, including entering the prescription into the pharmacy

software, selection of drug from stock, and technical check may be performed by the pharmacy

technician. This assessment allows for the pharmacy technician to check products or prescriptions

prepared under both set of circumstances.

If another pharmacy team member has played a role in the preparation of the product or prescription,

it is important that this team member does not communicate what he or she expects the pharmacy

technician to see, which would create bias and reduce the visibility of a potential error.

To address this competency, pharmacy technician candidates must accurately perform a total of 500

consecutive technical checks of prepared products or prescriptions under the following conditions:

a. Normal working conditions

b. A maximum of 50 prescriptions/orders per day

c. A full complement of the various types of prescriptions/products should be checked, including

new and repeat prescriptions, compounds, sterile preparations (if applicable), different types

of unit dose packages, cards and dosettes.

d. NO ERRORS are permitted during the checking process. IF AN ERROR OCCURS, the

preceptor must inform the participant and discuss the error made. The checking process

must then be reset to zero, regardless of how many of the targeted 500 consecutive checks

have been completed.

e. The checking process is considered complete once the applicant has accurately performed

500 consecutive checks.

1 For definition, see the Institute for Safe Medication Practices (ISMP) Canada www.ismp-canada.org/definitions.htm

http://www.ismp-canada.org/definitions.htm


Page | 18

All items checked by the pharmacy technician candidate must be second checked by the

preceptor or preceptor’s delegate (other pharmacist or licensed pharmacy technician) for

technical accuracy.

No product can be released to the patient until the pharmacist has assessed the

appropriateness of therapy.

3. Prescription Daily Tracking Log

a. The purpose of the Daily Tracking Log is to:

i. record/track the checking that has been completed.

ii. help document any errors caught or made during the checking process.

b. Procedure for filling out the Daily Tracking Log:

i. The candidate must start a new log sheet each day to record all checked prescriptions and

any identified errors.

ii. The candidate must record all relevant information on the log:

Date and name

Prescription number or type of items checked

Any errors identified or “no error” if none are found

Initials once the check has been completed

iii. The preceptor must also check the item checked by the pharmacy technician and:

Initial “no error missed” if:

there is no error in the prescription and this has been appropriately identified

by the pharmacy technician candidate; or

there is an error in the prescription but this has been appropriately identified

by the pharmacy technician

Initial “error missed” if:

there is an error in the prescription but it is NOT appropriately identified by

the pharmacy technician candidate

Records the type of error missed by the pharmacy technician candidate if applicable.

4. The Technical Checking Process

a. When checking the dispensed medication, the label and medication should always be checked

against the prescription. The order in which these checks are carried out may vary but all of the

following checks need to be performed:

i. Right patient

ii. Right drug, dosage form, and route

iii. Right dose and quantity

iv. Right directions

v. Right doctor

vi. Additional considerations


Page | 19

b. The following process may be used as a reference for checking community and/or hospital

prescriptions, orders, vials, compounds, unit dose bins, blister packing and other compliance

packaging, or other similar processes.1 All steps may not be applicable to all settings.

i. Right patient

Check the patient’s name on the prescription/order and vial/product label for

accuracy. Be extra vigilant when there are duplicate names in the pharmacy

computer system.

Check patient’s address and/or date of birth especially when multiple patients have

the same name.

(Hospital) Check that the bin/card/product item, etc. has been labeled with the correct

patient name, room number, and floor.

iii. Right drug, dosage form, and route

Check to ensure that the drug name on the prescription/order matches that on the

vial/product label (with allowance for generic substitution). Pay particular attention to

checking drugs ordered that have a name that is similar to another medicine to

ensure that the correct drug is dispensed.

Refer to Nova Scotia Formulary or hospital formulary to determine if a generic drug is

available.

(Hospital) Follow automatic substitution policies as applicable.

Match the DIN (Drug Identification Number) on the hard copy to the manufacturer

bottle label/product.

Check that the dosage form matches that stated on the prescription.

Check the physical appearance of the drug to ensure that the product in the

vial/package is what the label states.

Ensure integrity of final product.

Check the expiration date on the manufacturer’s stock bottle/product to ensure that it

is sufficient for the treatment period. Take extra care with liquids which may have a

shorter shelf life once the stock bottle has been opened.

iv. Right dose and quantity

Check the strength of the medication to ensure that the strength on the prescription

has been interpreted correctly.

Check calculations for dosage, compounding, etc.

Check the quantity on the prescription and vial label to ensure they are the same. If

the quantity has been calculated from information on the prescription, double check

the calculation.

Check the number of refills on the prescription and vial/product label to ensure they

are the same.

(Hospital) Ensure the product has been correctly selected and placed into the correct

bin/card/bag/etc.

1 The pharmacy technician candidate and preceptor may need to adapt the checking process to be workplace specific where

necessary.


Page | 20

Quantity of the product item matches the quantity on the pick list/MAR/label

or other form of checking list.

Placed into the bin in order of administration times with regularly scheduled

medications in the front and prn orders in the back.

v. Right directions

Verify that the directions on the prescription are the same as what is stated on the

vial/product label.

Ensure that the directions are clear and easy to understand.

vi. Right doctor

Check the prescriber’s name on the prescription and vial/product label to ensure all

information is correct.

Consider prescribing laws and regulations.

vii. Container/Packaging and Additional Considerations

Check that the most appropriate packaging/container has been used.

Consideration should be given to any auxiliary information/labels necessary for

appropriate care (may be site specific).

Prescriptions/orders need to be checked that they are in compliance with all

regulations and policies regarding the dispensing of drugs.

The candidate must ensure that all documentation has been completed and filed.


Page | 21


Page | 22


Page | 23

NOTES

Documents

Pharmacy TEchnician Assessment (PTA) · The Pharmacy Technician Assessment (PTA) is a competency assessment of a technician candidate performed in the workplace by an approved licensed