Pharmacy Technician Career EnvironmentsRetail Pharmacy

Retail pharmacy, also know as community based pharmacy or community pharmacy, is a very common environment in which pharmacy technicians are employed. These pharmacies provide prescription services and an outlet for the sales of commonly purchased good and services.

Retail pharmacies consists of independent pharmacies and chain pharmacies.

In general, the major benefit of retail pharmacies is accessibility. Often the patient will go to see the pharmacist at a retail store first before seeking medical attention for which they may have limited access to or no insurance to help cover the costs.

Independent PharmacyOwned as a sole proprietorship by one or a

few owners.Provide prescription filling along with other

ancillary services (surgical supplies, vitamins, hallmark®)

Often provide personal services Major benefit: familiarity of the pharmacists

with the customersDisadvantage: may not have the pricing

power of larger chain stores.

Chain Drug StoresNational franchises like Walgreen’s, CVS,

Rite Aid, and Duane Reade (east coast) have many stores around the US and/or in a regional area

Offer convenience with many stores operating 24/7

Major advantages: pricing power, convenience, and accessibility.

Disadvantages: lack of personalized service between pharmacist and patient.

Retail StaffSupervising pharmacist: a full time pharmacist who is in charge

of the legal and administrative aspect of the pharmacyStore Manager: a person, who may or may not be a pharmacist,

that is in charge of the operation of the store in generalTypically the store is divided into front end and back end.

Front end deals with OTC issues and other non medication issues a customer may have

Back end contains the pharmacy Stores the legend medications Stores other restricted meds and higher priced devices

Blood glucose strips, blood pressure monitors, Plan B, and products that contain pseudoephedrine.

Combat Methamphetamine epidemic act of 2005 requires removal of pseudoephedrine products from the public area

Regulatory AgenciesState Boards of Pharmacy regulates the practice of pharmacy

which in NYS are contained in the education law of the board of regents article 137, the public health law article 33 for controlled substances, and the NYSRR title 10 among others. SBOP conducts inspections of pharmacy facilities.

Centers for Medicare and Medicaid Services: CMS regulates the federal programs of Medicare and Medicaid along others. CMS conducts inspections to ensure compliance with federal regulations.

Third Party Payers: Third party insurance companies also may conduct inspects of pharmacy establishments to determine if contractual agreements are kept between insurance payer and the pharmacy.

Summary of Retail Pharmacy Technicians Handling Deliveries Inventory management Record keeping Stock rotation and others Enter prescriptions in the patient’s medical profile Create and maintain patient profiles to include:

Name, address, DOB, contact information Medical allergies Food allergies Medical history (pertinent to medication use) Current medications and herbals that patient is taking

One area where technician can offer advise is in the use of medical devices like blood pressure monitors, glucose testing equipment, etc.

Communicate with physician’s or their agents to obtain refill authorizations In some states, compounding of solutions, suspensions, creams and ointments Handling insurance issues to obtain pharmacy reimbursement

Health System PharmacyPharmacy setting where patients reside at the facility

where the pharmacy is locatedIncludes acute care hospitalsLong term care facilities-provides skilled nursing

services to patients in need of long term rehabilitative services

Hospices-facilities that provide end of life palliative care to terminally ill patients.

Nursing Homes-facilities that provide skilled nursing care to elderly people who can no longer care for themselves due to chronic illness

Correctional Facilities-prisons

Hospital Staff Includes pharmacists, nurses, physical therapists, respiratory therapists,

nutritionists, etc DO- doctor of osteopathy is a medical doctor that can practice

conventional medicine and tends to use musculoskeletal manipulation to assist the patient.

MD- doctor of medicine who practices conventional medicine. Physician Assistant- a licensed individual who is trained to work with and

under the supervision of a physician in the care of patients. Nurse Practitioner- a licensed individual who has rights similar to a

physician assistant RN- a licensed individual who is trained to provide and administer

medical therapy (including medications) to patients under the order of a DO or MD

LPN- similar to an RN, however, works under the supervision of an RN. Certified Nursing Assistant- CNA works under the supervision of an RN;

however medication administration is not allowed

Regulatory Agencies in the HospitalJoint Commission on the Accreditation of

Healthcare OrganizationsCalled Joint Commission or JCAHO for shortProvides accreditation to hospitals, Long term

care facilities and other organizationsSite inspections conducted every three yearsPassing of site inspections required for

accreditationAccreditation required for CMS funding by the

government

State Board of PharmacyState board of pharmacy typically monitors

community pharmacies; but in the hospital setting monitors the staff in the hospital and not the department as a whole.

State Health DepartmentsState health departments directly governs

hospitals, including the pharmacy department.

Directly charters a hospital and grants its privilege to operate in the state.

Medication Dispensing SystemFloor Stock Distribution. A system where a compliment of

medication inventory is keep at the nursing station. System is prone to diversion and is not used anymore in most hospitals, except in cases of ADC.

Cart Fill System: A system where a given supply of medication (24-72 hours)is dispensed to a patient via a locked cassette located in a centralized physical cassetteUnit Dose System/Prepackaging : A system where bulk

medications are pre packaged into individual packets where the contents of such packets are a single unit of use. i.e A bulk container of 100 phenobarbital tablets in 100 individual blister packets of a single tablet. Extremely cost efficient Can be used in the Floor Stock System and/or the Cart Fill system

Summary of the Pharmacy Technician’s Duties in the Health System PharmaciesData collection (information on drug turnover

and usage)Survey and inspections (nursing station

inspection)Education (training new technicians)Maintenance (restock of omnicell and pyxis,

monitoring and replacement of crash cart items)

Dispensing/inventory management

Filling patient’s medication cassettesRepackaging medicationsCompounding oral solutions, creams, and

suspensionsCompounding, in some states, IV parenteral

drug products after being USP 797 trainingRestocking and maintaining institutional

crash cartsNursing Station inspections