Pharmacy Technician Errors – Policy & Procedure Reviews

Policies and Procedures for Pharmacy Technician Errors:

Pharmacy technicians are an integral part of every pharmacy team. Whether in a retail, hospital, institutional or specialty setting, pharmacy technicians are taking on increasingly important roles with expanding responsibilities. However, as  roles expand, so does the potential for pharmacy technician errors to increase and prove dangerous or even fatal. The 2006 death of a young two-year old girl named Emily Jerry spurred the initiation of numerous intensive studies regarding pharmacy technician dispensing errors. In the 2006 tragedy, the conclusion was clear that her death was due to a preventable pharmacy technician error that took place. Basically the infant died during her final chemotherapy treatment after receiving a dose of an improperly diluted IV prepared by a hospital pharmacy technician. An investigation revealed that the hospital pharmacy was short-staffed on the day of her death, the pharmacy computer was not properly working, and there was a backlog of physician orders.

It is important to note that the above case took place in Ohio and resulted in numerous legislative changes. At that time (2006) pharmacy technicians in Ohio were only required to have a high school diploma with no certification or oversight by the Ohio Board of Pharmacy. The passing of Ohio Senate Bill 203, or “Emily’s Law,” in 2009 now requires all Ohio pharmacy technicians to pass an exam and to be approved by the Ohio Pharmacy Board.

Medication dispensing errors are on the rise according to many studies. A study released in 2006 (at the time of the technician error that resulted in the infant’s death) by The Institute of Medicine stated that medication errors harm at least 1.5 million patients every year. Another study showed that over 400,000 patient injuries take place in hospitals in the US alone due to medication errors. Yet even if a Pharmacist is “overwhelmed”, when pharmacy technicians contribute to dispensing errors, the pharmacist is still ultimately responsible and liable for the error.

If you utilize pharmacy technicians in your practice, when was the last time that you took a good look at your policies and procedures regarding their roles and utilization?? Are you following “best practices” and limiting the chance for potential medication dispensing errors (and therefore reducing your risks of potential lawsuits and bad publicity)? If the answer is “not lately”, then we strongly advise that you get a qualified Pharmacy Consultant to take an objective look at your policies and procedures! Being in the business of Pharmacy consulting for over 25 years now, HCC has been stressing for decades that addressing and preventing issues before they occur is the key to avoiding future problems and bad publicity that pharmacies so frequently encounter these days. With the rise of social media, digital mass media and internet “real-time” news, our advice that the old cliché that “an ounce of prevention is worth a pound of cure” has never been more relevant. Although we all hope that we will never personally deal with such situations cited in the example above, HCC strongly urges you to be prepared. Contact us on line or call us today for a Free Consultation at 800-642-1652 to discuss how we can help you.

Bob Miler
8/18/2015


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