Cont. Ch 4 Flashcards
1
Q
Physician Administration/Dispensing of Dangerous Drugs
A
- Physicians generally not allowed to dispense in Texas
- Exceptions: 72-hour supply of dangerous drug in office dispensement to meet immediate therapeutic needs, certain rural areas where there isn’t a pharmacy to dispense dangerous drugs to patients and be reimbursed for cost, and vets
2
Q
Impaired Pharmacists/Student Program (PRN)
A
- Pharmacist and students who have alcohol or drug impairment can enter into tx and monitoring through Professional Recovery Network (PRN)
- Enter voluntarily => not reported to TSBP as long as they follow recommendations
- Can also be placed into program as part of discipline
- Any Board order by TSBP for impairment is confidential
- Program partially funded by surcharge on all pharmacy/pharmacist licenses (pays for evaluation, not tx)
3
Q
Peer Review Program
A
- Peer review committee may be set up by pharmacy owners/associations to evaluate QoC from pharmacies by evaluating errors/near errors or other quality issues
- Statute provides legal protection of peer review documents in civil litigation
- Setting up committee is voluntary; however, some pharmacies may be mandated to establish committee as part of a disciplinary action against pharmacy license
4
Q
Reporting Professional Liability Claims
A
- Insurer who provides professional liability insurance to pharmacist/techs/pharmacies must report any claim that ends in injury/death filed against them to TSBP
- If one of these claimed is received by individual who doesn’t have liability insurance, must report to TSBP themselves
- Initial report required within 30 days of receiving claim notice and follow-up report within 105 days after disposition (settlement, judgement, etc.)
5
Q
Tech/Trainee Registration
A
- Must be registered as pharmacy tech/trainee prior to beginning work in pharmacy
- Trainee license valid for two years, not renewable
- Initial registration as tech requires passing Board-approved certification exam, but maintaining certification is not required for renewal of registration
- Renewal of registration requires 20 CE Q2y including 1 hour of Texas law
6
Q
Tech Ratios
A
- Class A is 1:6 pharmacists:trainees/techs in Class A pharmacy… max of 3 trainees
- No ratio in Class C and G pharmacies
7
Q
Tech Training
A
- Pharmacy techs and trainees must complete training conducted by PIC as outlined in pharmacy tech training manual
- Specific requirements can be found on TSBP website
- PIC must document their training
8
Q
CE for Techs
A
- Techs are required to complete 20 contact hours of CE Q2y
- 1 hour must be Texas law
- Acceptable forms of CE are same as pharmacists (include courses for pharm. tech. training program)
- Those who maintain certification are considered to have met CE requirements and aren’t subject to audit by TSBP
- Sep 2020 - Sept, 1 2022: must completed 1 human trafficking course
9
Q
Immunization/Vaccinations
A
- Requires written protocol with physician
- Services to patient under 14 yo may only be provided if referred by physician (exception: flu shot for child >7 yo without established physician-pt relationship)
- Can only be given at pharmacy or location provided in protocol (not residence unless nursing home/hospital)
- Immunization certification required BLS, 20 hours of CDC training, and 3 hours of CE Q2y related to immunizations/vaccines
- Must notify physician who issued protocol within 24 hours and patient’s physician within 14 days
10
Q
DTM Under Protocol
A
- Pharmacist may perform DTM as authorized under written protocol
- Includes getting med histories, getting assessment procedures (vitals), ordering related labs, and implementing/modifying drug therapy as detailed in protocol
- Any other drug therapy related act delegated by physician
11
Q
Pharmacists can sign prescription order for dangerous drug (NO CS) if…
A
- Delegation follows a diagnosis, initial assessment, and drug therapy order by physician
- Pharmacist practices in federal HC AND that facility has bylaws that permit medical staff to delegate a pharmacist the management of a patient’s drug therapy
12
Q
DTM Written Protocols
A
- Must identify supervising physician and pharmacist permitted with DTM
- Must identify types of DTM decision a pharmacist can make
- Must state activities pharmacist shall follow in performing DTM
- State mechanism/time schedule for pharmacist to report to physician
13
Q
DTM CE Requirements
A
- Must report to TSBP before performing DTM
- Complete at least 6 hours of CE related to drug therapy
14
Q
DTM Supervision
A
- Physician must review protocol and any deviations from protocol annually (min.)
- Physician must have physician-pt relationship with each pt
- Physician must be geographically located to be physically present daily
- Must receive periodic status reports as defined in protocol
- Physician must be telecommunicatively available to consult
15
Q
DTM Records
A
- Kept for 2 years
- Must keep copy of written protocol and any pt-specific deviations from protocol
- Must document ALL interventions
- Must review protocol annually
16
Q
Inventory Requirements
A
- PIC responsible for ensuring all inventories done
- Inventories must be maintained in pharmacies, filed separately, available for inspection x2years
- Inventories include all stock “on hand” of CS (includes expired meds)
- Persons taking inventory and PIC shall sign/date inventory and indicate time it was taken
- Signature of PIC/date of inventory notarized within 3 business days (not including initial/change of PIC)
- PIC responsible for each exact count of CII and estimated counts of CIII-V (container hold <1000 pills)
- CII shall be listed separately
- Perpetual inventories must be reconciled on date of annual inventory
17
Q
Required Inventories
A
- Initial inventory (on opening day of business, if no CS then record 0)
- Annual inventory of CS - Texas requirement
- Change of ownership for A/C/F pharmacies: take on date of change of ownership (acts as closing and initial inventories respectively)
- Change of PIC in A/C/F pharmacies
