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P1 Spring 2024 > Ipc -IPC -exam 1 - community pharmacy > Flashcards

Ipc -IPC -exam 1 - community pharmacy Flashcards

1
Q

Medication Use Process: Workflow

A

The sequence of industrial, administrative, or other processes through which a piece of work passes from initiation to completion

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2
Q

Workflow

A

Important to manage in various settings

Organization and communication are key

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3
Q

Workflow

A

Proper workflow helps to ensure prescriptions are filled accurately, safely, efficiently, _timely____________

A well-established workflow keeps the pharmacy organized, sets an appropriate pace, and can maximize quality patient care

It is the pharmacist’s responsibility to ensure the process runs smoothly

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4
Q

Pharmacists’ Responsibilities

A

Prescription accuracy and safety

Overall workflow
- Triage and prioritization, this fits in with the assess portion of PPCP
- Task delegation
- Time management

Be honest and realistic with patients, do not say 10 minutes when it is not

Make sure technicians and interns work within their scope of practice

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5
Q

Pharmacy Stations

A

Drop off*
Prescription / Data Entry*
Filling / Production*
Verification*
Pickup*
Consultation Area

Compounding area
Reconstitution area
Counseling / Vaccination room

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6
Q

Flow of the pharmacy

A

Prescription received by pharmacy
- E-prescriptions
- in-person drop-off

Data / Prescription Entry
- Insurance billing
- Resolving issues

The prescription order is filled
- NDC matched via scan
- Pills counted
- Bottle is labeled

Prescription Verification
Order entry verification
Product Verification

Prescription dispensing
Pickup

Consultation
Patient Counseling

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7
Q

Drop Off

A

Most prescriptions are “dropped off” electronically

In some situations, prescriptions may be dropped off in person
- Patients or their agents - make sure all of the info is obtained

Accepted by technicians, interns, or pharmacists

Information obtained from patients
- Name and DOB
- Update:
Demographic info
Insurance info
Allergies and health conditions
- Plans for pickup

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8
Q

Drop Off

A

Receive the prescription

Identify the class or type of medication

Ensure the prescription has all the required items

Do you have any questions or concerns for the prescriber or patient?

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9
Q

Drop Off: Special Considerations

A

Prescription preferences
- language
- text messages
- easy off caps

Controlled Substances
- Patient ID
- Good faith dispensing (GFD) process
- Check the Prescription Drug Monitoring Program (PDMP) and/or refill history
- Prescriber notes
“Do not dispense until…” or “Do not dispense before…”
- Contact the prescriber for verification or validation of prescription PRN

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10
Q

“Drop Off”
what else happens

A

vaccination check-in

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11
Q

What percentage of prescriptions are physically dropped off to community pharmacies?

A

5%

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12
Q

Prescription (or Data) Entry

A

E-prescriptions are matched to the corresponding patient
- Scan dropped-off prescriptions into the computer system

Prescription information is entered/updated
- Date
- Patient name
- Drug name, strength, dosage form
- SIG
- Quantity, refills, days’ supply
- Prescriber
- DAW

Submit claim to insurance, resolve 3rd party issues

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13
Q

Third-Party Billing

A

Refill too soon

Prior Authorization required

Patient no longer eligible

Drug not covered

Plan limits exceeded

Invalid/missing days supply

Insurance limitations/contractual issues

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14
Q

Filling / Production

A

Patient monograph/leaflet prints

Find stock bottle/product

Match and scan leaflet and stock bottle(s)

Count medication and label vial

Image capture?

Attach any additional instructions and/or MedGuide

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15
Q

Filling / Production

A

Patient monograph/leaflet prints

Find automation-filled bottle

Match and scan leaflet to bottle

Image capture?

Attach any additional instructions and/or MedGuide

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16
Q

Filling / Production

A

Med bottles w/ leaflets placed into baskets or totes
Often color-coded

Sent to pharmacist for visual product verification

Or – the prescription is bagged and ready for pickup
- RPh can verify remotely

17
Q

Verification Flow of the Pharmacy

A

receiving rx to

rx entry to

order verification to

filling meds to

product verification to

dispensing

18
Q

Verification Flow of the Pharmacy

A

receiving rx to

rx entry to

filling meds to

rx verification:
- order verification
- product verification

dispensing

19
Q

When considering pharmacy workflow, Which type(s) of verification can be done remotely by a community pharmacist?

A
Order Verification

B
Product Verification

C
Both

D
Neither

A

C
Both due to image capture and scanning into the computer

I pray lord that you help me to work remotely after I graduate from this program in Jesus’ name amen

20
Q

Order Entry Verification

A

Verify entered information is correct and matches the original prescription

Look-alike, sound alike

Allergies

Dosing
- Unusual dosing
- Pediatric dosing

Dosage forms

Special requests from prescriber or patient

If controlled substances
- Review history
- Prescription Drug Monitoring Program (PDMP)

21
Q

Good Faith Dispensing (GFD)

A

Used when dispensing C2 substances
- Oxycodone, hydromorphone, methadone
- Should always be using GFD when dispensing C2s

Review patient comments

Check diagnosis code

22
Q

GFD

A

Check PDMP (MassPAT/ NH PDMP)
- Verify geographical proximity
- Multiple prescribers and scope of practice

Payment type

Pharmacists actions:
- Dispense – valid and meets requirements
- Refusal – determines elements of GFD are not present

23
Q

Drug Utilization Review (DUR)

A

Unnecessary drug therapy

Drug selection not optimal

Clinical significant drug interaction

Medication dosing regimen not optimal

Adverse drug reaction

Needs additional drug therapy

Failure to receive drug therapy appropriately

Needs additional follow-up

24
Q

DUR in community pharmacy

A

Dosing regimen not optimal or appropriate

Allergies/Health conditions

Drug-drug interactions

Duplication of therapy

Adverse drug reaction

25
Q

DUR in community pharmacy

A

This may require contacting:
- Prescriber
- Third Party
- Patient

Different levels of severity

Utilize drug information resources
- Lexicomp, Clinical Pharmacology, Micromedex
- your own knowledge

Document, document, document

Do not become desensitized to DUR alerts!

26
Q

Prescription Product Verification

A

Medication in the vial is correct
- NDC
- Drug markings
- Drug name and dose
- Matches image

The patient is correct and matches all items

Double-checking fill dates for control substances

27
Q

Prescription Product Verification

A

Packaging
- Safety cap
- Correct language
- Large font

Storage
- Refrigerated
- Room temp

Pharmaceutical elegance - making sure the product is presentable.

28
Q

Pickup

A

Verify patient identifiers

Confirm correct medication(s) - what meds are you looking for

Ensure the copay makes sense
- Check insurance claim if needed

Scan ID (if controlled substance)

Offer to counsel

29
Q

Drive Thru

A

always a station

30
Q

Consultation

A

Counseling is the final step in the workflow, but can happen anywhere in the process
- Ask open-ended questions
- Explain what to expect
- Verify directions and how to take
- Answer any questions and address concerns

Depending on State and insurance requirements may require a minimum offer to counsel

31
Q

Consultation: patient counseling

A

Nonprescription medication questions and recommendations

Prescription medication counseling

Immunization screening (done at Drop Off?)

32
Q

Disruptions in Workflow

A

Solving TPRs (third-party rejections)

Staffing limitations

Phone calls

Rush hour

Stock issues

MTM

Immunizations

Consultations

33
Q

Future of Pharmacy Workflow

A

Pharmacist-centered services
- working remotely!

Increased technician responsibilities
- tech check tech
- Technician immunizing

Pharmacists becoming prescribers
- Collaborative Practice Agreements

Automated dispensing

Delivery

Fulfillment centers

34
Q

disadvantage of fulfillment

A

what if the patient wants it right now

maximize inventory

P1 Spring 2024 (57 decks)

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