Lecture 12: Pharmacy Service (quality) And Competence Standards

Question 0

What does delivery of pharmacy services depend on?

Answer 0

Competence of pharmacist providing service and quality of system through which service is delivered

Question 1

What are the pharmacy service standards for pharmacy in NZ?

Answer 1

Incorporates following principles of consumer oriented pharmacy care set out in the 7 principles of the pharmacy council code of ethics.

Question 2

What is the intention of this pharmacy services standard?

Answer 2

To set minimum quality standards for the delivery of this service

Question 3

What is not covered by the pharmacy services standard?

Answer 3

Pharmacist competence is not covered, but will continue to be covered by the pharmacy council competence standards for the pharmacist scope of practice

Question 4

What is the effect of having consumer rights?

Answer 4

Consumers can receive safe services of an appropriate standard which comply with consumer rights legislation

Services are provided in a manner that is respectful of consumer rights, facilitates informed choice, minimises harm, acknowledges cultural and individual values and beliefs.

Question 5

What is the outcome of organisational management?

Answer 5

Consumers receive services that comply with legislation and are managed in a safe, efficient, and effective manner

Question 6

What is the outcome of a continuum of service delivery?

Answer 6

Consumers receiving pharmacy services including dispensing, participate and receive timely assessment followed by services that are planned, coordinated and delivered in a timely and appropriate manner, consistent with current legislation

Question 7

What is the outcome of a safe and appropriate environment?

Answer 7

Services are provided in a clean, safe environment that is appropriate to the needs of the consumer.

Environment ensures privacy is maintained, is in a setting suitable for the consumer group and meeds the needs of people with disabilities

Question 8

What is the outcome of dispensing, compounding, repackaging and batch preparation?

Answer 8

Dispensing, compounding repackaging and batch preparation practices in pharmacies have clearly defined procedures and are organised so that appropriate staff, premises, equipment and materials are used according to the requirements of the individual preparation.

Question 9

What is the outcome of aseptic dispensing of sterile products in community pharmacies?

Answer 9

Consumers receive aseptically prepared products dispensed by community pharmacists pursuant to a prescription from a designate prescriber in accordance with standards and guidelines

Question 10

What does aseptic dispensing of sterile products in hospital pharmacies mean?

Answer 10

This section of the service standard replaces annex 1 of the NZ code of good manufacturing practice for manufacture and distribution of therapeutic goods. Part III compounding and dispensing 1993

Question 11

What is good practice? Why has it replaced best practice?

Answer 11

It is the current accepted range of safe and reasonable actions that result in efficient and effective use of available resources to achieve quality outcomes and minimise risk for the consumer

Question 12

What are the compentency standards?

Answer 12

These are a written description of skills, knowledge and attitudes a pharmacist must have to be competent

There are 7 competence standards, each one describing a broad role of pharmacy

Question 13

What is the purpose of the competence standards?

Answer 13

They ensure that a pharmacist possesses all relevant competencies to undertake the roles and services prescribed in the pharmacist scope of practice,

They assist the individual pharmacist to facilitate their continuing professional development (can be used as a tool to assess their own practice)

They also help in the development of education, and training of pharmacists and interns to inform the development of the initial cirriculum. They assist providers in identifying learning outcomes
Can be used to assist employers and pharmacists to identify ongoing training and development needs

Question 14

What are the 7 broad areas of competency?

Answer 14

Practice pharmacy in a professional and culturally competent manner
Contribute to the quality use of medicines
Provide primary healthcare
Appy management and organisation skills
Research and provide information
Dispense medicines
Prepare pharmaceutical products

Question 15

What is profession?

Answer 15

An occupation requiring advanced education and involving intellectual skills of the practice, medicine, pharmacy, law, teaching etc

Question 16

What does it mean to belong to a profession?

Answer 16

To agree to abide by all rules of that profession.
I.e. To be a pharmacist in NZ is to agree to be competent in the 7 areas of competency and see 7 areas of service standards are upheld in the environment where you work as a pharmacist

Question 17

What is competence standard 1

Answer 17

Practice pharmacy in a professional and culturally competent manner

cultural competence, clinical competence and ethical conduct are recognised by the pharmacy council as integral to professional pharmacy practice.

This standard Outlines responsibilities which apply to all pharmacists, regardless of their pharmacy practice

Question 18

What is clinical competence?

Answer 18

As expected of a pharmacist, it is the application of knowledge and skills to ensure the safe and quality use of medicines to optimise health outcomes

Question 19

What is ethical conduct?

Answer 19

As described in the pharmacy code of ethics, it is the expression of those principles and values that underpin the pharmacy profession. All pharmacists must understand and apply the legal and ethical requirements to practice pharmacy professionally

Question 20

What is competence standard 2?

Answer 20

Contribute to the quality use of medicines

This covers the role of the pharmacist in promoting the quality use of medicines within an environment of professional pharmaceutical care,

Includes selecting, recommending monitoring and evaluating medicine therapy as part of a health care team

Rational medicine refers to the evidence based selection, monitoring and evaluation of medicine therapy in order to optimise health outcomes

Question 21

What does it mean that at this level (the level of competence standard 2), the pharmacists responsibilities are reactive?

Answer 21

The pharmacist carries out tasks described in this standard in response to requests about individual patients,

Pharmacist is responsible for making recommendations on and providing information about common medicines to other health professionals.

Question 22

What are common medicines?

Answer 22

Those listed in the latest edition of MIMS New Ethicals,

Question 23

What are readily available references?

Answer 23

Those available from within the pharmacy including current editions of martindale, MIMS, BNF, and pharmaceutical schedule

Question 24

What is competence standard 3?

Answer 24

Provide primary health care

This concerns the role of the pharmacist in encouraging and assisting people to take responsibility for their own health

Primary health incorporates holistic care of patients including attention to lifestyle, diet, health promotion, illness prevention, referral and the supply of non prescription medicines, therapies, diagnostic and therapeutic aids.

Involves the pharmacist in treatment, referral and education.

Question 25

What are the pharmacists responsibilities in competence standard 3?

Answer 25

They are reactive,

Pharmacists provides primary health care to individuals in response to requests
Pharmacists assesses, treats, advises for common minor conditions.

Treatment includes all OTC medicines including pharmacist only medicines, and therapies, common diagnostic and therapeutic aids, advice and counselling and referral to health professionals.

Question 26

What are therapies? As recognised under competence standard 3

Answer 26

These include complementary medicines, herbal remedies and other healthcare products not provided by another healthcare provider

Question 27

What is competence standard 4?

Answer 27

Apply management and organisation skills

This covers organisation and management skills common to all pharmacists,
It encompasses the ability to deal with contingencies in the workplace as well as routine work

Question 28

What is the pharmacist responsible for at the level of competence standard 4?

Answer 28

Management and organisation of his or her own work and professional duties within the workplace,

Pharmacist may work alone or with other pharmacists and if in a pharmacy, takes responsibility for the work of non pharmacist staff

Question 29

What is competence standard 5?

Answer 29

Research and provide information.

This covers the role of pharmacist in providing health related info to other health professionals, patients and public

Role includes finding, interpreting, evaluating, compiling, summarising, generating and disseminating info for purposes of optimising medicine related health outcomes

Question 30

What does the research component of competence standard 5 apply to?

Answer 30

Both applied and practice based research covering medicines and all areas within pharmacy and health

Including science, social, cultural, economical and management factors in the health field

Question 31

What does it mean when the pharmacists medicine and health care info responsibilities are reactive?

Answer 31

They carry out tasks described in this standard in response to requests from patients, members of public and health professionals.

Pharmacist provides accurate info to other health professionals, patients and public in a manner that is timely and suitable for the receiver

Question 32

What kind of research is the pharmacist expected to undertake as set out in competence standard 5?

Answer 32

Workplace based research that provides new personal knowledge and or facilitates more effective medicine use or work place management

Question 33

What is competence standard 6?

Answer 33

Dispense medicines.

This covers the supply of prescription medicines, pharmacist only medicines, including extemporaneously compounded products

Question 34

What is the dispensing process?

Answer 34

This includes all actions and responsibilities of the pharmacist from receipt of a prescription, medicine order or patient request through to counselling the patient about the use of the medicine

Pharmacist possesses all prescriptions and medicine orders including practitioners supply orders and bulk supply orders received in written form or by fax, telephone or computer

They dispense pharmacist only medicines and all caregores of prescription medicines.

Question 35

What is competence standard 7?

Answer 35

Prepare pharmaceutical products

This covers the preparation of pharmaceutical products in community and hospital pharmacies,

Pharmacist prepares small quantities of nonsterile or sterile products or including creams, ointments, suppositories, mixtures, suspensions, solutions, and/or TPN eye drops, injections, subcutaneous syringes according to the health and disability services pharmacy services standard NZS8134.7 and standards 5, 6 and 7

Pharmacist explains principles of aseptic dispensing and recognises situations in which it is necessary

Question 36

What is the difference between pharmacy service standards and competency standards?

Answer 36

Pharmacy service standards is to set minimum quality standards for the delivery of the service from a pharmacy

Competency standards relate to the standard of service provided by the pharmacist

Question 37

What competency standard is pharmacy 201 based on?

Answer 37

Competency Standard 7: prepare pharmaceutical products

Pharmacy services standard 5: dispensing, compounding, repackaging and batch preparation

Question 38

Why can you not repackage a container of 2000 paracetemol tablets into containers of 20 tablets each twice a week?

Answer 38

Standard 5 states that size of each batch cannot exceed 100 repackaged units, you are trying to repackage 200

Also cannot be prepared more than once a week unless previous batches have been dispensed or supplied in that period. They are popular, but does not say they sell out

Question 39

What kind of quality assurance could be introduced into the process of extemporaenous compounding?

Answer 39

Label all ingredients and products
Have procedures clearly specified and documented
Have calculations checked by another pharmacist
Have the finishing product checked adequately

Question 40

Why should you wear gloves when compounding if you have inflammed scratches on your hands?

Answer 40

It is part of the service standard 5.11.3 which states that open skin leisons must be covered. If not, the pharmacist should refrain from compounding and dispensing until the condition is corrected.

The pharmacist can still compound and dispense so long as they do not come into direct contact with the pharmaceutical products so wearing gloves is mandatory in this scenario.