Technician Training and Technician Training and Roles in Institutional Roles in Institutional Pharmacy PracticePharmacy Practice

Cindy Wilson, Pharm.D.Cindy Wilson, Pharm.D.Harborview Medical CenterHarborview Medical Center

Learning ObjectivesLearning Objectives

Understand laws regarding technician training, Understand laws regarding technician training, certification, licensure, and utilizationcertification, licensure, and utilization

Review types of training programsReview types of training programs

Understand role of technicians in institutional Understand role of technicians in institutional pharmacypharmacy

Legal definitionsLegal definitions

““Pharmacy technician" isPharmacy technician" is (a) A person who is enrolled in, or who has satisfactorily (a) A person who is enrolled in, or who has satisfactorily

completed, a board approved training program….orcompleted, a board approved training program….or

(b) A person who is a graduate with a degree in pharmacy (b) A person who is a graduate with a degree in pharmacy or medicine of a foreign school, university, or college or medicine of a foreign school, university, or college recognized by the boardrecognized by the board

"Pharmacy assistant" is"Pharmacy assistant" isa person registered by the board to perform limited a person registered by the board to perform limited functions in the pharmacyfunctions in the pharmacy

RCW 18.64A.010RCW 18.64A.010

May I see your license and May I see your license and registration?registration?

Licensure = Agency of government grants permission to engage in a Licensure = Agency of government grants permission to engage in a given occupation once the applicant has attained the minimal degree given occupation once the applicant has attained the minimal degree of competency necessary to ensure that the public health, safety, and of competency necessary to ensure that the public health, safety, and welfare will be reasonably well protected. Technicians are licensed welfare will be reasonably well protected. Technicians are licensed by the state.by the state.

Certification = Non-governmental agency or association grants Certification = Non-governmental agency or association grants recognition to an individual who has met certain predetermined recognition to an individual who has met certain predetermined qualifications specified by that agency or association (accreditation qualifications specified by that agency or association (accreditation refers to an institution). Technicians are certified by their training refers to an institution). Technicians are certified by their training site.site.

Registration = to make or secure official entry of in a registerRegistration = to make or secure official entry of in a register. . So, So, registration with the State means you are on their list of persons registration with the State means you are on their list of persons operating as an assistant. Assistants are registered.operating as an assistant. Assistants are registered.

It’s the law…It’s the law…

The board shall adopt…rules governing the extent to The board shall adopt…rules governing the extent to which pharmacy ancillary personnel may perform which pharmacy ancillary personnel may perform services associated with the practice of pharmacy.services associated with the practice of pharmacy.

These rules shall provide for the certification of These rules shall provide for the certification of pharmacy technicians by the department….pharmacy technicians by the department….

RCW 18.64A.030RCW 18.64A.030

It’s the law…It’s the law…

Pharmacy assistants may perform, under the Pharmacy assistants may perform, under the supervision of a licensed pharmacist, duties including supervision of a licensed pharmacist, duties including but not limited to, typing of prescription labels, filing, but not limited to, typing of prescription labels, filing, refiling, bookkeeping, pricing, stocking, delivery, refiling, bookkeeping, pricing, stocking, delivery, nonprofessional phone inquiries, and documentation nonprofessional phone inquiries, and documentation of third party reimbursements and other such duties of third party reimbursements and other such duties and subject to such restrictions as the board may by and subject to such restrictions as the board may by rule adopt. rule adopt.

RCW RCW 18.64A.03018.64A.030

It’s the law…It’s the law…

Pharmacy Technicians may assist in Pharmacy Technicians may assist in performing, under the supervision and control performing, under the supervision and control of a licensed pharmacist, manipulative, of a licensed pharmacist, manipulative, nondiscretionarynondiscretionary functions associated with functions associated with the practice of pharmacythe practice of pharmacy

RCW 18.64A.030RCW 18.64A.030

Pharmacist’s ResponsibilityPharmacist’s Responsibility

……the pharmacy or pharmacist shall retain the pharmacy or pharmacist shall retain responsibility for any act performed by responsibility for any act performed by pharmacy ancillary personnel in the course of pharmacy ancillary personnel in the course of employment.employment.

RCW 18.64A.080RCW 18.64A.080

Pharmacist : TechnicianPharmacist : Technician

……no pharmacist may supervise more than one no pharmacist may supervise more than one pharmacy technician…pharmacy technician…

EXCEPTEXCEPT In the preparation of medicine or In the preparation of medicine or other materials used by patients within the other materials used by patients within the facility, one pharmacist supervising no more facility, one pharmacist supervising no more than three pharmacy techniciansthan three pharmacy technicians

RCW 18.64A.040RCW 18.64A.040

Pharmacy AssistantsPharmacy Assistants

The pharmacy assistant may assist a pharmacist in The pharmacy assistant may assist a pharmacist in performance of all tasks performance of all tasks exceptexcept those reserved to those reserved to the pharmacist and pharmacy technician.the pharmacist and pharmacy technician.

Pharmacy ancillary personnel may record or Pharmacy ancillary personnel may record or provide medication data when provide medication data when no interpretationno interpretation is is required.required.

WAC 246-WAC 246-901-020901-020

Pharmacy AssistantsPharmacy Assistants

May prepackage and label drugs for subsequent use May prepackage and label drugs for subsequent use in dispensing operationsin dispensing operations

May count, pour, and label for individual May count, pour, and label for individual prescriptionsprescriptions

May stock medicationsMay stock medications

BillingBilling

Clerical workClerical work

Deliver medicationsDeliver medications

Pharmacy Technicians may…Pharmacy Technicians may… perform certain perform certain nondiscretionarynondiscretionary and specialized and specialized

functions consistent with their training in pharmacy functions consistent with their training in pharmacy practice while under the immediate supervision of a practice while under the immediate supervision of a licensed pharmacistlicensed pharmacist

perform entry of a new medication order into the perform entry of a new medication order into the pharmacy computer system and retrieval of the drug pharmacy computer system and retrieval of the drug product to fill a prescription are tasks reserved to the product to fill a prescription are tasks reserved to the pharmacist and pharmacy technicianpharmacist and pharmacy technician

assist a pharmacist in the performance of all tasks assist a pharmacist in the performance of all tasks except those reserved to a pharmacistexcept those reserved to a pharmacist

WAC 246-WAC 246-901-020901-020

A pharmacist shall not delegate… A pharmacist shall not delegate… professional responsibilitiesprofessional responsibilities

Consultation with patients & providersConsultation with patients & providers

Receipt of verbal order, other than refill authorizationReceipt of verbal order, other than refill authorization

Professional judgmentProfessional judgment

Interpretation of dataInterpretation of data

Ultimate responsibility for all aspects of completed Ultimate responsibility for all aspects of completed prescriptionprescription

Professional communications with providersProfessional communications with providers

Dispensing to patients with proper informationDispensing to patients with proper information

WAC 246-863-095WAC 246-863-095

What What cancan technicians do? technicians do?

Prescription preparationPrescription preparation Compounding Compounding Computer entry of new orderComputer entry of new order Retrieval of drug productsRetrieval of drug products Medication inventory managementMedication inventory management Information management when no interpretation is Information management when no interpretation is

requiredrequired TrainingTraining

What What can’tcan’t technicians do? technicians do?

Receive verbal orders for prescriptionsReceive verbal orders for prescriptions Consult with patients or providers, Consult with patients or providers, exceptexcept providing providing

information not requiring professional judgment like dates information not requiring professional judgment like dates of refills or prescription price informationof refills or prescription price information

Consult with providers regarding patients, except Consult with providers regarding patients, except interpret data in patient medical recordinterpret data in patient medical record

Final check on completed prescriptionsFinal check on completed prescriptions

Training requirementsTraining requirements Pharmacy technicians must obtain education or training from Pharmacy technicians must obtain education or training from

one of the following:one of the following: Formal academic program Formal academic program On-the-job training program On-the-job training program

The minimum educational prerequisite for entering a training The minimum educational prerequisite for entering a training program shall be high school graduation or G.E.D program shall be high school graduation or G.E.D

An out-of-state pharmacy technician applicant must meet the An out-of-state pharmacy technician applicant must meet the same requirements as a pharmacy technician trained in this same requirements as a pharmacy technician trained in this state state

Applicants whose academic training has been obtained in Applicants whose academic training has been obtained in foreign countries shall meet certification requirementsforeign countries shall meet certification requirements

WAC 246-901-WAC 246-901-030030

Training requirementsTraining requirements

Pharmacy technician and assistant applicants Pharmacy technician and assistant applicants must complete four clock hours of AIDS must complete four clock hours of AIDS educationeducation

WAC 246-901-120WAC 246-901-120

Technician training programsTechnician training programs

Community Colleges (NSCC, Edmonds CC)Community Colleges (NSCC, Edmonds CC)

Trade/Technical Schools (PIMA, Bryman)Trade/Technical Schools (PIMA, Bryman)

MilitaryMilitary

On-the-job training (Board approved programs)On-the-job training (Board approved programs)

Basic competencies for technician Basic competencies for technician training programstraining programs

Chemistry & PharmacologyChemistry & Pharmacology

Drug info: classes, names (brand & generic), Drug info: classes, names (brand & generic), dosages, dosage forms, routes, etc.dosages, dosage forms, routes, etc.

Interpretation of prescriptionsInterpretation of prescriptions

Drug preparation & distributionDrug preparation & distribution

Inventory controlInventory control

Safety and infection control proceduresSafety and infection control procedures

Pharmacy lawPharmacy law

Communication skillsCommunication skills

Professional developmentProfessional development

Basic competencies for technician Basic competencies for technician training programstraining programs

American Society of Health-American Society of Health-System PharmacistsSystem Pharmacists

ASHP Technical Assistance Bulletin on Outcome ASHP Technical Assistance Bulletin on Outcome Competencies and Training Guidelines….Competencies and Training Guidelines….

• Outcome competencies and training guidelines Outcome competencies and training guidelines for institutional pharmacy technician training for institutional pharmacy technician training programsprograms

• Contains 11 primary objectivesContains 11 primary objectives

• Intended to be general enough that the trained Intended to be general enough that the trained technician can function well in most hospital technician can function well in most hospital settingssettings

Model Curriculum for Technician TrainingModel Curriculum for Technician Training

Developed in collaboration with APhA, National Assoc. of Developed in collaboration with APhA, National Assoc. of Drug Store Chains, two national technician groupsDrug Store Chains, two national technician groups

ASHP accreditation of technician training programsASHP accreditation of technician training programs

• Over 90 programs accreditedOver 90 programs accredited

• 3 in Washington3 in Washington

American Society of Health-System American Society of Health-System PharmacistsPharmacists

National Pharmacy Technician National Pharmacy Technician Certification ExamCertification Exam

Closed book exam of 125 multiple choiceClosed book exam of 125 multiple choicequestions covering:questions covering:

• Assisting pharmacist in serving patients (50%)Assisting pharmacist in serving patients (50%)

• Medication distribution & inventory control Medication distribution & inventory control systems (35%)systems (35%)

• Operations, including administrative activities Operations, including administrative activities like human resources & information systems like human resources & information systems (15%)(15%)

Specialized and developing rolesSpecialized and developing roles

Investigational Drug ServicesInvestigational Drug Services

Unit-dose medication checking (tech-check-tech)Unit-dose medication checking (tech-check-tech)

Automation system managersAutomation system managers

Unit Pharmacy Technicians (UPT’s)Unit Pharmacy Technicians (UPT’s)

Pharmacy Benefits Managers (PBM’s)Pharmacy Benefits Managers (PBM’s)

Computer information systemsComputer information systems

Billing specialistsBilling specialists

Pharmacist–Technician Pharmacist–Technician RelationshipRelationship

Supervisor

Mentor Preceptor

Technician