Looking for some general guidance regarding retail pharmacy.
Started by justjoe
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
That sounds like a stressful situation. Can you ask the Rx manager for advice on improving your speed? Then you may get better advice, but they'll also know you want to improve and are actively trying to improve.
Advertisement - Members don't see this ad
ummm is this another independent? I'm not really sure what you mean by mid label... but I'm pretty sure you can combine step 1 and 2 in verfying process, and 3 and 4... as for voltaren gel, yeah, nobody cares about that stuff, if the doctor didn't put a max on it, just guess a day supply... as for refills, if they did not indicate refills, always just refill one time only
but these are just general advice, every situation is diiferent, depending on how many scripts your store is doing, and how many people you are working with, I'd be able to estimate how many scripts you need to verify per hour to be considered at least decent
P.S. I haven't been a pharmacist as long as you have, but I trained under one of the most efficient manager in the district, and I consider myself to be pretty effcient lol
but these are just general advice, every situation is diiferent, depending on how many scripts your store is doing, and how many people you are working with, I'd be able to estimate how many scripts you need to verify per hour to be considered at least decent
P.S. I haven't been a pharmacist as long as you have, but I trained under one of the most efficient manager in the district, and I consider myself to be pretty effcient lol
It's an independent chain. The mid label contains all the info that the tech enters. It has the Rx number, patient name, DOB, all the Rx info. And no, we don't scan the Rxs into the computer. For refills, we just make sure that the correct drug gets put into the vial, since the original Rx was checked by a pharmacist. Would you list the steps you take to verify a new Rx? I would like to compare them to what I do. Thanks.
****, that sucks, refills can have mistakes too, an indepedent chain should have upgraded to scanning by now! lol
well my steps would be different than yours because I view the image of the prescription on the computer and the information thats typed to the left, I scan the bottle, verify patient name DOB, medication name direction number of refills, doctor name (correct office too), then there is a DUR page, where I check if there is anything major, then on to the next one
if your store does around 300 scripts, and you verify 20 an hour, then everyone will love you
well my steps would be different than yours because I view the image of the prescription on the computer and the information thats typed to the left, I scan the bottle, verify patient name DOB, medication name direction number of refills, doctor name (correct office too), then there is a DUR page, where I check if there is anything major, then on to the next one
if your store does around 300 scripts, and you verify 20 an hour, then everyone will love you
Huh? If refills are not indicated it is understood to be no refills.
In my situation, the MD didn't put a quantity or refills. The techs usually do enough to get the patient to their next cycle in the nursing home fill and put PRN refills.
no I understood it as, if the doctor faxed back to ok a refill but didn't indicate how many times, then its just for that one time only
I think that I'm around that range. The store I was referring to fills about 300 to 400 Rxs per day, but most are refills, so I don't have to check a hard copy. I just make sure the right drug gets put into the vial, check the day supply, and make sure the directions and dosage look appropriate or are in the dosing range.
300 and 400 can be different, but also depend on how many hours the pharmacy is open, if it's open for 10 hours vs only 8 hours, obiviously you need to verify more... if you have enough tech help, and all you do is verify refills, then you can do 40 an hour or 30 an hour and you should be fine
P.S. around that range can mean alot of things too... 15 an hour vs 20 an hour for example... if 15, you would only verified 75 in 5 hours vs 100... that extra 25 scripts can mean alot
Last edited:
Skip the "appropriateness check" here. Just look at name and DOB.
Check "appropriateness" while you're verifying accuracy here.
Do you always get an on-screen image? Just use that. Stock bottles will slow you down.
Did you just get an image of the correct drug and compare it to what's in the vial? Then this is all a waste of time.
Did you just get an image of the correct drug and compare it to what's in the vial? Then this is also a waste of time.
You might want to do this first, because it will potentially negate all the other work you've just done.
My question is how many do you actually verify a day? If you personally verify ~200 scripts as the sole pharmacist on duty for a given day and clearing the day's scripts requires verifying 400, then the manager would probably be pissed off because he has to clean up after you. (I personally have encountered this with floaters are so slow despite doing nothing but verify and still manage to commit a disproportionate amount of dispensing errors. No PDMP check, no filling, no drop-off/pick-up, don't know how to deal with basic insurance rejects, no problem-solving skills, no critical thinking ability like hmm why am I filling IR opioids from an ED doc when this "patient" goes to "pain management". And they always use the excuse that they can catch up on the weekend. Well if you work only weekdays you don't get time to catch up. Eff you.)
On the other hand I am sympathetic if you have to deal with crappy inaccurate techs (they do sound ****ty if they actually input scripts without quantities written or do PRN refills when none are stated. Specifying a quantity is a ****ing basic requirement of writing a script)
I would do DOB check first (compare mid label to hard copy). Presumably the Rx vial label has the same information as on the back tag/mid label, so I would then check the hard copy against the Rx vial (skip looking at the mid label for other info)..
If the Rx vial label has a description of the drug, use that instead of inspecting stock bottles. Skip NDC check. This is the responsibility of the manager to train techs to enter the right NDC.
On the other hand I am sympathetic if you have to deal with crappy inaccurate techs (they do sound ****ty if they actually input scripts without quantities written or do PRN refills when none are stated. Specifying a quantity is a ****ing basic requirement of writing a script)
I would do DOB check first (compare mid label to hard copy). Presumably the Rx vial label has the same information as on the back tag/mid label, so I would then check the hard copy against the Rx vial (skip looking at the mid label for other info)..
If the Rx vial label has a description of the drug, use that instead of inspecting stock bottles. Skip NDC check. This is the responsibility of the manager to train techs to enter the right NDC.
Last edited:
Steps 1 and 2 seem redundant, did you check name and DOB twice? Just read the prescription once (you can gauge appropriateness here), then immediately read the RX/middle label to make sure everything matches.
Steps 3, 4, and 5 also seem redundant. Why are you even checking NDC? If you get a pill image, that's all you need to check.
Advertisement - Members don't see this ad
there are six things you need to know when verifying a prescription. patient name, doctor name, drug name, directions, quantity, refills. here are your steps for verifying refills:
1) is the name of the patient on the vial in front of you the same as the name of the patient on the prescription? if yes, you are done here
2) is the name of the doctor on the vial in your hands the same as the prescription? if yes, you are done here
3) is the drug and dosage strength on the label the same as specified on the prescription? do the pills in the bottle look like the picture of the pills on the screen? you do not need the stock bottle to verify this. is it more likely than not that the drug and directions are appropriate for a patient of this gender/age? if a controlled substance, are they too early? if yes, you're done here. don't worry about NDCs
4) is the quantity on the label the same as the prescribed quantity? if not, is it likely that it was changed for insurance reasons? if yes to either, you're done here. don't double count unless it's a C2
5) are the refills right? if yes, you're done
you do not need to worry about days supply for refill prescriptions -- use the same days supply as the previous fill.
i ask this in the most sincere way: have you ever been diagnosed with anxiety?
1) is the name of the patient on the vial in front of you the same as the name of the patient on the prescription? if yes, you are done here
2) is the name of the doctor on the vial in your hands the same as the prescription? if yes, you are done here
3) is the drug and dosage strength on the label the same as specified on the prescription? do the pills in the bottle look like the picture of the pills on the screen? you do not need the stock bottle to verify this. is it more likely than not that the drug and directions are appropriate for a patient of this gender/age? if a controlled substance, are they too early? if yes, you're done here. don't worry about NDCs
4) is the quantity on the label the same as the prescribed quantity? if not, is it likely that it was changed for insurance reasons? if yes to either, you're done here. don't double count unless it's a C2
5) are the refills right? if yes, you're done
you do not need to worry about days supply for refill prescriptions -- use the same days supply as the previous fill.
i ask this in the most sincere way: have you ever been diagnosed with anxiety?
You are being compared to your peers, almost in every place of employment. Since retail pharmacy is about numbers (script counts, verification rate, error rate, etc.), you want to be at least average as far as speed. If you have seen what others do to get their speed up when you worked side by side with them, then that is what you have to do and tailor it to your process. I think if you focus on getting the script out on-time (customer service) and not leaving excessive work/mess for the next guy coming in, you'd be ok. You don't have to be super fast at managing those. It helps but it is not everything.
Now if you feel you can't go above your comfort level and not make mistakes, then you would need different setting. The reality is that every pharmacist carries same liability and responsibility, so yes, it is not exactly fair if extra burden is put on the next guy or if results suffer.
Why don't you just come in and shadow another pharmacist. That is what I would do if I was concerned about my job security or unsure on how they do it better than you.
Now if you feel you can't go above your comfort level and not make mistakes, then you would need different setting. The reality is that every pharmacist carries same liability and responsibility, so yes, it is not exactly fair if extra burden is put on the next guy or if results suffer.
Why don't you just come in and shadow another pharmacist. That is what I would do if I was concerned about my job security or unsure on how they do it better than you.
I got this info from another pharmacist and it helped me surviving retail pharmacy...so here I share.
************************
http://forums.studentdoctor.net/thr...ion-in-retail-pharmacy.1041223/#post-14990825
Agreed, and here is my List of 7 steps that I Must Check:
1. (Letter) Name of patient: Must match. Why? If that is wrong, the patient can die and I can lose my license.
2. (Number) Date of Birth: Must match. Why? If that is wrong, the patient can die and I can lose my license.
3. (Letter) Name of med: Must match. Why? If that is wrong, the patient can die and I can lose my license.
4. (Number) Strength (milligrams, grams, mEq, percent, ratio (250 mg / 5 ml), Bactrim DS, Bactrim SS...): Must match. Why? If that is wrong, the patient can die and I can lose my license.
5. (Letter) Instruction: Must match. Why? If that is wrong, the patient can die and I can lose my license.
6. (Number) Imprint on pill (or NDC of liquid): Must match. Why? If that is wrong, the patient can die and I can lose my license.
7. Of course, must check Drug Interactions. Why? If that is wrong, the patient can die and I can lose my license.
I MUST ALWAYS check the 7 items above. Why? Life is very important, theirs or yours.
The rest, I may check or no, depending on situation.
Why? May have trouble later but NOT deadly.
Date of script? May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
Name of doctor? May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
Signature of doctor? May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
Quantity written? May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
Quantity counted by my tech? May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
Refills? May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
Day supply? (Fear insurance audit) May check or no. If that is wrong, the patient WILL NOT die and I WILL NOT lose my license.
http://forums.studentdoctor.net/thr...ion-in-retail-pharmacy.1041223/#post-14990825
**************
Let's hold hand and work together as friends:
1. I look at the Rx and determine if the prescription is:
appropriate, I would skip this.
dosage, I would skip this because I do this in step 2 do after checking DOB of step 1.
directions, etc. I would skip this because I do this in step 2 do after checking DOB of step 1.
Then I
match patient name and DOB on the Rx to name DOB on the middle label: Good. I do this because patient may die and I may lose license.
2. Match Rx label with prescription:
Patient name, DID IN STEP 1. I would skip this. Or skip step 1 and start with this: Check name and DOB here.
drug, Good. I do this because patient may die and I may lose license.
strength, Good. I do this because patient may die and I may lose license.
sig, Good. I do this because patient may die and I may lose license.
quantity, Good. I do this because patient may die and I may lose license.
refills, : I often skip this because patient will not die.
doctor, : I often skip this because patient will not die.
Next I flip the Rx over and check using the middle label,
day supply, : I often skip this because patient will not die.
date written, : I often skip this because patient will not die.
origin, : I often skip this because patient will not die.
DAW code: I often skip this because patient will not die.
3. Open the stock bottle and open the medication vial and make sure the same drugs are in each. I often skip this because I check LABEL and REAL PILL (or if liquid, LABEL'S NDC and REAL BOTTLE'S NDC). Please remember, the patient will find out wrong pill because the patient will see description on label and description on pill. If descriptions don't match, patient will freak out. Think about phenazopyridine 100 mg: my label shows different imprint even if I have correct bottle. I have to cross that out and hand write correct imprint so patient will not freak out. Compare label's imprint and pills' imprint.
At some locations, I do not get a stock bottle. Instead on the screen in the computer system, a picture or description of the medication appears. I often skip this because I don't trust the picture on the computer (often seen wrongly at my national chain pharmacy.) Compare label's imprint and pills' imprint.
4. Match drug name and strength on the stock bottle, to drug name/strength on vial, to drug name/strength on the prescription:
That means: 4.A Match drug name and strength: bottle to vial,: I skip this because I don't trust stock bottle: I have seen enough people putting wrong pills back into wrong stock bottle. Compare label's imprint and pills' imprint.
That means: 4.B Match drug name and strength: vial to prescription: I skip this because we did in step 2C already. Let's review:
Step 2. Match Rx label with prescription:
Patient name,
drug,
strength, Good. I do this because patient may die and I may lose license.
I checked already in step 3: I check LABEL and REAL PILL (or if liquid, LABEL'S NDC and REAL BOTTLE'S NDC). Compare label's imprint and pills' imprint.
5. Match NDC on Rx label to NDC on stock bottle: This is same step 3 for me. I often skip pill bottle because I checked already in step 3: I check LABEL and REAL PILL (or if liquid, LABEL'S NDC and REAL BOTTLE'S NDC). Compare label's imprint and pills' imprint. Once we are sure we matched label's imprint and pills' imprint, we don't need to worry about bottle at all. In fact, we don't even need the pill bottle at my chain pharmacy. We only get liquid bottle to compare bottle's NDC or color of liquid with label's description. Remember, the patient will see label and drug. Descriptions must match.
6. For some drugs, and all controlled substances, I go into the profile to determine if they've had the medication before, or if the controlled substance is okay to be filled on that date: Good. I do this because patient may die because of NEW DOSE of same drug. If we don't stop old drug, they take both, they overdose and die and I may lose license.
Thank you for listening and try out the comments here.
Please share so we all can improve.
Last edited:
for the love of god please do not listen to the 7 steps listed by helpfulpharmer, i thought people already said that was horrible advice in the other thread, yeah you will not lose your license, but you sure as hell will make the other pharmacists job alot harder and you are a floater, good luck at being asked back if you follow that 7 steps and not check other things listed
this is retail pharmacy, especially chain, you either go fast or go home.
i do agree, some of the stuff you still need to check even though you wont lose your license, the stores might kick you out
A lot of this is building up your own confidence so you can quickly check things, and not 2nd guess yourself.
1) I check pt name & DOB, if this is wrong then you haven't wasted time checking anything else....you say you check for appropriateness before you check the pt name & B-date, but there is no way you can know if a prescription is appropriate, if you haven't checked the patient b-date and name/gender first.
2) I check dr name & office, if name or office is wrong it makes major headaches when trying to get refills. But check this quickly, its not critical if you make an error here. This is a minor step to get out of the way quickly.
3) I check drug name, drug strength, directions, qty, refills, date written. Spend the most time here, its critical you get it right, but have the confidence to trust yourself to get it right. If that makes sense. Look at it all carefully, then move on to the next part (don't reread & reread everything triple checking yourself.) If something is extremely odd, then yes, double check, but if everything is normal, move on.
4) I check the patient profile (almost always) and DUR screen. Again, do this quickly, train yourself to look for major concerns, but don't get nitpicky about every details.
5) Check the product against *either* the vial label/computer image/physical bottle. Checking against the vial label or the computer image is best, but either of the 3 will do. There is no need to check against all 3, and certainly no need to check NDC's (the exception being if its something like diltiazem that comes in a thousand different forms and you question if the right generic was picked....but for 99% of drugs, the exact NDC doesn't matter.)
Then bag and move on. You want to check thoroughly, but keep moving. Go efficiently from one step to the next, and don't double & triple check everything you do. Have confidence in yourself.
1) I check pt name & DOB, if this is wrong then you haven't wasted time checking anything else....you say you check for appropriateness before you check the pt name & B-date, but there is no way you can know if a prescription is appropriate, if you haven't checked the patient b-date and name/gender first.
2) I check dr name & office, if name or office is wrong it makes major headaches when trying to get refills. But check this quickly, its not critical if you make an error here. This is a minor step to get out of the way quickly.
3) I check drug name, drug strength, directions, qty, refills, date written. Spend the most time here, its critical you get it right, but have the confidence to trust yourself to get it right. If that makes sense. Look at it all carefully, then move on to the next part (don't reread & reread everything triple checking yourself.) If something is extremely odd, then yes, double check, but if everything is normal, move on.
4) I check the patient profile (almost always) and DUR screen. Again, do this quickly, train yourself to look for major concerns, but don't get nitpicky about every details.
5) Check the product against *either* the vial label/computer image/physical bottle. Checking against the vial label or the computer image is best, but either of the 3 will do. There is no need to check against all 3, and certainly no need to check NDC's (the exception being if its something like diltiazem that comes in a thousand different forms and you question if the right generic was picked....but for 99% of drugs, the exact NDC doesn't matter.)
Then bag and move on. You want to check thoroughly, but keep moving. Go efficiently from one step to the next, and don't double & triple check everything you do. Have confidence in yourself.
