Sig components?

[Asia]

---

Members don't see this ad.

I am working with a few seasoned (read: stubborn) techs that disagree with me on what a proper vial label should include as far as directions for use go.

I say they should include dose, form, route and frequency. They say route and sometimes frequency can be omitted, as in: "take 1 tablet in the morning". In my book, it should say: "take 1 tablet by mouth every morning".

Who's right?! I'm in CA by the way, but in a military facility.

Thanks!

 

[Ackj]

Not sure if it's law or just good practice, but I always include "by mouth" for orals. Most computer systems should automatically give you the complete sig when you type in the code, for example 1am gives you "take one (tablet/capsule/teaspoonful) by mouth in the morning."

Many times the doc will write "po" so if he does you probably must legally include it. No harm from putting it, but maybe harmful if you don't put it (antibiotic suspension for ear infection goes where?).

Ultimately, you're the pharmacist, they're the tech. Unless they can cite some law or policy saying that your way is wrong, they should be doing it however you prefer.

 

[Chris co2012]

I am working with a few seasoned (read: stubborn) techs that disagree with me on what a proper vial label should include as far as directions for use go.

I say they should include dose, form, route and frequency. They say route and sometimes frequency can be omitted, as in: "take 1 tablet in the morning". In my book, it should say: "take 1 tablet by mouth every morning".

Who's right?! I'm in CA by the way, but in a military facility.

Thanks!

Okay, well this is the part where you tell your techs to go find the guidelines to back up their statements. The FDA is a good place to start.

BTW, I have heard stories of patients trying to swallow suppositories. I've heard of patients placing transdermal patches in their mouthes. So if the route is omitted, then it's an adverse event. And a pharmacist's job is to minimize adverse events.

Adverse reaction: Not preventable
Adverse event: Preventable

 

[Corpseman]

Civilian or military techs?

If military, you tell them to shut up and do their job the way you demand.

 

[Pharmizzle]

Are you a civilian working with military techs? In my experience, a lot of the non-commissioned officer techs would often forget that they aren't pharmacists.🙄

Ask if you can check your pharmacy's Operating Instructions to see if there's anything written there. If not, talk to your pharmacy's officer-in-charge about the issue.

 

[Carboxide]

I always do it the way you like it. And the idea of leaving out frequency is just preposterous. If I were you I would repeatedly send it back until they get the idea that it's better to do it how you want it the first time.

 

[R2pharmD2]

Ultimately, you're the pharmacist, they're the tech. Unless they can cite some law or policy saying that your way is wrong, they should be doing it however you prefer.

Seriously. It's your name on the prescription. It should say whatever the heck you want it to say.

 

[delano2000]

I agree with everyone else. Ultimately you are the pharmacist and they are the techs. You have the final say.

 

[farmadiazepine]

You should relax a little bit, its not that big of a deal. Don't send it back if its not the way you like it, then your going to create tension between you and your staff.

Ask yourself is it really a big deal between "Take 1 tab daily" vs "Take 1 tab by mouth daily" ?

For me, I say no.

The best is the CVS sig code when MD's send E-rx's with the SIG as: 1 (ONE) DAILY and no one changes it and it gets all the way to verification..

We don't even bother changing it. We leave it.

 

[Asia]

LOL, this is exactly what I'm dealing with: an NCO with 19 years of experience. I may outrank him but I still get crap from him. Unfortunately, my OIC doesn't care and prefers not to create problems.

I keep getting an argument that they've done it like this for years and none of the previous pharmacists (civilian or military) asked them to do what I'm asking (really?!).
Anyway, I pretty much did what most here recommended. Told them "it is my license and let's not discuss it further." There's been some improvement but still, a lot of resistance. It's a work in progress I guess.

 

[Notecard]

The best is the CVS sig code when MD's send E-rx's with the SIG as: 1 (ONE) DAILY and no one changes it and it gets all the way to verification..

We don't even bother changing it. We leave it.

Or when the E-rx bypasses the entering tech, goes straight into dispensing and when it gets to verification the pharmacist yells at you for being lazy

 

[Pharmgrlnxdor]

The argument that "they have done it this way for years" is a cop out and they might as well just admit that they don't want to change what they are doing because they are lazy. Who cares how many millions of years they have done it this way...it is a less accurate method that may not affect anyone for your whole career or one day it could really harm someone. Do you know which situation will occur? Can you predict this? The answer is no. Which is why they teach us to be specific. Because someone, somewhere along the line is going to do it wrong unless they are given specific instructions. You are there to make sure they get those instructions. You have been educated on health literacy and the different levels of health literacy you will encounter. Those techs have not been taught this and they show their ignorance by not caring enough to be specific and thorough. Care more about your patients then your "stubborn" techs and you will be fine.