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Focus on managing medicines

23 February 2017

This month we are focusing on managing and dispensing medicines safely and effectively, in our series of articles which we hope will help pharmacy owners and the pharmacy team continually improve the services they provide to patients and the public.

Pharmacy professionals play a vital role in supplying medicines safely and helping their patients to make informed decisions about their medicines and manage their treatment and care.

Managing and identifying the risks associated with pharmacy services including the supply of medicines is essential to improve the outcomes for people using pharmacy services. To do this, it is important that procedures are in place to ensure that medicines are obtained from a reputable source, stored securely, safeguarded from unauthorised access, and are safe and fit or purpose.

We acknowledge that for anyone operating a registered pharmacy there will always be competing professional, managerial, legal and commercial demands.  But medicines are not ordinary consumer goods so as a pharmacy owner, it’s important to make sure you comply with all legal requirements and dispensing is carried out by appropriately qualified people.

Changes in society and scientific and technological developments such as the greater use of dispensing robotics and the automation of supply processes mean that pharmacy services will continue to adapt and evolve. We recognise that this may have the potential to create new and different risks compared to those of a ‘traditional’ pharmacy service. Despite this, pharmacy owners should continue to make sure that the dispensing process is safe and effective.

The case studies below are examples of what we have seen from our inspection of registered pharmacies and show how medicines can be managed and dispensed safely.

Case study one

A pharmacy near a drug treatment centre provided services that were heavily focused on instalment supplies of methadone and buprenorphine, and needle exchange services. The pharmacy was particularly good at identifying and managing the risks associated with the services it provided. Methadone and buprenorphine instalment supplies were prepared in a well-organised, secure and safe manner. They were clearly labelled and stored securely in the CD cabinet with the prescription until they were collected. There was also evidence of actions that had been taken after previous adverse incidents to prevent them happening again.

Case study two

A village pharmacy had an established process for dispensing and an audit trail was in place for dispensed medicines. This workflow was continually monitored and reviewed and changes were made, as needed. There was a strong emphasis on minimising risk and avoiding repetition of mistakes. Importantly, there were processes in place to make sure that there was no disruption to services in the absence of the regular pharmacist. For example, there was a comprehensive folder, easily accessible on the checking bench, to help locum and relief pharmacists understand the dispensing process, as well as the tasks and competencies of each member of staff. Even though the pharmacy was not very big, the space was well-utilised and the dispensing space was divided in two distinct areas, which provided a dedicated area free of distraction for high risk dispensing activities.

Case study three

A prison pharmacy had carried out an audit after identifying that the way it supplied medicines to patients was not leaving suitable time gaps between doses due to a change in the prison day. Staff considered which medicines were not suitable to be administered because of the changes and revised some formulations of medicines, so that they could supply longer acting options. This meant that the needs of the patients were not compromised by the change in the prison regime. The changes were communicated to individual patients by the pharmacy team before they were put in place to make sure that each person was aware of how it could affect them and why the changes were happening. If changes were not possible then safe ways to administer the remaining night time doses were found and implemented.

Case study four

An accuracy checking technician was largely responsible for managing the pharmacy’s service to 13 nursing homes. Disposable MDS trays were used to supply medicines to about 270 patients who had compliance difficulties and the system was very well-managed, using a separate dispensary at the rear of the premises which had its own telephone line. The technician produced MAR charts to accompany the nursing home MDS trays and had personalised these at their request: each home had their own specific reasons for non-administration printed on bespoke MARs. All trays were labelled with descriptions to enable identification of individual medicines and patient information leaflets were routinely supplied. A dispensary assistant visited the three largest nursing homes regularly to go through the monthly medication delivery with nursing staff and to deal with any problems or queries. The pharmacy had a good relationship with the medicines management technician for the local Health Board and would frequently liaise with her about any logistical problems with medicines that occurred when patients were transferred from the community into a nursing home.

Find out more

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