This applies to: Path 1 Pharmacy Technician Assessment (PTA) Path 2 Structured Practical Evaluation (SPE)

Transcription

1 1224 ch. Mountain Rd., Unit(é) 8 Moncton, N-B E1C 2T6 Tel: (506) Fax / Téléc: (506) info@nbpharmacists.ca The training manual may only be started after the pharmacy technician student receives acknowledgement from the NB College of Pharmacists that the Apprenticeship Agreement form they submitted is approved. This applies to: Path 1 Pharmacy Technician Assessment (PTA) Path 2 Structured Practical Evaluation (SPE)

2 Pharmacy Technician Assessment (PTA) Training Manual Path 1 New Brunswick College of Pharmacists December, 2014

3 This manual is adapted from information obtained from: Nova Scotia College of Pharmacists British Columbia College of Pharmacists Alberta College of Pharmacists 2 Path 1

4 Contents Acronyms and websites... 4 Introduction... 5 Objectives of the training program... 7 Upon completion of the training program... 7 Program Requirements... 8 Student requirements... 8 Preceptor requirements:... 9 Practice site requirements: Regulations Legislation - The New Brunswick College of Pharmacists Orientation to the practice site Community Orientation to the Practice site Hospital Dispensing process Skills Assessment (Pre and End) documentation form Personal Learning Plan Structured Practice Experience Program Appendices Appendix 1 Student Evaluation of the training period and Preceptor Appendix 2: - Preceptor Evaluation Appendix 3 Statement of Completion of Student Training Appendix 4 Competencies & Documentation of Skills Workbook Appendix 5 Prescription Daily Tracking Log Path 1

5 Acronyms and websites CDSA Controlled Drugs and Substances Act CPhA Canadian Pharmacists Association CPSNB CSHP College of Physicians and Surgeons of New Brunswick Canadian Society of Hospital Pharmacists NABP NAPRA NBCP NBPDP NBPA PIPEDA RIPPA PHIPAA National Association of Boards of Pharmacy National Association of Pharmacy Regulatory Authorities New Brunswick College of Pharmacists New Brunswick Prescription Drug Program New Brunswick Pharmacists Association Personal Information Protection and Electronic Documents Act NB Bill 89 Right to Information and Protection of Privacy Act NB Bill 9 Personal Health Information Privacy and Access Act F & D Act Food and Drugs Act e.htm 4 Path 1

6 Introduction The purpose of this manual is to provide the pharmacy technician student and the preceptor a framework for assessing the competencies, knowledge and skills required of the pharmacy technician student to practice as a pharmacy technician in New Brunswick. The training period is a learning process! The education of the pharmacy technician student is accomplished by a process of explanation, repetitive practice and constructive criticism through, and with, an experienced preceptor. The intent of this training period is to immerse the pharmacy technician student in a practice setting thereby providing a transition period between the academic environment and the real world of practice, prior to licensure. This will give the student the opportunity to apply his/her acquired academic skills with actual "on the job" situations and develop the knowledge, skills and attitudes required for competent pharmacy practice. For the program to be successful, it is important that the pharmacy technician student perform her/his activities under the guidance of the preceptor. An atmosphere suitable to asking questions is absolutely necessary. What may seem simple and straightforward to an experienced preceptor may be very unclear to the student. This Path 1 program is developed for pharmacy technician students with previous experience. They must still review this manual completely, although they may proceed faster than a pharmacy technician student who has had minimal contact hours in a dispensary. (Preceptors must also remember that the separate Path 2 program of student training is geared to an individual who has had minimal contact hours in a dispensary.) Preceptors are required to forward the final evaluation report to the New Brunswick College of Pharmacists (NBCP) once the content of the manual has been reviewed and discussed with the pharmacy technician student. The preceptor s signed statement, indicating successful completion of the training program, is the final step in the pharmacy technician student training process before moving to the steps of licensure. We trust the training period will be educational and enjoyable and that it will stimulate continued learning, and providing quality services to clients. One of the qualifications for registration and licensure as a pharmacy technician with the New Brunswick College of Pharmacists (NBCP) is defined in Regulation 12.3(e) Persons who have not graduated from a CCAPP accredited program but wish to apply for licensure as a pharmacy technician may, until December 31, 2018, be registered as pharmacy technicians if they meet the following conditions: (e) have successfully completed a structured practical training program approved by Council. 5 Path 1

7 The Pharmacy Technician Assessment (PTA) is an assessment of the pharmacy technician candidate s competencies performed in the workplace by an approved licensed pharmacy technician or pharmacist preceptor. NOTE: Path 1 students are not limited to a 6-week training period. Depending on experience and previous training, the student may complete the required activities in less than 6 weeks, or may take longer to complete. The pharmacy technician student must be familiar with the activities that fall within the licensed pharmacy technician s scope of practice in New Brunswick. These are based on competencies set forth in the National Association of Pharmacy Regulatory Authorities (NAPRA) Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice (2014) The pharmacy technician candidate is required to demonstrate competence to the satisfaction of the preceptor, regardless of the practice setting where completion of the assessment is taking place. Activities are to be completed in areas where a combination of self-assessment or preceptor assessment indicate knowledge or skills gaps. For Path 1 students, prior work experience in a practice site(s) may provide the knowledge and skills that meet some, or all, of the competencies for practice. Path 1 students should complete a self-assessment of knowledge and skills, discuss with his/her preceptor and both must sign-off on the Path 1 student s competencies. Path 1 students are required to complete those activities and exercises listed in the manual that were identified as lacking sufficient competency (lacking knowledge or skill) to perform. 6 Path 1

8 Objectives of the training program The primary objective of the training period is to use the knowledge and skills learned in your educational program and/or workplace training to develop skills in providing pharmacy services in a real world setting. This program covers general pharmacy practice and the 9 competencies defined in the NAPRA Professional Competencies for Canadian Pharmacy technicians at Entry to Practice. The following objectives are part of, and support, the provision of pharmacy services: 1. Maintain the client medication profile, evaluate therapy (example: duplication, adherence), and evaluate new prescriptions, and to resolve potential and existing problems. 2. Accurately dispense medication according to the prescription. 3. Assist the client on the use of medical devices. 4. Communicate with clients and/or health professionals regarding drug and health information. 5. Comply with all legal requirements associated with the distribution of drugs and the operation of a pharmacy. 6. Provide information and/or referral services in emergencies and upon request. 7. Develop and exercise appropriate professional judgment. 8. Be knowledgeable of, and maintain, ethical and professional standards of practice. Completing the training outlined in this manual will enable the pharmacy technician student to further develop his/her knowledge base, skills and attitudes necessary for the provision of quality pharmacy care to clients. Upon completion of the training program No later than two weeks after completing the work as set out in this manual, the student must submit the following to the NBCP office: Item Preceptor Sign off Required Skills Assessment (Pre & End) documentation form Yes Personal Learning Plan Yes Appendix 1 Student Evaluation of the training period and Preceptor - Appendix 2 - Preceptor Evaluation Yes Appendix 3 Statement of completion of Student Training Yes Appendix 4 Competencies & Documentation of Skills Workbook Yes It is the ultimate responsibility of the student to ensure the required items for registration are sent to the NBCP office. 7 Path 1

9 Note: Appendix 5 Daily tracking log: do not send with other documents; retain for your records. Program Requirements Student requirements In order to complete the New Brunswick College of Pharmacists Pharmacy Technician Assessment Program, the Path 1 applicant must: A. Complete at least the PEBC Evaluating Exam and the four Bridging Modules. B. Be registered with the New Brunswick College of Pharmacists as a Pharmacy Technician Student. C. Ensure the Apprenticeship Agreement form has been sent to the NBCP office and the preceptor has been approved prior to starting the training period. D. Be supervised throughout the training period by a licensed pharmacist or pharmacy technician. The pharmacist or pharmacy technician will ensure that any pharmacy technician student engaged in practice experience has the level of supervision that, in the professional judgment of the preceptor, is required to ensure safe and effective client care given the knowledge, skills and experience of the pharmacy technician student. The student may have a maximum of two preceptors for the training period. E. Complete and submit all required documentation. 1. Skills Assessment (Pre and End) documentation form 2. Personal Learning Plan 3. Appendix 1 4. Appendix 2 5. Appendix 3 6. Appendix 4 F. Fulfil the time service requirement within a normal workweek (minimum of 15 hours and a maximum of 40 hours per week). A maximum of six months is allowed to complete the Pharmacy Technician Assessment (PTA) program requirements. 8 Path 1

10 Preceptor requirements: Preceptor qualifications As per Regulation 12.23(1) A member, in order to serve as a preceptor, must meet the following requirements: (a) be an active member registered in direct client care that practises in New Brunswick for at least 18 hours a week; (b) have been registered and practising in New Brunswick for at least one year; (c) meet the training requirements of the NBCP by either completing a preceptor training program approved by the NBCP, or meeting the requirements to be a preceptor for the structured practical experiential program (SPEP) in the curriculum of an accredited pharmacy education program; (d) practise in a pharmacy that meets the SPEP Practice Site Criteria established by the educational institution, or at a location approved by Council; (e) confirm that the student is properly registered with the NBCP; (f) ensure that any student engaged in practice experience has the level of personal supervision or direction that, in the professional judgment of the preceptor, is required to ensure safe and effective client care given the knowledge, skills and experience of the student; and (g) not have or be perceived by the NBCP to have a conflict of interest or bias with respect to the student they are supervising (eg is not a close relative of, or in a close relationship with the student). Regulation 12.23(2) A preceptor may not: (a) have any terms, conditions or limitations on his/her certificate of registration and licence other than those applicable to all members of that register unless otherwise authorized by the Registration Committee; (b) have been found to have committed an act of professional misconduct or to be incompetent by the Discipline and Fitness to Practise Committee; (c) have been found to be incapacitated by the Complaints Committee. (d) have been the subject of allegations of professional misconduct or incompetence that have been referred to, but not yet decided upon by, the Complaints Committee, or the Discipline and Fitness to Practise Committee. Regulation 12.23(3) Where a preceptor ceases to be licensed, or his registration is suspended or otherwise ceases to be qualified as a preceptor, the Registrar shall notify every student with whom an apprenticeship agreement is in effect, at the most recent contact information of the student appearing 9 Path 1

11 on the NBCP s register. In addition, the preceptor shall: Have a minimum of three months experience at the practice site to provide the student adequate familiarity with systems and clients. Have no more than two students under his/her responsibility during the student training period. The preceptor (or appropriate delegate) will provide close supervision at the practice site where the student is undertaking training activities. Practice site requirements: The training period after graduation must be completed within the province of New Brunswick under the supervision of a licensed preceptor so that the student becomes familiar with the laws and regulations of the province. The practice site must: Be a community or institutional pharmacy providing direct client care where dispensing, compounding and product preparation occurs. Have sufficient staff and resources to provide appropriate educational opportunities and interaction between the preceptor and student to allow for completion of the required activities. Comply with the standards and other requirements as specified by the NBCP. Have had acceptable inspection reports. Have no outstanding complaints on record. Have no restrictions on the pharmacy Certificate of Operation that would impact the ability to provide a good learning environment. Be located in New Brunswick. 10 Path 1

12 Regulations related to the program Pharmacy technician students 12.19(1) A pharmacy technician student shall register with the New Brunswick College of Pharmacists as a "registered student" prior to the commencement of any employment and shall not hold themselves out to be other than a registered pharmacy technician student. Pharmacy technician students shall not hold themselves out to be pharmacy technicians/assistants (2) Pharmacy technician students may only provide pharmacy services while under the supervision of an authorized preceptor. 11 Path 1

13 Legislation - The New Brunswick College of Pharmacists The student must be familiar with the provisions of the Pharmacy Act of New Brunswick and Regulations, and the various federal and provincial acts as listed. In reviewing this legislation, particular attention should be given to the following (which can be found on the NBCP website): Date Complete A. Purposes Activity B. Membership - See Act Part VIII and Regulations Part XI and XII C. Meetings (see Act Part VII and Regulations Part IV and IX) - Annual - Special D. Inspections Conducted by the NBCP E. Council (see Act Part IV and Regulations Part II and III) - Districts - Elections - Terms of Office - Officers - Duties of the President F. Code of Ethics G. Standards of Practice for Pharmacy Technicians H. Continuing Education I. National Drug Schedules (see NAPRA website ) J. Personal Information and Electronic Documents Act K. Right to Information and Protection of Privacy Act L. Personal Health Information Privacy and Access Act M. Food and Drugs Act and Regulations (Federal) N. Controlled Drugs and Substances Act (Federal) 12 Path 1

14 Orientation to the practice site Community Depending on your work experience, you may already be familiar with the following activities and components of pharmacy practice. Review with your preceptor to ensure you have a good understanding of pharmacy practice in a community pharmacy. The preceptor will sign to indicate this has been done. The following is a guideline for the student's orientation to the pharmacy at the commencement of the training period. A. COMMUNITY PHARMACY A. Orientation to the pharmacy Date complete 1 Product areas in the front store 2 Security devices 3 Dispensary/counselling area: stock room equipment and supplies speciality areas 4 Staff roles and responsibilities B. Pharmacy policies and procedures 1 Customer relations 2 Confidentiality and PIPEDA, PHIPAA and RIPPA 3 Dress code 4 Telephone procedures 5 Relations with other health care providers 6 Handling of damaged stock 7 Medication error & discrepancy documentation 8 Intervention documentation C. Other information you have learned about: Date complete D. Dispensary layout The student should be made aware of the physical layout of the dispensary. The student should be encouraged to ask questions as to the logic and necessity of the physical workings of the dispensary. The preceptor should review the following with the student: Dispensing area 1 Drugs (solid-dose, liquid dose, bulk supplies, ear, nose and throat, rectal and vaginal, injectable, topical products) 2 Drug distribution system (e.g. Company or Alphabetical) 3 Distilled/de - mineralized water 4 Library and reference material 5 Vials (childproof and plain), prescription labels, Date complete 13 Path 1

15 auxiliary labels 6 Equipment for weighing and measuring 7 Syringes and needles 8 Prescription files and storage requirements 9 Controlled/Narcotic Drug storage 10 Confidential area for client counselling 11 Abuse potential products sold from dispensary 12 Unauthorized access 13 Storage of prepared prescriptions 14 Distribution of prepared prescriptions 15 Client information leaflets 16 Secure storage areas 17 Refrigerated products 18 Schedule 2 and 3 medications 19 Unscheduled products E. Library & Reference sources The student should be made aware of the library resources (hard copy & electronic) in the pharmacy: 1 C.P.S. - Use and Correlation of the Various Sections (hard copy, electronic) 2 Internet (World Wide Web) Access and 3 Client Counselling Handbooks 4 Drug Interaction and Toxicology Handbooks 5 Manufacturer's Catalogues 6 Dosage Information -eg (paediatric, geriatric) 7 The NBCP guidance documents and website Information therein and Use 8 Site specific Policy and Procedure Manual 9 Confidentiality and PIPEDA, RIPPA and PHIPA documentation 10 Harmonized Drug Schedules with specific references to Schedules 2 and 3 and products contained therein F. Other pharmacy areas Date complete 1 Self-medication products 2 Home care supplies and devices (if applicable) 3 Client information area 4 Self-testing products, eg monitors 5 Methadone distribution (if service provided) 6 Sterile compounding (if service provided) 7 Central fill (if service provided) G. Management Activity Security procedures. Opening and closing, loss prevention, procedures to follow in the event of hold up, location of alarm buttons, power failure policies, fire Date completed 14 Path 1

16 protection, computer(s) back up policy, lock and leave procedures (if applicable). Inventory control, both manual and computerized techniques. Criteria for decision making when purchasing stock. Records kept with respect to Narcotic and Controlled Drugs. Advertising and promotion policies as they relate to Regulation 19 on advertising The pharmacies Policy and Procedure manual Manufacturer s representatives and sales agents can provide useful information on the latest products and medications available. However, they should schedule appointments with the pharmacist and should not be allowed into the dispensary for reasons of client confidentiality Privacy concerns, and procedures in place (for new employees, for existing employees, for trustees) at the practice site. Preceptor Acknowledgement: I confirm that is knowledgeable of the items listed above Signature Print Name 15 Path 1

17 Orientation to the Practice site Hospital Depending on your work experience, you may already be familiar with the following activities and components of pharmacy practice. Review with your preceptor to ensure you have a good understanding of pharmacy practice in a community pharmacy. The preceptor will sign to indicate this has been done. The following subjects should be discussed with the student: A. Orientation to the pharmacy Date complete 1 Administration area 2 Drug storage areas in pharmacy & institution 3 Entrances and exits 4 Security devices 5 Dispensary/counselling area: stock room equipment and supplies speciality areas 6 Staff roles and responsibilities B. Departmental policies and procedures 1 Pharmacy & Therapeutics Committee 2 Formulary system 3 Dress code 4 Telephone procedures 5 Relations with other health care providers 6 Confidentiality and PIPEDA, RIPPA and PHIPAA documentation 7 Ward stock delivery 8 Pharmacy opening and closing 9 Provision of Pharmaceutical care 10 Compounding and repackaging 11 Medication order processing 12 Handling of damaged stock 13 Medication distribution 14 Sterile compounding 15 On call (after hours) services 16 Medication error & discrepancy documentation 17 Intervention documentation 18 Collaborative practice agreements C. Other information: 16 Path 1

18 D. Pharmacy layout The student should be made aware of all the physical necessities of the pharmacy, where products and equipment are located. The student should be encouraged to ask questions as to the logic and necessity of the physical workings of the pharmacy: The preceptor should emphasize the following points: Dispensing area 1 Drugs (solid dose, liquid dose, bulk supplies, ear, nose and throat, rectal and vaginal, injectable, topical products) 2 Drug stock organization (e.g. company, AHFS or alphabetical) 3 Library and reading area 4 Drug packaging 5 Equipment for weighing and measuring 6 Syringes and needles 7 Prescription files and storage requirements 8 Controlled/narcotic drug storage 9 Confidential area for client counselling 10 Abuse potential products sold from dispensary 11 Unauthorized access 12 Storage of prepared prescriptions 13 Distribution of prepared prescriptions 14 Client information leaflets 15 Secure storage areas 16 Refrigerated products 17 Schedule 2 and 3 medications 18 Unscheduled products Other areas covered: Date complete 17 Path 1

19 E. Library & Reference Sources The student should be made aware of the library resources (hard copy & electronic) in the pharmacy with emphasis on: 1 C.P.S. - use and correlation of the various sections (hard copy, electronic) 2 Internet (World Wide Web) access and 3 Client counselling handbooks 4 Drug Interaction and toxicology handbooks 5 Manufacturer's Catalogues 6 Dosage Information (e.g., paediatric, geriatric) 7 NBCP guidance documents and website - information and use 8 Site specific policy and procedure manual. 9 Confidentiality and privacy 10 Harmonized drug schedules with specific references to Schedules 2 and 3 and products contained therein F. Management 1. Awareness of: Date Complete 1 The role played by the Department of Pharmacy in the provision of health care services in the hospital. 2 Position of the department in the organizational chart of the institution. 3 The role and responsibility of the governing Regional Health Authority (RHA) 4 Satellite and decentralized service 2. Knowledge of: 1 The functions of the Pharmacy and Therapeutics Committee 2 The purpose of the hospital formulary 3 Procedure for handling non-formulary requests 4 Therapeutic substitutions 3. Familiarity with: 1 The policy and procedures manual of the pharmacy Department 2 The benefits of having written policies and procedures 3 The concept of quality assurance and the quality assurance program of the Department 4. Understanding of the basic differences among drug distribution systems 1 Traditional 2 Total ward stock 18 Path 1

20 3 Unit-dose - centralized/decentralized/mobile 4 Automated dispensing systems 5. Understanding of the existing drug distribution system 1 Knowledge of drug distribution process from the time the order is written until the medication is administered to the client and charged to the cost centre. 6. Familiarity with Date Complete 1 Rationale for ward stock drugs 2 Process for addition/deletion to ward stock 3 Ward stock check 4 Role and responsibility of pharmacy assistants and technicians in the distribution system 7. Knowledge of the purpose of workload measurement and the application of information obtained. 8. Introduction to principles of personnel management 1 Department policy and procedures 2 Communication 3 Supervision of employees 4 Personnel evaluation 5 Collective bargaining process 9. The process involved with hospital accreditation 1 Client care teams 10. Hospital procedures in case of emergency 11. Sterile Products 1 Knowledge of established policies and procedures. 2 Knowledge of a) Required product research and calculations b) Aseptic technique c) Record keeping procedures d) Appropriate disposal of materials 3 Familiarity with use and maintenance of equipment 4 Role and Responsibilities of the pharmacy technician and pharmacist 19 Path 1

21 Preceptor Acknowledgement: I confirm that is knowledgeable of the items listed above Pharmacy Technician Student Preceptor Signature Preceptor name (print) 20 Path 1

22 Dispensing process Depending on your work experience, you may already be familiar with the following activities and components of pharmacy practice. The dispensing procedure may appear to be relatively simple. What is not immediately apparent are the dozens of decisions to be made during the process. The preceptor must impress upon the student that the prescription must be safe and effective when it is released to the client and that the preceptor and student bear the responsibility for the accuracy of the finished prescription. The client is vulnerable in this situation and accurate dispensing is fundamental to all the other value-added professional services provided to the client. The dispensing procedure may be expressed in a series of steps as follows: 1. Checking for Completeness of Information Prescription must be recent and all statutory information present. A prescription is valid for one year and may not be refilled after that time. Find out client's age, weight, allergies and type of reaction, any self-medication, dietary restrictions, prior and present medical problems and enter in client record. Ascertain method of delivery to client (waiting, call later, delivery, give to client's agent or sent to nursing unit) and give estimated waiting time. Determine any third-party coverage and subscriber's number. What to do if the order is not legally complete. The preceptor should impress on the student that the onus is on the pharmacist to determine that a prescription is legitimate. 2. Checking the Prescriber information Is the prescriber licensed to practice in any province in Canada? In hospital practice, is the prescriber a resident or intern with prescribing privileges? Is the prescription within their scope of practice (applicable to dentists, veterinarians, optometrists, nurse practitioners and pharmacists)? What if the prescriber recently moved from the province or is now deceased? 3. Interpreting the Prescription (Be aware of look-alike, sound-alike drugs) Interpreting handwriting and abbreviations; understanding what the prescriber intended. Be capable of recognizing errors or omissions and know what action to take. Check for safe and appropriate dosage and mode of administration. Be prepared to communicate with the prescriber and/or client. 21 Path 1

23 4. Check Client Records Contraindications (allergy, contraindicated disease state or medication) and any other factors affecting drug use/abuse. 5. Compounding Know the difference between compounding and manufacturing (Review the compounding versus manufacturing guidelines according to Health Canada. Recognize when a prescription needs to be compounded and when it is commercially available, and advise client if more time is needed in the case of a compound. 6. Selecting Container and Labelling Select appropriate container bearing in mind the child resistant and light resistant container regulations, physiochemical properties of the medication, the convenience to the client and the aesthetic appearance of the finished product. Selection of all appropriate auxiliary labels including storage and stability of the medication. Prescription medication container must be labelled with the generic name for all single entity products and with the trade name for multi-ingredient products. Compliance (monitored dose) packaging standards are to be reviewed. 7. Selecting the Medication and Transferring to Container Selecting correct drug product from pharmacy's inventory. Ensure drug has not expired or deteriorated. Know what to do when drug is not stocked or there is not enough of the drug to completely fill the prescription order. Note product name, manufacturer, strength, dosage form and quantity dispensed on the prescription order and client's medication record. Know the proper procedure for "Do Not Substitute" prescriptions. Check finished prescription for accuracy. Return the stock bottle to the dispensary shelf and note if it needs to be re-ordered. 8. Releasing the Medication to the Client Ensure appropriate counselling is provided when required. Document any refusal for counselling. 22 Path 1

24 9. Refilling a Prescription Be knowledgeable of the legal requirements for refill and part-fill prescriptions, (e.g., narcotics). Understand acceptable refill records (hard copy, logs, etc.) Know what steps to take to obtain authorization to renew a prescription, including procedures for physicians who will not accept verbal or fax renewal requests from a pharmacy. Check for over- and under-utilization and notify the pharmacist if utilization not appropriate. Know how to record refill information on the prescription order and the client's record. Know how to request a transfer of a prescription from another pharmacy or how to obtain authorization from a prescriber and fill it as a new order. Know how to transfer a prescription to another pharmacy. 10. Medication Errors A pharmacy technician must know how to handle a medication error and assist the pharmacist in correcting the problem immediately. (See document: Medication Errors Prevention and Reduction) 11. Stale Dating of Prescriptions Under federal and provincial legislation, there is no mention of stale dating prescriptions, except for the Targeted Substances. Stale date refers to a date when a prescription could not be honoured due to the passage of time from when it was originally ordered. Under the regulations for the Targeted Substances, a prescription for a product covered under the Regulations cannot be filled or refilled one year after the date on the original prescription. NBCP Regulation (17.2) prohibits filling or refilling a prescription more than one year after the date of issue. 12. Prescription Records Prescription records are required to be kept a minimum of two years from the last date of refill if written and for 15 years written or electronically thereafter. Check with the preceptor or pharmacy manager to discuss pharmacy policy. 13. Drug Schedules Schedule 1 drugs require a prescription for sale and are provided to the public by the pharmacist following the diagnosis and professional intervention of a practitioner. The sale is controlled in a regulated environment as defined by provincial pharmacy legislation. Schedule 2 drugs, while less strictly regulated, do require professional intervention from the pharmacist at the point of sale and possibly referral to a practitioner. While a prescription is not required, the drugs are available only from the pharmacist and must be retained within an area of the pharmacy where there is no public access and no opportunity for client self-selection. 23 Path 1

25 Schedule 3 drugs may present risks to certain populations in self-selection. Although available without a prescription, these drugs are to be sold from the self-selection area of the pharmacy which is immediately adjacent to the dispensary. The pharmacist is available, accessible and approachable to assist the client in making an appropriate self-medication selection. Unscheduled drugs can be sold without professional supervision. Adequate information is available for the client to make a safe and effective choice and labelling is deemed sufficient to ensure the appropriate use of the drug. These drugs are not included in Schedules I, II or III and may be sold from any retail outlet. NAPRA has developed and published national standards of practise for pharmacists, corresponding to the level of professional intervention and advice necessary for the safe and effective use of drugs by the Canadian consumer. The latest listing of the drug schedules is available through the NAPRA website at Preceptor Acknowledgement: I confirm that is knowledgeable of the items listed above Pharmacy Technician Student Preceptor Signature Preceptor name (print) 24 Path 1

26 Skills Assessment (Pre and End) documentation form Demonstration of skills is accomplished through the completion of program activities developed for each of the nine competency categories mentioned in the Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice developed by the National Association of Pharmacy Regulatory Authorities (NAPRA). Some competency categories (e.g., distribution) are identified as areas that may not require completion of program activity as skill accomplishment has been previously demonstrated in practice. These nine competency categories include: Ethical, legal and Professional Responsibility Patient Care Product Distribution Practice Setting Health Promotion Knowledge and research Application Communication and Education Intra and Inter-Professional Collaboration Quality and Safety METHOD The student must complete the Self-Assessment (Pre and End) documentation form to assess their knowledge, skills and abilities at these intervals. This form must be reviewed with the preceptor and should be used as a tool to plan the training period in a way that will provide the student opportunities to develop additional knowledge, skills and abilities to demonstrate the competencies required to successfully complete the training period. This assessment must be sent to the NBCP office with the other required appendices. PRECEPTOR A preceptor for a pharmacy technician student is responsible for supervising the pharmacy technician student engaged in practice experience. The preceptor must complete an assessment at midpoint and an evaluation at endpoint. The preceptor must sign the Self-Assessment (Pre and End) documentation form and discuss it with the student. Regardless of the number of hours completed in the program, the student must demonstrate each required competency with confidence and a limited amount of support. If the preceptor does not feel 25 Path 1

27 the competencies have been demonstrated at an acceptable level, additional time and learning should be planned. Students must adequately demonstrate all competencies to complete the training period. Use the following rating scale as your guide: 1 Can demonstrate, but only with support Needs Improvement 2 Can demonstrate, but frequently requires support 3 Can demonstrate with confidence but sometimes needs support Acceptable 4 Can demonstrate, rarely needs support No Opportunity n/o Unable to demonstrate due to lack of opportunity 1.0 Ethical, Legal and Professional responsibility 1.1 Practice within Legal Requirements Pre End Apply legal requirements to practice, including federal and provincial/territorial legislation, policies, by-laws, and standards Apply federal and provincial/territorial workplace, occupational health and safety, and other related legislation to the practice setting Apply federal and provincial/territorial privacy legislation to the collection, use, storage, disclosure and destruction of personal health information. 1.2 Uphold ethical principles Apply the principles of professional codes of ethics Apply ethical principles in the decision-making process. 1.3 Manage actual and potential illegal, unethical, or unprofessional actions or situations in practice Identify illegal, unethical or unprofessional actions or situations Undertake appropriate intervention to address illegal, unethical or unprofessional actions or situations. 26 Path 1

28 1.4 Apply principles of professionalism. Pre End Apply principles of self-regulation Accept responsibility and accountability for own actions and decisions Seek guidance when uncertain about own knowledge, skills, abilities and scope of practice Apply principles of continuing professional development including assessing own learning needs and developing a plan to meet these needs Maintain appropriate professional boundaries Protect the privacy and confidentiality of the patient Manage situations of actual and perceived conflict of interest Describe the Canadian health care system and the role of health professionals within it. 1.5 Document activities of practice in compliance with federal and provincial/territorial legislation, standards and policies Maintain complete, accurate and secure patient records Identify situations in which documentation should and should not be shared with other health professionals or third parties Select appropriate methods to share documentation within the circle of care and facilitate patient care. 2.0 Patient care 2.1 Develop a professional relationship with the patient. Pre End Establish and maintain rapport by using effective communication skills Demonstrate a caring, empathetic and professional attitude Determine and acknowledge the patient s needs, values and desired level of care Identify and respect the roles and responsibilities of each party in the relationship. 2.2 Obtain patient information for pharmacist review. Pre End Gather information from the patient using appropriate interview techniques, including active listening Identify factors such as culture, language, demographic and physical characteristics that may impact the patient s care Gather information from the patient s health records Gather information required for medication reconciliation Measure the patient s physical parameters such as height, weight and blood pressure Organize, reconcile and record the patient s information. 2.3 Obtain patient information for pharmacist review. Pre End Identify patient needs related to issues such as dosage forms, special packaging or labelling Assist the patient in making informed decisions regarding the selection and use of drug administration devices, monitoring devices and health aids Gather monitoring parameter information for pharmacist review, including adherence information and lab test results Communicate relevant information and identified concerns to the pharmacist in a clear, concise and timely manner. 27 Path 1

29 3.0 Product Distribution 3.1 Receive, interpret and process a prescription. Pre End Determine the validity, clarity, completeness and authenticity of the prescription and resolve concerns in collaboration with the pharmacist Transcribe verbal orders and ensure their accuracy Transfer a prescription and receive a transferred prescription Interpret numerals, symbols, measurement systems and Latin abbreviations Perform pharmaceutical calculations Identify patterns of unusual drug prescribing and usage including possible diversion or drug misuse and report relevant findings to the pharmacist or appropriate authority Process the adjudication for payment of prescriptions and other pharmacy services using knowledge of third-party payer policies and formularies. 3.2 Prepare products for dispensing Select appropriate products by applying knowledge of brand and generic names, dosages, and dosage forms Apply drug interchangeability principles in accordance with applicable formularies, policies or legislation Verify the integrity of a product by considering stability and, where applicable, sterility, including checking expiry dates, physical appearance, and odor Measure products by counting, pouring or weighing using the appropriate equipment and technology Package products in a suitable container to maintain product integrity, stability and, where applicable, sterility Use packaging that is safe and appropriate for the patient, including prepackaging, multi-dose or unit dose packaging and child-resistant vials Label products according to legislative requirements, best safety practices, established protocols and patient-specific needs. 3.3 Prepare and compound non-sterile and sterile products according to recognized guidelines and standards of practice Perform compounding calculations Prepare and compound sterile products according to recognized guidelines and standards of practice Prepare and compound non-sterile products according to recognized guidelines and standards of practice. 3.4 Verify the technical aspects of the prescription to ensure accuracy and quality of products Identify when an independent double check should be performed Check the product and its prescription label against the prescription using a systematic approach. 3.5 Collaborate with the pharmacist in the release of the product Determine whether the legal and professional requirements for a product to be released to the patient have been met Identify when the patient requires further consultation or education from the pharmacist. 28 Path 1

30 4.0 Practice Setting 4.1 Optimize the safety, efficacy and efficiency of operations in the practice setting Demonstrate the organizational and time management skills necessary to effectively prioritize, organize and manage product distribution workflow Supervise pharmacy support personnel so that accepted standards are met Use and maintain automation and other technology to enhance safety, efficacy and efficiency in the practice setting. 4.2 Contribute to the management of pharmacy inventory to ensure safe, effective and efficient product distribution Apply inventory and formulary management systems and strategies that incorporate best practices, including new technologies Prepare and place orders for stock and supplies, using appropriate technology, from licensed and legitimate sources Identify issues with the drug supply chain, including drug shortages and drug recalls, and collaborate with the pharmacist to resolve these issues Return or properly dispose of recalled, expired and unusable products Reconcile inventory for controlled substances, or any other substances selected Investigate inventory discrepancies and communicate findings to the pharmacist and/or other appropriate authority. 4.3 Contribute to the management of record keeping activities within the practice setting Use appropriate information technology to organize, maintain and retrieve pharmacy records Use information technology and record-keeping procedures that maintain the integrity, security and permanence of pharmacy records. Pre Pre Pre End End End 5.0 Health Promotion 5.1 Support patient-specific health promotion activities in collaboration with the pharmacist Identify and inform the pharmacist of socio-economic, cultural, environmental and other factors that are barriers to, or facilitators of, health and wellness for the patient Gather health promotion information relevant to the patient Participate in health promotion activities in collaboration with the pharmacist Facilitate the patient s access to and interaction with support agencies and health services within the healthcare system. 5.2 Support public health activities in collaboration with the pharmacist Identify factors that are barriers to, or facilitators of, public health and wellness Participate in public health initiatives in collaboration with the pharmacist Participate in organized initiatives for disaster, pandemic and emergency preparedness. Pre End 29 Path 1

31 5.3 Contribute to the maintenance of a healthy environment for the public Promote the proper handling and disposal of drugs and hazardous materials with the patient, self and others Identify and minimize the risk of disease transmission from the pharmacy environment. 6.0 Knowledge and Research Application 6.1 Respond to questions that do not require pharmacist referral using appropriate strategies Clarify requests for information to identify questions that require pharmacist referral Use a variety of retrieval techniques to access reliable and appropriate information, including evidence-based information when possible Organize and provide information using strategies appropriate to the target audience. 6.2 Apply relevant information to practice Gather new information, including evidence-based information when possible, that may be applicable to practice Evaluate the information and use current, relevant and reliable information to improve practice. Pre End 7.0 Communication and Education 7.1 Establish and maintain effective communication skills Pre End Demonstrate proficiency in written and verbal English or French Demonstrate appropriate verbal and non-verbal communication skills, including listening skills Demonstrate appropriate interview techniques Select appropriate communication and education techniques for use with the patient and other health professionals Conduct interpersonal interactions, including conflict management, in a professional manner Communicate with sensitivity, respect and empathy. 7.2 Use safe, effective and consistent communication systems Use communication techniques that maximize safety and understanding, including repeating back verbal orders, using recognized terminology and avoiding unnecessary or unsafe abbreviations Record and store information in a consistent manner for efficient access and retrieval by relevant personnel Select appropriate technology to facilitate communication. 8.0 Intra and Inter-Professional Collaboration 8.1 Create and maintain collaborative professional relationships. Pre End Identify potential collaborators with whom to initiate ongoing professional relationships Collaborate with other parties in the relationship to define the roles and responsibilities of each party. 8.2 Contribute to the effectiveness of working relationships in collaborative Pre End 30 Path 1

32 teams Interact respectfully with other members of the team by accepting accountability for themselves and managing disagreements and conflict Share decision-making activities with other members of the team. 8.3 Participate in the delivery of collaborative health services in collaboration Pre End with the pharmacist Collaborate with team members to ensure appropriate utilization of resources Collaborate with team members to determine and achieve team goals and objectives Facilitate continuity of care. 8.4 Accept referrals from and make referrals to the pharmacist. Pre End Recognize situations that fall beyond the scope of practice of pharmacy technicians and refer these situations to the pharmacist Accept responsibility for referrals from the pharmacist. 9.0 Quality and Safety 9.1 Contribute to a culture of patient safety. Pre End Apply principles of patient safety to improve practice Employ best practices when informing the patient of the occurrence of a medication incident Share information about problems, resolutions, system changes and lessons learned with the workplace team. 9.2 Contribute to continuous quality improvement and risk management activities related to the drug distribution system Apply principles of continuous quality improvement to practice Apply principles of risk management to practice by anticipating, recognizing and managing situations that place the patient at risk Identify the occurrence of a medication incident or close call and respond effectively to mitigate harm and prevent reoccurrence Identify high-alert drugs and high-risk processes in order to respond effectively. 9.3 Ensure the quality, safety and integrity of products. Pre End Maintain the cleanliness, functionality and integrity of compounding, packaging, dispensing and storage equipment Ensure products are stored and transported under the conditions required to maintain product quality, safety and integrity, including cold chain management Evaluate the quality of supplies and products using recognized quality assurance techniques including visual inspection, verification of the legitimacy of the supplier and use of manufacturers quality markers. Pre End 31 Path 1

33 9.4 Create and maintain a working environment that promotes safety. Pre End Minimize and manage distractions in the work environment Manage factors that affect personal wellness including work-life balance, sleep deprivation and physical and emotional health Identify factors that impact the safety of the working environment, including resource allocation, procedural consistency and ergonomics Handle hazardous products safely by minimizing personal exposure and reducing environmental contamination. Additional comments: Preceptor Initials Student Initials Discussed with preceptor (start of week 1): Discussed with preceptor (end of training period): At the end of your training period, use your evaluation and preceptor comments to develop your goals for your learning/action plan on your Personal Learning Plan. 32 Path 1