Pharmacy Practice
Pharmacy Practice
Pharmacy Practice
Read chapter 20, 21, 22 and 23 in the text book and do the sample questions at the end.
When you have finished you should read the web lesson and do the web test
Pharmaceutical care:
The goal of pharmaceutical care is to optimize the patients health related quality of life, and
achieve positive clinical outcomes,
within realistic economic expenditures.
To achieve this goal the following must be accomplished:
a. A professional relationship must be established and maintained.
b. Patient specific medical information must be collected, organized recorded and maintained.
c. Patient - specific medical information must be evaluated and a drug therapy plan developed
mutually with the patient.
d. The pharmacist assures that the patient has all supplies, information and knowledge necessary
to carry out the drug therapy plan
e. The pharmacist reviews, monitors, and modifies the therapeutic plan as necessary and
appropriate,
in concert with the patient and healthcare team.
Practice principles:
a. Data collection
b. Information evaluation
c. Formulating a plan
d. Implementing the plan
Schedule III:
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 operated under the direct supervision of the pharmacist, subject to any local
professional discretionary requirements which may increase the degree of control. Such an
environment is accessible
to the patient and clearly identified as the professional services area of the pharmacy.
The pharmacist is available, accessible and approachable to assist the patient in making an
appropriate self medication selection.
For example:
Acetaminophen > 650 mg; Al (OH)3 ; 5 % Benzyl peroxide; Benzocaine; Cimetidine, etc
Unscheduled drugs:
can be sold without professional supervision. Adequate information is available for the patient
to make a safe and effective choice and labeling 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.
Drug Consultation:
Development of effective communication skills:
The pharmacist establishes and maintains rapport by using effective communications
skills which includes:
a. Listening, speaking and writing skills.
b. Sensitivity to non verbal forms of communication
c. Sensitivity to diversity in the community
The best method is verbal and writing.
The pharmacist demonstrates a caring and professional attitude.
The pharmacist elicits the needs, values, desired level of care and desired outcome of the
patient.
The pharmacist considers the impact of life style factors on the health of individual patients.
The pharmacist discusses with the patient the role of the pharmacist and the responsibilities
of the patient.
The pharmacist encourages patients to participate in decisions about their health and supports
the patients right to make choices.
The pharmacist develops professional relationship with patients and/or their agents/healthcare
providers.
To determine the patient's needs, values, desired level of care and desired outcomes regarding
drug therapy and to establish the mutual responsibility of each participant.
6. Medication distribution:
The supervising pharmacist shall establish medication distribution services that meet the needs
of the hospital patients and optimize safety, efficiency and economy.
7. Return of medications:
The supervising pharmacist shall ensure that medications dispensed for individual patients in the
hospital,
but not used are returned to the pharmacy. Procedures should be undertaken for crediting and
returning medications to stock (the meds never left the hospital).
8. Repacking of medications:
The supervising pharmacist shall ensure that repacking of medications is done in according to the
CSHP guidelines for repacking medications in hospitals listed in the official publications guide.
9. Medication preparation:
The supervising pharmacist shall ensure that written policies and procedures are in place for
medication compounding, including the preparation of sterile products and cytotoxic drugs.
Patient counselling:
1. How to use ophthalmic drops:
a. Wash your hands carefully with soap and warm water.
b. If the product container is transparent, check the solution before use.
If it is discolored or has changed in any way since it was purchased (i.e. particles
in the solution, color change), do not use the solution.
c. If the product container has a depressible rubber bulb, draw up a small amount
of medication into the eye dropper by first squeezing, then relieving pressure on the bulb.
d. Tilt the head back with chin tilted up and look toward the ceiling.
e. With both eyes open, gently draw down the lower lid of the affected eye with your index finger.
f. In the gutter formed, place one drop of the solution.
g. Do not touch the tip of the eye drops with your eyelid or any other surface to maintain sterility.
h. Close the eye and rotate the eyeball for few seconds.
i. You may apply pressure to the eye bridge to prevent systemic absorption.
j. Close the eye drops
After passing through the prefilter, air is channeled through the high efficiency particulate air
(HEPA) filter to remove fine bacterial contaminants. This filter is built into the hood and is
responsible for the sterile environment
in the hood. The HEPA filter is not easily removed and generally requires outside maintenance for
cleaning
Air flow velocity determines the filtering capacity of the hood. If air flow is reduced, the filter is
presumed to be clogged with contaminants and must be cleaned.
There are two types of laminar air flow hood available for compounding non toxic sterile
products:
a. Horizontal air flow:
The air flow is directed forward. Work is preferred in the hood and the product is protected,
however, the operator is not protected from the particles or fumes originating from ampules or
vials.
b. Vertical air flow:
The air flow is directed downwards and away from the operator providing a safer working
environment.
This is the preferred hood for community pharmacists.
When working under the laminar air flow hood, these guide lines should be followed for propare
use.
1. Ideally the hood should be operating continuously 24 hours a day. Since this is not feasible in a
community setting the hood should be turned on at least 30 minutes prior to use.
2. The working counter top and sides should be cleaned with suitable disinfectant (i.e. salvodil)
prior to and after each use.
3. Any bottles, vials or containers should be wiped down with alcohol or disinfectant before being
brought into the hood to prevent possible contamination.
4. Objects placed in the hood should be suitably placed to provide good air flow with minimum
obstruction.
Work should be at least 15 cms into the hood.
5. The HEPA filter should be checked, cleaned or re-certified once a year.
6. It is suggested that anyone working under a hood be gowned, gloved and masked.
A lab coat should be worn to protect the operator from spills and if hair is long, a suitable cap
should be worn.
Aseptic Technique:
Aseptic technique is defined as procedures that will minimize the chance of contamination with
microorganisms.
Contaminants may be brought into the aseptic area by equipment, supplies or people, so it is
important to control these factors during preparation. A number of simple guide lines should be
followed:
1. Anyone using laminar hoods should wash their hands with a suitable antimicrobial at the
beginning of their work and when re-entering the aseptic preparation area.
2. Appropriate dress (i.e. gowns, gloves, or mask) suitable for sterile preparation should be worn.
3. Activities unrelated to product preparation should be kept at minimum.
4. Eating or drinking or the storage of food, drinks or personal items should not be allowed into
the aseptic area.
5. Only one person should be working in the hood at any given time.
6. All items that will be used during preparation should be checked for defects and expiry dates
prior to use.
7. All non sterile items surfaces should be disinfected with appropriate disinfectant prior to being
placed into the hood.
This includes scissors, clamps, and pumps.
8. All items necessary for the preparation should be placed into the hood prior to commencing the
procedure.
9. Direct contact between a sterile product and non sterile product should be avoided.
10. All non sterile surface areas should be swabbed with alcohol and left for 30 seconds before
puncturing. This includes ampules, vials and intravenous solutions port holes.
11. Ampules and vials should be opened and contents aspirated using appropriate techniques to
avoid particulate contamination. This may require the use of filters for glass containers/ampules.
12. Reconstituted powders should be mixed carefully according to manufacturer's
recommendations to ensure complete dissolution of the drug.
13. Needle entry into vials with rubber stoppers should be done at 45 degree angle to minimize
rubber core particulates.
14. All finished products should be carefully inspected after preparation for visible precipitation.
This should be done outside the laminar air flow hood.
15. Each prepared sterile product should be assigned an expiry date based on available data. If
non is available, a short period should be applied (i.e.24 hours).
If aseptic technique is not followed, the final product may be contaminated. It is important that
proper technique be utilized to ensure the integrity of the product.
Environments in which medication errors are more likely to occur tend to be characterized
by:
a. disorganized work flow
b. fatigued staff
c. frequent interruptions and distractions
d. poor physician handwriting
e. emphasis on volume over service quality
f. stress
g. ineffective communication with patients
h. improper technician training
i. a pattern of inadequate staffing.
As pharmacists devote more time to counselling and providing cognitive services in order to
achieve desired health outcomes, the need to implement procedures and policies to prevent
errors should not be forgotten. Leading edge practitioners commented that all pharmacy practices
are prone to medication error, which is due, after all, to the human element inherent in pharmacy
practice.
It was felt that consumers accept the fact that pharmacists are human and errors will be made,
but that the way an error is handled is critical.
Common suggestions for practice changes to decrease the risk of errors:
Human resources:
a. more technical workers
b. clear checking procedures for technicians and pharmacists
c. maximum of two technicians per pharmacist
d. well defined roles and job descriptions for all functions in the dispensary
e. technician certification or adequate technician training.
f. work in teams
g. staff meetings to address annual and regular reviews and discussions after errors.
Dispensing procedures:
a. electronic DIN scan
b. ensure accountability through identifying staff involved at each step in the process
c. do not hesitate to question a prescription if it is unclear.
d. be clear about what is wanted/needed by the patient, ensure that checks occur in every
step of the dispensing process
e. always take the time to do all the checks. Dont be rushed by a "low time" parking meter.
f. be aware of other potential sources of error such as looking alike, sound alike drugs names and
products, drugs for which a reasonable dose may vary by a factor of 10 (i.e. prednisone 5 mg vs
50 mg) drugs with a high potential for negative outcomes or a large variation in prescribed
dosages (i.e. warfarin)
g. provide thorough patient counselling beginning by asking the patient what their physician told
them the medication was for.
h. show the patient the tablets or capsules to ensure they are receiving the medication they
expected to receive
Policies:
Institute a policy for error evaluation and subsequent practice improvement.
Insist all sales reps make appointments, dont allow them to "drop in because the doctors; offices
are closed".
Dispensary re-design to decrease the risk of errors:
a. minimize interruptions, like headsets to answer phones, specific staff assigned to phones
b. keep traffic flow in the dispensary at a minimum.
c. adequate space to perform each function
d. non dispensing functions like stock control, filing, etc, should be separated from the
prescription filling area.
e. ensure adequate storage space for supplies, books, etc to minimize clutter
f. UPC computerized scanner to verify product entered - DIN checked.
g. Picture of medication on computer screen for technician and pharmacists
h. large work counter for technicians and a system in place for checking
i. separate pharmacist service counter, where pharmacists discuss therapy with patients,
from the rest of the dispensing process.
j. a dedicated phone line for physicians/pharmacist communication
k. work flow should facilitate pharmacist review with profile and patient without interruptions
l. electronic exchange of information to enhance prescription legibility, provide patient history,
diagnostic, etc
m. shadow box displaying tablets or capsules used in automated counting cells.
Handling errors:
Although the admission of an error is a controversial issue with the respect to legal liabilities,
as professionals pharmacists have an obligation to "make it right" if a patient suggested that an
error has been made. Reviewers with experience on discipline committees of the provincial
regulatory authorities suggest that often an aggrieved party is more upset by the way an error is
handled that the actual error itself.
A patient's inconvenience and distress should be recognized and acknowledge.
Potential error situations should be handled promptly, with courtesy and professionalism.
"Handling Dispensing Errors, Pritchard (1995) offers a brief review on dealing with medication
errors and described 2 documents available from OCP:
1. Suggested protocol for handling dispensing errors.
2. An incident form for documentation
"The initial contact between a patient alleging a dispensing error and pharmacy is usually
conducted over the phone. It is suggested that if the error can be confirmed over the phone the
pharmacist should offer to send the replacement medication rather than ask the patient to return
to the pharmacy immediately."
"After "no discrepancy" the flow chart states "reassure patient/agent". The pharmacist should also
consider that the physician might have inadvertently ordered the wrong drug or the correct drug
with the incorrect patient name on the prescription form. Another step for pharmacists is to
"confirmed with prescriber if necessary" and then: reassure patient/agent".
I. Primary Sources:
It contains articles and journals. Articles are generally defined as a study that describes step by
step evaluation of a drug including experimental procedure, data collection, purpose of
experiment, conclusion and result of experience.
Examples:
Drug Topic; Pharmacy Times; Hospital Pharmacy; US Pharmacist.
References
1. Product oriented
Example of references
PDR
Red Book
Facts and comparisons
Blue Book
Non prescription drug
2. Drug oriented
3. Therapeutic oriented
Merck manual
Applied Therapeutics
Clinical Pharmacy and Therapeutics
4. Dispensing oriented
Remington
USP - NF
Merck Index
5. Poisoning Information
4. For Orphan drugs (drugs that are used to prevent or treat a rare disease and for which the
FDA offers assistance and financial incentives to sponsors undertaking the development of the
drugs), the following resources are available:
a. Drug Facts and Comparisons
b. The National Information Center for Orphan Drugs and Rare Diseases
c. Drugdex
5. for an unknown drug (one that is in hand but not identified) chemical analysis can be
performed or the drug can be identified by physical characteristics, such as color, special
marking, and shape.
Consult the following sources for help:
a. The PDR, CPS, Drug Facts and Comparisons
b. Identidex
c. The manufacturer
d. A laboratory
7. Unapproved uses:
a. Drug Facts and Comparisons
b. AHFS Drug Information
c. Martindale
d. Drugdex
e. Index medicus, Medline
f. Inpharma
g. USP DI
8. For signs and symptoms of a possible adverse drug reaction, consult the following
resources:
a. Meyler's side effects of drugs
b. A general drug reference
c. Reactions (ADIS)
d. Index Medicus
9. For signs or symptoms for drug interactions, consult the following resources
a. Drug Interaction Facts, Hansten's Drug interaction analysis and management,
Evaluations of drug interactions (EDI)
b. PDR
c. Reactions
d. Index Medicus
10. For stability of the drug and its compatibility with other drugs, the administration
technique and the equipment that holds it, check the following resources:
a. Trissel's Hand Book on injectable drugs
b. King's guide to parenteral admixtures
c. Trissel's stability of compounded formulations.
Sample questions:
1. Which resource will you use to find half life?
answer:
CPS or USP DI
2. Which resource will you use to find HLB?
Answer:
Remington
3. Which resource will you use to find solubility?
answer:
Merck Index
4. Which resource will you use to find infusion rate?
answer:
Manufacturer leaflet.
Smoking cessation:
1. Recommendation from health care professional like pharmacist is one of the most important
ways of influencing a patient to consider quitting.
2. Target group:
Cardiovascular disease; osteoporosis, lung diseases, pregnant women or planning to be.
3. Address concern for increase in weight, offer solutions like eating healthy snacks like carrot,
fruits, sugarless gum, etc.
Standards of Practice:
Standard 1
The pharmacist, using unique knowledge and skills to meet a patient's
drug-related needs, practices patient-focused care in partnership with
patients and other health care providers, to achieve positive health
outcomes and/or to maintain or improve quality of life for the patient.
Refer: Operational Components 1.1 - 1.8
Operational Component 1.1
The pharmacist develops professional relationships with patients and/or
patients'agents and/or health care providers:
a. To determine the patient's needs, values, desired level of care and desired
outcomes regarding drug therapy, and
b. To establish the mutual responsibility of each participant.
1.1.1 The pharmacist establishes and maintains rapport by using effective
communication skills. Effective communication includes:
The profile shall include demographic information about the patient as articulated
under the Drug and Pharmacies Regulation Act and Regulations or the CSHP
Standards of Practice and may also include, where appropriate, other information
that is considered important for continuity of care and achievement of an optimal
therapeutic outcome. This could include known patient risk factors for adverse drug
reactions, drug allergies or sensitivities; known contraindications to prescription
drugs, nonprescription drugs, natural health products, and complementary or
alternative medicines, and other medications or treatments the patient is currently
taking that may contribute to their condition or interact with suggested therapy.
Operational Component 1.3
Prior to dispensing any medication, the pharmacist shall review the prescription to
ensure that it is authentic, accurate, appropriate, and complete. In a hospital, when
the review of each medication order is not possible at time of dispensing or use, the
pharmacist should review medication orders for appropriateness within a reasonable
amount of time.
With the information available, the pharmacist evaluates the patient's drug therapy
and identifies potential and actual drug-related problems.
1.3.1 The pharmacist determines whether the drug therapy is appropriate including
appropriate dosage form, route, and length of therapy.
1.3.2 The pharmacist determines if the correct amount of the drug is being received
and taken appropriately.
1.3.3 The pharmacist recognizes and takes steps to avoid or minimize adverse
outcomes related to drug therapy such as side effects, toxicity, adverse drug
reactions, drug-disease incompatibilities, drug-drug interactions, and duplication of
therapeutically similar medications.
1.3.4 The pharmacist recognizes and takes steps to avoid problems related to
intravenous administration including potential incompatibilities, drug stability,
volume of intravenous fluid for medication administration and rate of administration.
1.3.5 The pharmacist recognizes and addresses patterns of inappropriate use of
drugs.
1.3.6 The pharmacist detects and responds appropriately to activities which would
divert drugs from their intended legitimate use.
1.3.7 The pharmacist provides appropriate information to facilitate the patient's
understanding of his or her drug therapy and ability to comply with the therapy
regimen.
Operational Component 1.4
If any potential or actual drug-related problems are identified, the pharmacist
determines appropriate therapeutic options to solve or prevent them.
1.4.1 The pharmacist prioritizes identified problems.
1.4.2 The pharmacist proposes alternative strategies, including non-drug and drug
therapies.
1.4.3 The pharmacist selects the most appropriate therapeutic option through
consultation with the patient and/or other health care providers.
1.4.4 The pharmacist refers the patient to an appropriate health care provider or
health care agency after determining with the patient if such a referral is necessary.
The following situations may prompt such a referral:
1.4.5 The pharmacist explains the rationale of the proposed treatment to patients
and/or patients' agents and/or other health care providers.
Operational Component 1.5
The pharmacist ensures documentation of significant observations arising from the
patient assessment, recommendations made and actions taken, in a readily
retrievable format. The pharmacist shall resolve any questions regarding the order
and shall document the resolution in the patient's health record.
Operational Component 1.6
The pharmacist is clearly identifiable and is available, accessible and approachable to
consult with the patient who is seeking to self-medicate with a nonprescription drug,
a natural health product, or a complementary or alternative medicine.
Operational Component 1.7
The pharmacist documents and reports any unexpected adverse drug reactions* to
the prescriber and other health care providers as appropriate, and complies with
formal adverse drug reaction reporting programs.
* "Unexpected adverse drug reaction" is an undesirable patient effect that is
inconsistent with the product information or labelling; is serious; or results from
administration of a recently marketed drug whether serious or not.
Operational Component 1.8
The pharmacist takes appropriate action to acknowledge and prevent medication
discrepancies* and errors**, takes the necessary steps to resolve issues arising from
medication discrepancies and errors, and implements measures to prevent
recurrence.
1.8.1 The pharmacist discusses the error with the patient, prescriber and other
health care providers as appropriate.
1.8.2 The pharmacist documents the error according to the protocol of the
workplace.
* "Medication discrepancy" - an event which does not involve the actual
administration of a drug to a patient, but where an error in the medication process
has been detected and corrected before reaching the patient.
** "Medication error" (may also be referred to as a medication incident) is an event
which involves the actual prescribing, dispensing, delivery or administration of a drug
or the omission of a prescribed drug to a patient.
Standard 2
The pharmacist practices within legal requirements and ethical
principles, demonstrates professional integrity and acts to uphold
professional standards of practice. Refer: Operational Components 2.1
- 2.4
Operational Component 2.1
The pharmacist complies with legal requirements and ethical principles of practice
including federal and provincial legislation governing the sale of drugs and practice
as a pharmacist, and provincial regulatory authority by-laws, standards of practice,
policies and guidelines.
Operational Component 2.2
The pharmacist upholds and acts on the ethical principle that the primary
accountability of the pharmacist is to the patient, with respect to:
Patient confidentiality
2.2.1 In the course of fulfilling the duty of care for the patient, the pharmacist has
the right to refuse to provide a product or service.
2.2.2 The pharmacist has the right to dispense less than the quantity prescribed, if
the proper exercise of professional judgement by the dispenser so requires (DIDFA,
Reg.936, Section 3).
Operational Component 2.3
The pharmacist demonstrates personal and professional integrity.
2.3.1 The pharmacist accepts responsibility for his or her actions and decisions.
2.3.2 The pharmacist shows respect for the dignity of the patient.
2.3.3 The pharmacist collaborates with other health care professionals to enable the
patient to achieve his or her health care goals.
Standard 3
The pharmacist identifies, evaluates, interprets and provides
appropriate drug and pharmacy practice information to achieve safe
and effective patient care. Refer: Operational Components 3.1 - 3.5
Operational Component 3.1
The pharmacist identifies and evaluates appropriate sources of relevant information.
Operational Component 3.2
The pharmacist critically evaluates drug information.
Operational Component 3.3
The pharmacist determines the critical content to be provided.
Operational Component 3.4
The pharmacist provides information in a manner suitable for the recipient's use.
Operational Component 3.5
The pharmacist organizes and provides drug information to appropriate recipients.
Standard 4
While respecting the patient's right to confidentiality, the pharmacist
communicates and educates to provide optimal patient care and
promote health. Refer: Operational Components 4.1 - 4.5
Operational Component 4.1
The pharmacist respects the patient's rights to confidentiality and privacy by taking
all reasonable steps to ensure that personal health information is communicated in a
manner in which the discussion cannot be overheard by others. This may involve the
use of an acoustically private area such as:
4.1.1 The pharmacist respects the confidences of the patient and protects the
information received as privileged communication between a patient and healthcare
Name, general description of the drug dispensed and directions for use
Storage requirements
4.4.1 When entering into dialogue, the pharmacist interacts with the patient or agent
to receive and provide information needed.
4.4.2 The pharmacist interviews the patient or agent to determine and assess as
appropriate to the request:
Current medications
As part of the patient/pharmacist dialogue, the pharmacist consults and reviews the
patient profile and ensures that it is updated as appropriate.
4.4.3 The pharmacist discusses with the patient any recommended drug therapy
including, where appropriate:
Expected response
4.4.4 Where it is deemed important for continuity of care of the patient, the
pharmacist documents relevant information in a readily retrievable format, such as
the patient's profile or health record.
Operational Component 4.5
Delivered Drugs
Upon a request from a patient in the community or outpatient setting, for the
delivery of a scheduled product, the pharmacist takes reasonable steps to dialogue
with the patient or agent.
4.5.1 If a prescribed drug is being released to a person other than the patient or for
delivery to another premise, the pharmacist takes reasonable steps to:
Provide the agent for the patient with the necessary information if the
pharmacist is satisfied that it is in the patient's best interest to do so, and
4.5.2 If a Schedule II drug is being released to a person other than the patient or for
delivery to another premise, the pharmacist must make the decision to sell the
product and take reasonable steps to dialogue with the patient or their agent.
4.5.3 If a Schedule III drug is being released to a person other than the patient or
for delivery to another premise, the pharmacist informs the patient that he or she is
available for consultation.
Standard 5
The pharmacist, in collaboration with the designated manager or
hospital pharmacy manager, manages drug distribution by performing,
supervising, or reviewing the functions of selection, preparation,
distribution, storage and disposal of drugs to ensure safety, accuracy
and quality of supplied products. Refer: Operational Components 5.1 5.4
Operational Component 5.1
The pharmacist ensures that all pharmacy support personnel know when to refer a
question or query to a pharmacist.
Operational Component 5.2 - (Applies to community practice)
The pharmacist locates drugs in the area of the pharmacy consistent with the
appropriate drug schedule classification, regulations and safety consideration which
reflect the level of risk of the drug for the patient.
5.2.1 Schedule I drugs must be located in the prescription services department
(dispensary) or in a secure storage area accessible only to authorized personnel.
5.2.2 Schedule II drugs for sale to the public must be located in the prescription
services department (dispensary) or in a secure area adjacent to the prescription
services department, ensuring the area is readily accessible for the pharmacist but
provides no opportunity for self selection by the patient. The pharmacist must always
be involved in the decision to sell a Schedule II drug to the public.
Where Schedule II, III and other nonprescription products are located in the
pharmacy
5.2.4 Schedule III drugs and all other nonprescription products should be located in
an area of the pharmacy adjacent to the prescription services department
(dispensary) which should allow self selection of Schedule III drugs by a patient, and
provide opportunities for patient/pharmacist consultation.
5.2.5 The pharmacist should endeavour to enhance patient awareness of the
benefits, limitations, appropriate use and risks associated with nonprescription
products through one or more of the following:
Shelf talkers
Pharmaceutical calculations
Selection of ingredients
Acquisition of pharmaceuticals
Appropriate packaging
Drug recall policies and procedures are in place and enacted if necessary
Dispensed drugs will not expire prior to the patient completing the course of
therapy
Ability to identify the drug, including the lot number and expiry date
Standard 6
The pharmacist applies knowledge, principles and skills of
management as they pertain to the site of pharmacy practice, with the
goal of optimizing patient care and inter-professional relations. Refer:
Operational Components 6.1 - 6.3
Operational Component 6.1
A pharmacist only practices under conditions which do not compromise his or her
professional independence or judgement, and does not impose such conditions on
other pharmacists.
Operational Component 6.2
The pharmacist, or the pharmacist in collaboration with pharmacy management,
ensures that pharmacy operations protect the public and the people working on the
premises.
6.2.1 The pharmacist uses the space, facilities, equipment and supplies available in
the pharmacy to ensure patient safety through proper storage, preparation,
dispensing, distribution, and disposal of drugs.
6.2.2 The pharmacist ensures that appropriate procedures for the handling and
evaluation of medication discrepancies and errors are followed.
Operational Component 6.3
The pharmacist or the pharmacist in collaboration with pharmacy management takes
reasonable steps to maintain adequate and appropriate staffing to ensure that
pharmacy practice is in accordance with these Standards.
6.3.1 The pharmacist assumes professional responsibility for and supervision of
pharmacy support personnel with whom they have direct interaction in their role
and/or assigned tasks.