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Minnesota Board of Pharmacy |
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Minnesota Board of Pharmacy |
DISCIPLINARY ACTIONS
The following
disciplinary actions have been taken by the Board during the months of June,
July, and August 2000.
DISPENSING
ERRORS/COMPLAINTS ON THE RISE
It should come as no
surprise to Minnesota pharmacists that,
like the rest of the country, Minnesota is seeing a dramatic increase in the
number of dispensing errors and, consequently, complaints to the Board. As of
the end of August of 2000, we have already surpassed the number of dispensing
errors and the number of complaints, filed with the Board, that were received in
all of calendar year 1999. In turn,
1999 saw more dispensing errors take place than occurred in 1998.
While the Board of Pharmacy has, for the most part, taken a non-punitive approach to
dispensing errors made by individual pharmacists, the Board has and will
continue to take disciplinary action when a pattern of errors occurs involving a
pharmacy or an individual pharmacist. For the most part, however, the Board is
concerned with finding the root cause of the error, and attempting to make sure
that changes are made in the procedures, policies, etc., at the pharmacy in
order to prevent similar such errors from occurring in the future.
In
the course of investigating dispensing errors that have been brought to our
attention, we cannot help but notice that a substantial number of the dispensing
errors could have been prevented had the pharmacist only counseled the patient
and performed a “show and tell” with the prescription being dispensed.
Pharmacists really do need to be held accountable for dispensing errors getting
to the patient when proper counseling of the patient could have avoided the
error.
Granted,
patient counseling takes a bit of time but, clearly, the patient is better
served by having to spend a few additional minutes waiting to pick up their
prescription and getting the correct prescription, as opposed to getting the
wrong prescription immediately. In addition, proper counseling of the patient
can serve to maximize the effectiveness of the patient’s drug therapy.
Minnesota
pharmacists owe it to their patients and themselves to take whatever time is
necessary to make sure the patient gets the correct medication and is counseled
on the proper use of the medication.
ELECTRONIC
PRESCRIBING BEGINNING TO APPEAR
The Board of
Pharmacy office has begun to receive phone calls from pharmacists who, in turn,
have begun to receive prescriptions transmitted electronically from the
prescriber to the pharmacist’s computer or to the pharmacist’s fax machine.
Of primary concern to those calling the Board office for guidance seems to be
the issue of whether or not these prescriptions are legitimate.
Board
of Pharmacy rules specifically allow physicians to electronically enter
prescription information and have that prescription information transmitted to
the pharmacy. The question has been raised, however, as to how the pharmacist
can know that a prescription received on the pharmacy’s fax machine is truly a
legitimate prescription submitted electronically by the prescriber, as opposed
to a faxed version of an electronically-generated hard copy prescription, sent
to the pharmacy’s fax machine by the patient.
At
the present time, there is no good answer to this dilemma. The Minnesota Board
of Pharmacy, like other boards of pharmacy around the country, are currently
struggling with the concept of electronically-generated prescriptions, and are
trying to identify ways of guaranteeing the authenticity of a prescription,
while at the same time not creating barriers for the use of electronic
prescribing.
Until
such time as the Board identifies the need for and actually implements rules
relating to electronic prescriptions, the best advice is for pharmacists to
contact the prescriber to verify the authenticity of the order if there is any
question as to its authenticity or any question as to whether it was submitted
by the prescriber, as opposed to the patient. As all Minnesota pharmacists know,
faxed copies of prescription orders, submitted by a patient, are not considered
valid prescriptions and cannot be legally acted on by the pharmacist.
At
the recently concluded District V NABP/AACP Meeting, attended by representatives
of boards and colleges of pharmacy from Nebraska, Iowa, South Dakota, North
Dakota, Minnesota, and Manitoba, the Board received information on a study,
recently completed in Canada for the National Association of Pharmacy Regulatory
Authorities, regarding a secure system for transmitting prescriptions and
related patient information between prescribers and pharmacists. The Board will
be reviewing this Canadian study, and hopes to learn from its northern neighbors
about what is workable in this regard.
While
on the issue of electronic prescribing, it should be noted that, while handheld
devices have reduced the potential for errors associated with misinterpretation
of drug orders, errors in patient identification have already been reported.
While the drugs commonly prescribed in a physician’s office are usually
somewhat limited, the identities of patients seen in that office setting can
number into the thousands. Apparently, it is very easy for a prescriber to
inadvertently select the wrong patient name, from a list of similar names,
resulting in a prescription that comes to the pharmacy with the wrong patient
name attached and, perhaps, more importantly, the wrong patient’s chart gets
updated with the prescribing information at the physician’s office.
Pharmacists
receiving electronically-generated prescriptions, whether by fax or directly to
the pharmacy computer, should be sure to review patient names and addresses with
the patient before dispensing the medication involved.
COMMONLY
ASKED INTERNSHIP QUESTIONS
Students must have our manual completed if more than 200 hours are worked in Minnesota. Out-of-state preceptors can sign off on appropriate competency statements.
We will transfer hours regardless of whether or not the manual is completed.
Students must have completed the entire manual in order to sit for the Board Exam in Minnesota
A registered preceptor (or a U of M faculty “preceptor” who might not be registered with the Board) must sign off on the manual.
Yes,
the Board will stay with the 10% per month deduction.
The College will deal with getting the manual signed off.
The student must continue to work as an intern until all of the required hours are completed.
The completed manual must be turned in to the Board at least 21 days prior to a scheduled Board Exam.
The
Internship Competency Manual must still be completed.
If a student has accomplished an objective previously, who should sign off on that item in the manual?
The
student can have either their current preceptor, or the preceptor under
whom the objective was accomplished, sign the manual.
How do students get “sign offs” on some categories, like long-term care or IV therapy, when they may not have had a rotation or any direct experience in that area?
The
student can work with any community pharmacist-preceptor; access the
information via the internet; work at a nursing home, served by the
pharmacy they are working for; and/or speak to the consultant pharmacist
at the nursing home served by the pharmacy.
Can a student have an out-of-state preceptor sign off on the competency statements?
Yes.
