If you know me then you know that Iâ€™m a proponent of expanding the role of pharmacy technicians in the acute care pharmacy setting. I believe pharmacy technicians are underutilized and are capable of doing many functions within a healthcare system to improve patient care, both directly and indirectly, as well as free up pharmacists to do the things they should be doing.
Anyway, thereâ€™s a nice article in the most recent ASHP InterSections titled â€œInnovative Technician Practices Debuting in Hospitalsâ€. The article discusses not only tech-check-tech, which is the most commonly cited â€œadvancedâ€ technician practice, but the use of technicians to perform medication reconciliation as well.
In 2008, the pharmacy department [at Mercy Hospital in Coon Rapids, Minn] instituted a tech-check-tech program, in which a certified pharmacy technician checks the accuracy of orders filled by another technician and provides final verification prior to patient administration.
â€œWe have technicians checking other technicians for 75 to 80 percent of our medications,â€ said Brent Kosel, Pharm.D., M.S., pharmacy operations manager. â€œOur auditing data shows that technicians do just as good a job as pharmacists. The pharmacists are champions of this program because they can focus more on our patientsâ€™ clinical needs.â€
The last audit, which covered about 7,500 doses, resulted in a 99.8 percent accuracy rate, according to Kosel. For now, the technicians check doses for automated dispensers, while pharmacists still conduct the final review for high-risk and intravenous drugs.
At Good Samaritan Hospital in Puyallup, Wash., pharmacy technicians have pretty much taken over the medication-reconciliation process at admission. In too many cases, the medication lists at the time of a patientâ€™s admission are inaccurateâ€”a common story at hospitals across the country.
â€œWe wanted to see how we could get a better list up front, because itâ€™s not a primary focus of nursing and we donâ€™t have enough pharmacists to obtain medication histories on all of our patients,â€ said Dianna Gatto, Pharm.D., BCPS, manager of pharmacy clinical services. â€œI thought we could train our technicians to do this.â€ So she did.
After a month-long pilot program involving two technicians, the program rolled out in the emergency department (ED), which treats about 175 patients daily (20 percent of whom are admitted). Since the programâ€™s debut, it has expanded significantly, with three technicians working daily to spend an overlapping 28 hours on medication reconciliation. Medication lists are obtained for ED patients and direct admissions. A pharmacist reviews each updated medication list before physician reconciliation.
Pay attention pharmacists. If you want to change your practice environment make better use of pharmacy technicians. Theyâ€™re more than capable of handling more advanced duties.