Curexa Pharmacy Technician Training Program PDF

Curexa Pharmacy Technician Training Program M O D U L E T 9 - D ATA E N T R Y  The contents of this education and training program are only applicable to employees of Curexa. Completion of this program shall certify the employee as a Pharmacy Techn...

Curexa Pharmacy Technician Training Program M O D U L E T 9 - D ATA E N T R Y  The contents of this education and training program are only applicable to employees of Curexa. Completion of this program shall certify the employee as a Pharmacy Technician within Curexa and is not transferrable upon discontinuation of employment. Disclaimer The training program is considered proprietary information and remains the sole and exclusive property of Curexa at all times. Curexa has the exclusive right, title, and interest to its proprietary information. No right or license, by implication or otherwise, is granted by Curexa as a result of disclosure of proprietary information under this disclaimer.  The Pharmacy Technician Training Program is made up of 10 modules and 8 separate compounding modules: Module T1: Program Overview Pharmacy Module T2: Technician Expectations Technician Module T3: Fundamentals- Math Training Program Module T4: Fundamentals- Prescriptions Part 1 Program Outline Module T5: Fundamentals- Prescriptions Part 2 Module T6: Inventory Module T7: Documentation and Records Module T8: Safety Module T9: Data Entry Module T10: Compounding Data Entry Module C1-C8: Compounding Curriculum (set of 8 modules)  At the conclusion of this presentation, team members should be able to: 1. Explain the prescription intake procedure 2. Explain patient profile requirements 3. Explain prescription requirements in the state of New Jersey Learning Objectives 4. Understand prescription timelines 5. Summarize key questions to ask before entering a prescription related to prescription components 6. Provide an overview on the processing of new prescriptions and prescription refills  Self-Assessment Questions 1) Key information to obtain when accepting a new prescription for the patient include which of the following EXCEPT: a) Time the patient is expecting the prescription (turnaround time) b) Patient birth certificate and social security card c) Patient name, address, telephone number, and other medications the patient is taking d) Date of birth of the patient and whether they have drug allergies 2) Which of the choices are included in patient profile requirements (select all that apply)? a) Dispense dates for all prescriptions (new and refill) b) Name, strength, and quantity of the drug dispensed c) Other prescription drugs that the patient is also taking d) Patients first and last name, DOB, allergies, address, and telephone number 3) Which of the choices are included in New Jersey prescription requirements (select all that apply)? a) A New Jersey Prescription Blank (NJPB) for hardcopy prescriptions b) Controlled substances written together with other prescriptions on the NJPB c) Words, in addition to numbers, to indicate the drug quantity authorized if the prescription is for a Schedule II controlled substance 4) True or False: Questions to ask before entering a prescription include whether the prescription is expired, provider credentials are on the prescription, and the patient information on the prescription matches the profile information it is being recorded in. Prescription Intake Prescriptions may be dropped off or mailed in “hard copy” form to the EHT location or may be electronically prescribed. Prescriptions may also be faxed or phoned in by the prescriber. When a patient drops off a prescription, they will often ask for a turnaround time. Be sure to check with the team for an appropriate estimated time of completion. When a patient is new to the pharmacy, it is necessary to gather enough information to start a patient profile. Patient Profile information will include: Name, address, telephone number, date of birth (or age) and gender. For children and animals, the weight of the patient should be obtained Individual history where significant, including disease state(s), known allergies and drug reactions, and a comprehensive list of their medications and relevant devices The Patient Profile Record System (PPRS) must contain the following for each patient: ◦ The first and last name of the person for whom the medication is intended (the patient) ◦ The address and telephone number of the patient ◦ The patient’s DOB and gender ◦ The original or refill date the medication is dispensed ◦ The number or designation identifying the prescription (Rx number or prescription number) ◦ The practitioner’s name ◦ The name, strength, and quantity of the drug dispensed ◦ Pharmacist’s comments relevant to the patient’s drug therapy ◦ Any allergies and idiosyncrasies of the patient ◦ Any medical conditions that may relate to drug utilization (as communicated by the patient/patient’s representative) ◦ Other prescription drugs that are being concomitantly utilized Patient Profile Requirements A practitioner shall include the following information on each written prescription: ◦ The prescribing practitioner's full name, address, telephone number, license number, and proper academic degree or identification of professional practice for which licensed ◦ The full name, age and address of the patient ◦ The date of issuance ◦ The name, strength and quantity of the drug prescribed ◦ Words, in addition to numbers, to indicate the drug quantity authorized if the prescription is for a Schedule II controlled substance, for example: ten (10) Percodan; or five (5) Ritalin 5 mg (unless it is an electronic prescription) ◦ The number of refills permitted or time limit for refills, or both ◦ The handwritten original signature of the prescribing practitioner (unless it is an electronic prescription) ◦ An explicit indication, by initials placed next to "do not substitute", if it is the prescribing practitioner's intention that a specified brand name drug be dispensed ◦ The prescribing practitioner's D.E.A. number, if the drug is a controlled substance ◦ Adequate instruction for the patient as to frequency; a direction of “PRN" or "if needed" alone may be used if appropriate ◦ Each prescription for a controlled substance shall be written on a separate NJ Prescription Blank (unless it is an electronic prescription) ◦ A prescription blank that contains a prescription for only one controlled substance and contains other prescription(s) other than another controlled substance shall be valid Prescription Requirements NJ Prescription Blanks If the prescription is transmitted verbally or electronically by a licensed prescriber, the prescriber New Jersey Prescription Blanks The NJPB may either be personal to may be exempt from utilizing the (NJPB) are required for hard copy the prescriber or of a licensed NJPB, but must provide the prescriptions issued in NJ. healthcare facility. pharmacist with his or her license number, DEA number (if controlled substance), and NPI number. If the NJPB is from a licensed healthcare facility, the patient must Separate NJPBs are required for be treated at that facility and the each controlled substance issued prescriber’s name, license number, and other medications may not be and DEA number (if a controlled listed on the same prescription substance) must be on the prescription  Prescription Expiration Date Other Requirements Legend Drug (non- 1 year from the date Even “PRN Refills” expire controlled prescription) written after 1 year from date written May be transferred as long as refills remain for up to 1 year Important CDS Schedule II 30 days from the date written No refills Prescription CDS Schedule III-V 6 months from the date May not be transferred First fill within 30 days of Timelines written date written Maximum of 5 refills plus original fill (6 total fills) May only be transferred once (except for pharmacies sharing a real-time online database or are engaged in centralized prescription handling) Validating the Prescriber’s DEA To validate the prescriber’s DEA number is For example, if a prescriber’s DEA number is legitimate: BD3214517 The first letter The doctor’s name is Jane Doe and she is a The second letter represents general practitioner = this is valid The number sequence should be 7 digits There are 7 digits = this is valid Add the 1st, 3rd, and 5th numbers together (first Add 3 + 1 + 5 = 9 [BD3214517] segment) Add 2 + 4 +1 = 7 and multiply by 2 = 14 Add the 2nd, 4th, and 6th numbers together and [BD3214517] multiply this total by 2 (second segment) Add 9 + 14 = 23 = this is NOT valid because 3 Add the first and second segments together. does not match 7 [BD3214517] The second digit of the total should be the last number of the DEA  Curexa employees are trained to identify the authenticity of prescriptions. Prescription Authenticity Some methods of validating whether a prescription is authentic include (but are not limited to): Prescriber credentials are present and accurate Electronic prescriptions Medication prescribed Prescription is written in a Pharmacist can validate by are sent via a secure, contacting prescriber or matches the provider’s consistent manner (same closed system of an checking credentials (ex. NPI or scope handwriting or print) DEA) approved platform  Alerts may be generated while performing data entry of prescriptions within Pioneer. When alerts are generated by Pioneer, the Data Entry Technician must notify the Pharmacist immediately. Pharmacy Technician’s may NOT perform Drug Data Entry Utilization Review (DUR) activities. Alerts Examples of DUR alerts include: Over-utilization or under-utilization Therapeutic duplication Drug-disease contraindications Drug-drug interactions Incorrect drug dosage or duration of drug treatment Drug-allergy interactions Clinical abuse/misuse Data Entry Data entry can be a complex process, involving many steps. As mentioned in previous modules, data entry should consider all necessary components of the prescription. There are several questions to answer: Is the patient information on the prescription? Is the prescription authentic? Is the prescription expired? Does the prescription include a valid medication name and strength? Are there adequate directions listed on the prescription? Are there valid prescriber credentials (NPI, DEA, License) and contact information? Does the prescription have sufficient refills (if refilling a medication) or did the prescriber indicate how many refills to give? Is the prescription signed by the practitioner? Can the medication be substituted for a generic? When entering the prescription, are dangerous abbreviations or symbols being used? Does the prescription information match what is being entered into the patient profile? Prescription Refills and Renewals Prescriptions may be refilled from the patient profile by selecting the prescription number and processing the refill. When the refills listed on the patient’s original prescription have been depleted or the prescription becomes expired, no additional renewals may be added to the original prescription. For additional dispensing, a new prescription must be authorized by the practitioner. Pharmacy Technicians are authorized to contact the prescriber to request additional refills. If a prescription requires a change, a pharmacist must make and document the change. Refill requests may be generated through Pioneer: ◦ The Pharmacy Technician may process refill requests and acquire authorization from the prescriber to renew unchanged prescriptions. New Prescriptions Select the appropriate patient profile using 2 patient identifiers (name and DOB) or add a new patient. ◦ If adding a new patient, all profile requirements must be entered Scan the hard copy prescription into the system, ensure the layout orientation of the image is easily readable. ◦ Scanning is not necessary for electronic prescriptions, as the prescription is directly captured by Pioneer ◦ Save the scanned prescription  Entering a Dr. Test Test, M.D. 123 Prescriber Road Prescription Nowhere, CA 12345 ▪Validate that the patient’s name and DOB on the NPI 123456789 prescription matches the profile within Pioneer. Ensure the address is correct Patient: Patient, Test DOB: 1/2/90 ▪Enter the appropriate prescriber’s name to search for a valid prescriber Address: 125 N Main St San Diego, CA 92101 Date: 10/27/22 ▪Match the phone number, address, and NPI number of the prescriber selected in Pioneer to the prescription (DEA if it is a controlled dangerous Lisinopril 10mg Tablet substance) #30 o Note that this information is currently missing on the Sig: 1T PO daily profile to the left and will need to be entered ▪Enter the date the prescription was written ▪Enter the specific drug name and formulation. Consider if a generic or brand must be selected Dispense as Written____________ Substitution Permissible ______ ▪Enter the Origin of the prescription (ex. Phone, fax, Prescriber signature Refills: 3 electronically prescribed) ▪Enter the quantity ordered and the number of refills  Entering a Prescription ▪Enter the directions (sig code) ▪Enter the ICD-10 code if listed on the prescription ▪On the Dispense Tab, enter the days supply, the priority (shipping, delivery, returning), and appropriate pricing and/or benefits information (if applicable) ▪The comments section may be used to place any important information to alert internal team during the filling or dispensing process ▪Review any critical comments and/or alerts. Notify the pharmacist immediately if an alert must be reviewed or requires an override  Self-Assessment Answers 1) Key information to obtain when accepting a new prescription for the patient include which of the following EXCEPT: a) Time the patient is expecting the prescription (turnaround time) b) Patient birth certificate and social security card c) Patient name, address, telephone number, and other medications the patient is taking d) Date of birth of the patient and whether they have drug allergies 2) Which of the choices are included in patient profile requirements (select all that apply)? a) Dispense dates for all prescriptions (new and refill) b) Name, strength, and quantity of the drug dispensed c) Other prescription drugs that the patient is also taking d) Patients first and last name, DOB, allergies, address, and telephone number 3) Which of the choices are included in New Jersey prescription requirements (select all that apply)? a) A New Jersey Prescription Blank (NJPB) for hardcopy prescriptions b) Controlled substances written together with other prescriptions on the NJPB c) Words, in addition to numbers, to indicate the drug quantity authorized if the prescription is for a Schedule II controlled substance 4) True or False: Questions to ask before entering a prescription include whether the prescription is expired, provider credentials are on the prescription, and the patient information on the prescription matches the profile information it is being recorded in a) True b) False References Controlled Dangerous Substances Regulations. New Jersey Administrative Code Title 13 Law and Public Safety. Chapter 45H. Revised February 19, 2019. Accessed November 2, 2022. https://www.njconsumeraffairs.gov/regulations/Chapter-45H-Controlled-Dangerous-Substances.pdf Curexa Policy A0055. Prescription Filling Process. Accessed December 9, 2022. Curexa Policy A0081. Prescription Authenticity. Accessed December 9, 2022. Curexa Policy A0083. Controlled Substances. Accessed December 9, 2022. Hopper, Theresa. Mosby’s Pharmacy Technician Principles and Practice. Saunders; 2003: 22. Institute for Safe Medication Practices (ISMP). ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations. ISMP; 2021. NJ State Board of Pharmacy Regulations. New Jersey Administrative Code Title 13 Law and Public Safety. Chapter 39. Revised October 17, 2022. Accessed December 2, 2022. https://www.njconsumeraffairs.gov/regulations/Chapter-39-State-Board-of-Pharmacy.pdf Uniform Prescription Blanks. New Jersey Administrative Code Title 13 Law and Public Safety. Chapter 45A subchapter 27. Revised March 17, 2014. Accessed November 16, 2022. https://www.njconsumeraffairs.gov/regulations/Chapter-45A-Subchapter-27-Uniform-Prescription-Blanks.pdf