PDL has recently updated the Guide to Good Dispensing to reflect changes in the dispensing process that have arisen from changes in technology and legislation, such as the introduction of electronic prescriptions and active ingredient prescribing. PDL Professional Officers would like to remind pharmacists that good dispensing requires a systematic approach, risk assessment and clear documentation.
Most pharmacies are now dispensing a combination of paper and electronic prescriptions, sometimes for the same patient. It is important to have a robust dispensary process that allows all prescription types to be dispensed in a safe and efficient manner. PDL Professional Officers recommend the following to prevent errors when dispensing electronic prescriptions:
- Always perform the final check of the prescription from the downloaded copy on the dispensing screen.
- An easily accessible monitor or screen should be available for pharmacists to review the prescription during patient counselling.
- Be alert for annotations. Prescribers often communicate additional dosing directions, such as staged supply requirements in the annotations section of the electronic prescription, and these can be easily overlooked during the checking process.
- The patient’s details as they appear on a paper prescription will not be available to confirm the patient’s identity so other steps must be taken to ensure the medicine is supplied to the correct patient.
Active Ingredient Prescribing (AIP)
PDL Professional Officers often provide advice on dispensing errors resulting from incorrect conversion of an active ingredient to a brand name. These errors often occur when the name of the medication is input into the dispensing software by brand name rather than the drug name. This type of error is more common with combination medications, oral contraceptives and vaccines. To prevent AIP errors, PDL Professional Officers recommend the following processes:
- Always scan the prescription barcode to input data into the dispense software where available.
- If manual data entry is required, enter the medication name as it appears on the script, i.e. if a prescription is written by drug name, input the drug name.
- When performing the final check, always check both the drug name and the brand name.
Documentation is crucial for patient care, particularly when multiple pharmacists work together, but it is also essential to protect pharmacists in the event of complaints and regulatory notifications. Documentation should include subjective and objective details, assessment decisions and plans for follow-ups. Pharmacists should document:
- discussions with other healthcare professionals and any agreed action or plan;
- concerns or issues with the prescription and actions taken or plans agreed with prescriber or consumer;
- deferral or declinature to supply including reasons for this action;
- relevant information provided by the consumer;
- reasons for supply outside therapeutic standards;
- provision of risk management advice or therapy, e.g. offer of staged supply, offer of HMR or supply of Take-Home Naloxone.
For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7.