Working as a Pharmacy technician you are prone to errors and to err is human. There are some common mistakes, pharmacy technician commits on-the-job and there are various factors which make these errors happen. The environment at the pharmacy can be stressful, handling several tasks, from dispensing medications, to answering calls, from entering patient data to settling insurance claims. As a pharmacy technician you are constantly juggling between clinical and administrative duties and this can be challenging sometimes. To better equip yourself and gear up for the challenges at work I highly recommend getting Certification and this will help you familiarize yourself with pharmacy operations and drug names. In the article below we will go through the possible errors a pharmacy technician can make and how to possibly avoid it, consequently helping you prevent a disastrous situation for yourself and your patient.
1) Dispensing the Wrong Medication Error
This occurs when you fill the doctor’s prescription with wrong medication. This can occur due to several reasons such as not reading the prescription carefully or on some busy days dispensing a large volume of medication at the pharmacy.
How to avoid: Prescriptions should be read carefully before entering in the computer and starting to prepare the medication. At the time of stocking the shelves utmost precision should be practiced while labelling and corrections if any, should be made immediately. Abbreviations should be used correctly and as a pharmacy technician you should be aware of all the relevant abbreviations
2) A mix-up between drug names and abbreviations Error
While entering data, some abbreviations, when used can create ambiguity. They will only increase the risk for errors while handling those medications.
How to avoid it: There is a list of abbreviations which you should avoid using because they can be misread.
- Writing MS, MSO4, MgSO4 which mean ‘MS and MSO4’ for Morphine sulfate and ‘MgSO4’ for Magnesium sulfate can be confused for one another to prevent it always write “morphine sulfate” Write “magnesium sulfate
- D. which means ‘Every day’ the period after “Q” can be mistaken for an “I,” so that the abbreviation is misread as “QID” or four times daily to avoid this mistake always write daily instead QD
- µg which means ‘Micrograms’ can be mistaken for “mg” just write it out as mcg
- AU, AS, AD which mean ‘Both ears; left ear; right ear’ can be mistaken as “OU” (both eyes), “OS” (left eye), or “OD” (right eye) just be careful.
- HS which means ‘Half-strength’ can be misinterpreted to mean “at bedtime”
- SQ or SC which means ‘Subcutaneous’ can be mistaken as “SL”
- O.D. which means ‘Every other day’ can be mistaken for “QD” or “QID”
3) Incorrect drugs (look-alike or sound-alike) used Error
Some drugs may look and sound similar and that sometimes creates confusion which leads to medication error. Check examples below
Valtrex (valACYclovir) and Valcyte (valGANciclovir).
acetaZOLAMIDE.and acetoHEXAMIDE.
bupropion and busPIRone.
ALPRAZolam and LORazepam and clonazePAM.
aMILoride and amLODIPine.
glipizide and glyBURIDE.
hydralazine and hydrOXYzine and HYDROmorphone.
chlorpromazine and chlordiazePOXIDE.
How to avoid it: The JTC recommends to use Tallman lettering (as shown above) and store the drugs at different locations. Also Placing reminders on the stock bottle or in the computer system to alert pharmacy technicians about the common confused drug names can keep you updated, possibly avoiding this error.
4) Misplaced zeroes and decimal points Error
A hurried transcription or interpretation of the prescription can at times cause misplacing of a zero, decimal point or a unit. This means dispensing a much higher or lower dose than indicated, leading to a life-threatening consequence
How to Avoid: when transcribing do not use trailing zeros e.g. 5.0mg instead write 5mg, also lack of leading zeros can cause confusions example .6mg so always use leading zeros 0.6mg
5) Handing over medication to the wrong patient error
This can happen when you hand over the medication bag to a wrong patient at the point of sale.
How to avoid it: Always verify patient Name, Date of birth and home address when they come to pick up their medications, never rush just because there is five people in line waiting for pick.
6) Ignoring and overriding ‘high-alert’ medication messages during order entry without checking with RPh
A wrong dosage of high alert medications such as chemotherapy drugs, oral hypoglycemic, insulin, methotrexate, opioids, opium tincture, injectable electrolytes, sedative agents and paralyzing agents can cause serious harm to the patients.
How to Avoid it: Always check with Pharmacist when you get high alert messages or when you are preparing high alert IV medication dosage forms
FINAL THOUGHTS
As we have seen above an error can be prevented and is certainly not the fault of only a pharmacy technician, but a system failure where it could be the prescriber, pharmacy technician, pharmacist, nurse or even the computer software causing it. As a pharmacy technician, your role is to identify and report any system failure to the pharmacist. Leaving any ambiguity to chance or taking short-cuts may prove to be dear, not only to the patient but also your career as a pharmacy technician