Interprofessional pharmacy observation activity for third-year dental students.

Interprofessional learning is a key component of today's health sciences education. Within a two-course series in dental pharmacology and therapeutics, a dental curriculum was revised to provide an interprofessional activity to expose dental students to a community pharmacy setting. The objectives of this activity were to augment students' learning about drug laws and prescription writing, as well as to foster interprofessional relationships and collaboration between pharmacists and dentists. Dental students were scheduled for one-hour observations at community pharmacies on campus. Learning objectives to guide this activity focused on demonstrating community pharmacy operating procedures, identifying ways to minimize prescribing and dosing errors, and understanding how pharmacists can assist dentists in prescribing. Following the observation, students were required to submit a written assignment, which accounted for 14 percent of their course grade. All 119 dental students (100 percent) enrolled in the course for the summers of 2012 and 2013 completed the activity. The average grade on the written assignment was 96.2 out of 100. At the end of the course, students were asked to participate in an online course evaluation survey, for which response rates were 37 percent and 43 percent for 2012 and 2013, respectively. The students rated the pharmacy observation activity favorably on this course evaluation. The pharmacy observation activity provided a successful interprofessional component to the didactic pharmacy course and was well received by the dental students as well as the community pharmacists.

Compounding & dispensing errors before and after implementing barcode technology in a nuclear pharmacy.

The objective of this study was to determine whether the incidence of compounding and dispensing errors changed significantly in a nuclear pharmacy after the pharmacy adopted a barcode assistance system. Nuclear pharmacy dispensing errors are extremely low compared to that of busy traditional pharmacies, but there is no data available describing the use of bar-coding assistance on the rate of dispensing errors in nuclear pharmacy. A retrospective review of dispensing errors pre-barcode assistance system implementation (2001 through 2004) and post-barcode assistance system implementation (February 2005 through 2009) was conducted using data from a nuclear pharmacy that dispenses approximately 500 prescriptions per day to nuclear medicine clinics and hospitals. Data was obtained from pharmacy error logs filed by the pharmacy as reported by an end user receiving the compounded preparation or the pharmacist having recognized the error before it reached the end user. Dispensing errors were defined as any deviation in the dispensed preparation from the prescribed order. Categories identified as incorrect were: dosage, drug, volume, procedure, patient, and delivery destination. Implementation of the barcode assistance system included installation of computers, software, barcoding devices, and training of personnel. The barcode assistance system provided barcodes for each compounding component, final preparation, syringe label, prescription, and shipping material. The barcode assistant system communicated directly with the dose calibrator, enabling the dose calibrator settings to automatically change according to time of administration and isotope required. The average error rate pre- and post-barcode assistance system was 0.012% and 0.002%, respectively (P<0.0001). Pre-barcode assistance system, two major categories represented 88% of all dispensing errors: wrong dosage (60%) and wrong drug (28%). Post-barcode assistance system, the major category was delivery destination (90%). The results suggest that the barcode assistance system has been instrumental in significantly decreasing compounding errors. The implementation of barcoding during compounding and dispensing has allowed improvement of the processes so much so that it enabled the identification of other sources of routine error.

Medication reconciliation in a community pharmacy setting.

OBJECTIVES: To describe the types and frequencies of medication discrepancies identified through medication reconciliation in a community pharmacy setting, to identify potential correlations between a patient's electronic medical record (EMR) and pharmacy medication list, and to determine the relationship between patients who use prescribers and/or pharmacies outside of the Family Medicine Center (FMC) and the occurrence of medication discrepancies. METHODS: Cross-sectional comparison of patients' EMR medication lists and pharmacy medication fill history for a sample of patients presenting to the Family Medicine Pharmacy (FMP), which is located in the FMC on the University of Oklahoma Health Sciences Center campus in Oklahoma City. Discrepancies identified were classified according to one of six categories that included therapeutic duplication, medication exclusion, medications that should be designated inactive in the EMR medication list, and differences in medication strength, dosage form, or dosing regimen. RESULTS: A total of 100 patients were included. Most patients reported having all of their medications dispensed from FMP (89%), and most patients had prescriptions prescribed by FMC physicians only (57%). Each patient had an average of six medication discrepancies. Most discrepancies belonged to the inactive medication category (41%). The correlation between patients' FMP medication lists and their EMR medication lists was 0.73. Patients with one or more non-FMC prescribers had a greater number of medication discrepancies than patients with FMC prescribers only, but this relationship was not identified for those who used pharmacies outside of FMP (P = 0.0264 and 0.2580, respectively). CONCLUSION: A variety of medication discrepancies were observed, signaling a need for medication reconciliation in the outpatient setting. Future research on this topic should focus on the implications of such discrepancies in the outpatient setting, interventions to reduce the number of discrepancies, and identifying patients at high risk for such discrepancies.