Institutional Pharmacy Setting
Institutional pharmacy refers to an array of services offered to residents of nursing homes, hospitals, and other healthcare facilities (Johnston, 2006, p.2). In an institutional pharmacy, the pharmacy technician gives support to the pharmacist and is responsible for the patient’s prescription-related needs. What’s more, institutional pharmacist identifies, determines, and averts medication-related complications (Institutional Pharmacy Technician, 2010, p.2). Pharmacist technicians are required to adhere to the institutional policies and statutory laws. In addition, they must be conversant with all medical procedures relevant to their duties (Johnston, 2006, p.3).
The Institutional pharmacy offers a variety of delivery services. They also provide drug prescriptions in customized packages for easy and safe dispensation. Institutional pharmacists are responsible for checking patients’ drug interactions to avert a potential repetition of treatment and side effects. Therefore, they are the primary defense against medication errors and help in providing quality health care (Strand, 1990, p. 78). On the other hand, Institutional pharmacy technicians offer support to the pharmacists and work under their supervision (Lambert, 2002, p. 12). In most cases, they do not engage patients directly, for instance, they do not advise patients. Their duties include recording information on the prescriptions, entering and updating patients’ profiles in the system, establishing patients’ entitlement and co-pay, and dispensing repayment claim forms (Institutional Pharmacy Technician, 2010, p.2). Institutional pharmacy technicians also record prescriptions in the data system after interpretation by the pharmacists (Lambert, 2002, p. 12; Institutional Pharmacy Technician, 2010, p.3).
In a nutshell, an institutional pharmacy technician is in charge of processing medication orders, taking care of and filling computerized dispensing machines or entity dose carts, management of inventory, distribution of medications, compounding non-sterile and sterilizing medications, labeling of prescriptions, among others. They also record prescription information in patients’ profiles and organize insurance forms. To qualify as a certified pharmacy technician, an individual must have over 600 hours of laboratory and classroom training and over 140 hours of monitored internship (Johnston, 2006, p.2).
Institutional pharmacy technicians generally utilize monitored dispensing systems to make sure that the correct dosage of prescription is given to patients at the correct time. These systems allow the medical team to provide medications with simplicity and inappropriate doses that are usually pre-measured. The dispensing system improves conformity, saves time, helps in averting prescription errors, and monitors medication usage. Prescription carts, filled and delivered by medical practitioners, make it possible for patients to get the correct medication at the correct time. Institutional pharmacies permit drugs that are not used and opened to be returned for credit. The return of unused drugs ensures that products are not wasted due to changes in the patient’s medication. This practice guarantees cost-effectiveness (Institutional Pharmacy Technician, 2010, p.3).
Similar to an ambulatory setting, medications can not be dispensed in an institutional pharmacy setting without a medication order. These orders may be delivered to the pharmacy in several ways: They can be handed directly, faxed, e-mailed, or collected from a specific source. The orders must contain the patient’s information (for instance name, room/bed number, hospital number, and age) and medication information (name, dose, number of administration, route, the signature of the physician, and date on which it was written. Subsequently, orders are verified by the technician engaged in the institutional setting. Unverified orders are not accepted until they are verified by the pharmacist. Different institutions have different types of dispensation systems and these may include floor stock, individual and unit-dose. The latter is the most efficient and involves close monitoring (Johnston, 2006, p.2; Strand, 1990, p. 79).
Non-institutional pharmacies are pharmacies that are located outside medical institutions, for instance, in supermarkets, grocery stores, drug stores, or an online pharmacy. These pharmacies are more similar to the institutional pharmacies except that they are not allowed to take unused medications (Lambert, 2002, p. 14). Patients within the institutional pharmacy setting do encounter numerous challenges. The most common one relates to medication safety/error. These revolve mostly around professional errors and patient errors. Professional errors entail acts of commission and/or omission by pharmaceutical physicians. This error usually depends on the type of dispensation system in use with the unit dose being the most efficient. A patient error results from poor observance and persistence to a given medication. This may be due to a lack of enough information or addiction to specific medication (Johnston, 2006, p.4).
Although Institutional pharmacies are similar to non-institutional pharmacies in terms of filling prescriptions and medication orders, they play different roles. The main responsibility of the institutional pharmacy technician is to offer a helping hand to the responsible pharmacist (usually under the pharmacist’s supervision). Therefore, they do not have direct contact with patients. Technicians working in institutional pharmacies work with numerous distribution systems. They not only package medication for their patients but also do bulk packages for the entire institution. They also engage in sterile and aseptic procedures, cytotoxins, and chemo prescriptions, in addition to automated dispensing systems. Therefore, institutional pharmacies are more multifaceted than non-institutional pharmacies.
Institutional Pharmacy Technician. (2010). Richland College Website. Web.
Johnston, M. (2006). The Pharmacy Technician Series: Fundamentals of Pharmacy Practice. Evergreen, CO: Pearson Education, Inc.
Lambert, A. (2002). Advanced Pharmacy Practice for Technicians. Clifton Park, NY: Delmar.
Strand, L.M. (1990). Pharmaceutical care and patient outcomes: notes on what we manage. Top Hospital Pharmaceutical Management, 10(2), 77–84.