ACT role in the dispensing process

[LeftArm]

There are far more ACTs now than before but I have never worked as a dispenser with one.
I was wondereing how the role of the ACT fits in to the dispensing process.
In most pharmacies where I have worked the prescriptions will be labelled and prepared by Technicians and the Pharmacist completes the final clinical and accuracy check.
My understanding is that the ACT can do an accuracy check but each script will still require a clinical check by the pharmacist.
So imagine a pile of scripts has arrived from the surgery. There is a pharmacist an ACT and a technician (or dispensing assistant) waiting in the dispensary.
How does the work flow?

[Defblade]

In theory, the ACT must not be involved in the actual dispensing of the script before the check. So the script must be picked labelled etc by some combination of pharmacist and/or tech, then passed to the ACT for checking.

The clinical check can be done at any point before the script is handed to the patient; I think it makes most sense, efficiency and safety to do this at the start of the process (rather than going back, undoing labels, unordering stock; plus the danger that once something's done and ready, it's more likely to reach the patient by mistake; better to ring the Dr with queries before the patient arrives; etc) but at least one multiple I've worked at doesn't agree with me.....

I also think that, as I can't see any way to do a vaguely proper clinical check without reference to the PMR (although that too obviously has its limiations), the pharmacist might as well do the labels while they're there. Not all clinical queries come from interactions bleeping up....



Lots of shops don't run exactly like this though!

[tinx25388]

Our ACTs main role in to check the Care Homes. The dispenser labels the prescriptions and generates the MARR sheets, highlighting (usually with post-it notes!) any changes to the medication and any interactions thats are flashed up. The prescriptions, labels & MARRs are then passed to the Pharmacist for clinical checking. Once the Pharmacist has signed them off, they go to the dispenser for dispensing and then on to the ACT, who performs the final accuracy check and bags it up for delivery.

[I♥NewYork]

Hmmmm well in our shop this is what happens and to be honest it probably aint what should be happening !!

Script taken in by whoever is free to serve the patient.
Dispenser labels and dispenses medication - if the PMR picks up an interaction then items and script passed to pharmacist, if not passed along the line to the ACT.
ACT checks the script and items and then hands to patient for them to take.
ACT then puts the script to one side to be clinically assessed by the pharmacist at some point in the day - usually once the patient has their meds and has gone home.

[bobbin]

ACT then puts the script to one side to be clinically assessed by the pharmacist at some point in the day - usually once the patient has their meds and has gone home.

What's the point in a clinical check occuring after the patient has gone home and started their medication?!

[dizzyb23]

Pharmacist has to be involved BEFORE the script is finished and handed out!!!!

[bobbin]

.

[LeftArm]

Thanks for your replies.

I guess it does make sense to complete the clinical check first. There doesn't seem to be an efficiency gain in either time or workload as far as it adds an extra step to the dispensing process.

I♥NewYork
I agree with others that the clinical check should be donebefore the patient collects the script. This system also relies heavily on the PMR system to make the clinical decision as to which scripts to check.
Should the Pharmacist check every prescription?

[Defblade]

Should the Pharmacist check every prescription?

Oh yes.

In fact, yes yes yes yes yes yes yes yes YES.

As I said in my earlier post, there's many things that won't be picked up by "bleepbleepbleepbleepbleep" coming from the PMR. So much so I can barely think of an example (if you see what I mean)... ummm.... easi-breathe inhaler prescribed for someone who uses a spacer..... oh, one from last week - metrosa gel prescribed for someone with a history of vaginal therapies (turns out should have been Zidoval - I'm guessing the Dr just picked the cheapest brand of metronidazole gel from the list).... there's a couple for a start. Most every day, you'll see something that's not an interaction, but still needs a bit of clinical thought/intervention - ie, is plain wrong. As a pharmacist, you develop a tingle for such things that the PMR warnings can and will never replace with any degree of safety.

[melly69]

in our shop scripts come from the doctors are sorted out into deliveries, under 3 items, over 3 items and dosettes, the act will dispense the deliveries while dispenser labels the rest of the scripits then anything new or changed gets a note put on for pharmacist then the pharmacist takes the baskets of labelled scripts and bnf and looks through all the scripts and signs them off and writes notes for act if needed then dispenser dispenses the scripts they are put in white baskets so the act knows the work is for her. she also checks the weekly dosettes except brand new ones