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  • dispensing from an invalid prescription

    I was wondering what people do or what course of action is taken if a previously dispensed Rx is seen to be invaid or has some issue with it, examples include an unsigned Rx already been dispensed previous day and, say a CD (blue) installment script has been dispensed by a few pharmacists previously, but when you come to dispense it you see there's somethng wrong with it???

    or the pharmacy is still using old registers which do not require the identity checks etc...
    We are the music makers, We are the dreamers of dreams and God damn we are that good

  • #2
    Re: dispensing from an invalid prescription

    Originally posted by SolomonQ View Post
    examples include an unsigned Rx already been dispensed previous day
    Photocopy the script and send it back to the prescriber for a signature

    and, say a CD (blue) installment script has been dispensed by a few pharmacists previously, but when you come to dispense it you see there's somethng wrong with it???
    Phone prescriber ask if the script is genuine then ask for a replacement script with the necessary corrections (unless of course it's the lack of a quantity for each instalment - in which case decide if you are going with the NTA guidelines that don't require them or the RPSGB/NPC guidelines which do - personally I go with the NTA guidelines and my own reading of the regulations - but I'd not be too upset if I was struck off)

    or the pharmacy is still using old registers which do not require the identity checks etc...
    Leave message for superintendent

    Also log all these as errors

    Jeff

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    • #3
      Re: dispensing from an invalid prescription

      thanks for the reply jeff,

      i dont you got the jist of my question, your answer about the POM script makes sense in this case, but for a Rx has ALREADY BEEN DISPENSED, its none of my business is it, or am still obliged to send it back to the prescriber, because if I do I dont know when or if they'll get it back, in my case i'd leave it on the side with a note, oulining the issue, and if someone wants to sort it out then they will.

      I know what to do if a NEW script comes in and has issues with it, but what my main question was:

      what do you do when say

      ...will post {later}
      We are the music makers, We are the dreamers of dreams and God damn we are that good

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      • #4
        Re: dispensing from an invalid prescription

        when i get an unsigned script in i normally do one of a couple of things :

        1. if it's a (very) nearby surgery, send the patient back to the reception to get is signed.

        2. If it's a bit further afield or the patient can't realistically get back to the surgery easily then i'll phone up the gp and get them to read out the Rx over the phone so i can do an emergency supply at request of prescriber then send the script back for signing at retrieve it within the 72 hour window.

        3. If it's the weekend (or late night) and an urgent i'll ring up the local ooh service who'll normally sort a legal script out for me.
        “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

        Terry Pratchett

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        • #5
          Re: dispensing from an invalid prescription

          Originally posted by Sir_Dispensalot View Post
          when i get an unsigned script in i normally do one of a couple of things :

          1. if it's a (very) nearby surgery, send the patient back to the reception to get is signed.

          2. If it's a bit further afield or the patient can't realistically get back to the surgery easily then i'll phone up the gp and get them to read out the Rx over the phone so i can do an emergency supply at request of prescriber then send the script back for signing at retrieve it within the 72 hour window.

          3. If it's the weekend (or late night) and an urgent i'll ring up the local ooh service who'll normally sort a legal script out for me.
          I do hope no-one has fallen for the temptation of doodling something similar to the usual squiggle on the prescription .

          Reminds me of a time when a doctor died in liverpool, but continued signing his scripts. Turns out that his receptionist had been signing them since 1948, and no-one had thought to check!
          ....just my opinion

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          • #6
            Re: dispensing from an invalid prescription

            ok here is the main question:

            say if you were locuming and find that an installment cd script (blue), had been dispensed 2 out of 4 times already, but find it had some sort of error (unrelated to total quantity or a typographical error), what are you supposed to do, how do you go about sorting that out?
            We are the music makers, We are the dreamers of dreams and God damn we are that good

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            • #7
              Re: dispensing from an invalid prescription

              solly, (pardon my blunt language everyone) if there's a balls-up on a blue Rx then you shouldn't dispense against it even if other planks have. Contact the local misuse service and get them to sort you a proper script out asap. Its up to you as to how much you want to stick your neck out if there's an angry addict jumping up and down in the shop (sometimes it's handy to offer them a one-off delivery once you've sorted things with the drug team).

              just remember the buck stops with you - and it's YOUR balls on the chopping block if it all goes tits-up.
              “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

              Terry Pratchett

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              • #8
                Re: dispensing from an invalid prescription

                Well these incidents always seem to surface on a Saturday when no contact possible. We OOH locums suffer a great deal more risk.
                johnep

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                • #9
                  Re: dispensing from an invalid prescription

                  Originally posted by johnep View Post
                  Well these incidents always seem to surface on a Saturday when no contact possible. We OOH locums suffer a great deal more risk.
                  johnep
                  We complained about potential issues etc and now have OOH contact numbers for the prescribers at the local addiction services - only to be used in utmost emergency etc. At least that way you could speak to the prescriber and might be able to help resolve things.

                  One benefit of having a community pharmacy facilitator at the local PCT who does occasional weekend locums and understands how things work in the real world
                  Titch

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                  • #10
                    Re: dispensing from an invalid prescription

                    ok, correct me if my 5 years training as a pharmacist fails me, but isnt a CD script e.g. fp10 mda supposed to have a dose on it for it to be legal, or am i hallucinating
                    We are the music makers, We are the dreamers of dreams and God damn we are that good

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                    • #11
                      Re: dispensing from an invalid prescription

                      fp10mda might have dose down either in ml or milligrams stating Xmg daily or Xml daily with 'dispense sunday dose on saturday' or words to that effect. some systems also put down the dose for each day eg daily dose xml from 4/8/08 to 10/8/08
                      x,0,x,0,x,0,0.
                      “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

                      Terry Pratchett

                      Comment


                      • #12
                        Re: dispensing from an invalid prescription

                        Originally posted by SolomonQ View Post
                        ok, correct me if my 5 years training as a pharmacist fails me, but isnt a CD script e.g. fp10 mda supposed to have a dose on it for it to be legal, or am i hallucinating
                        Yes - get on to the prescriber to sort it out - ask that they note it as a critical incident - note that you have done so (and on the script for the next locum) - fill in an error report - and in the patients best interest - dispense on the promise of a properly written script.

                        Yup if you're there for a day it's down to you to sort out yesterdays cock up's and to try and prevent tomorrows if you can. A not my problem leave it for the next guy attitude doesn't help anyone very much.

                        Jeff

                        How many dolphins?

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                        • #13
                          Re: dispensing from an invalid prescription

                          "A not my problem leave it for the next guy attitude doesn't help anyone very much."

                          i don't like the mentioned attitude as at the end, the staff member get all the headache to solve other p'cists problems..... p'cist A was on monday, p'cist B on tuesday, methadone does not balance for example, p'cist B simply says it's not my problem and i end up tracing where things went wrong. obviously this is a simple example but i guess you get my point.

                          the funny thing is, some MDS trays( around 30) needed to be checked, p'cists on duty left it to the saterday p'cist who refused to check them because " he does not like dealing with these dosette as it takes a lot of time". i feel him, but well both behaviours from him and the other p'cists will just make the situation harder to handle! and patients calling and complaining to us, staff member.
                          [COLOR=Olive]xxxx They tried to break my back, but i survived. whatever doesn't kill you, will only makes you stronger xxxx
                          [/COLOR]

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                          • #14
                            Re: dispensing from an invalid prescription

                            Legally, you are 100% correct...it's just that occasionally, an "executive decision" may be required to ensure that every customer receives prompt service..as long as you feel you have made the correct decision in all circumstances, you really should have little to worry about, should it go any further, which is unlikely.
                            Don't Stop Believing

                            http://youtube.com/watch?v=rnT7nYbCSvM

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                            • #15
                              Re: dispensing from an invalid prescription

                              Today had script for patches and quantity in reg did not agree with CD cupd. Fortunately Pharmacy Manager has a 'dispensed item' report and this identified an entry not made in mid June. I entered and then wondered re exact rules.
                              1) Entry supposed to be made within 24 hours.
                              2) If entry missed completely the offence.
                              3) If entry made late then ?

                              johnep

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