Pharmacy Operations, Personnel, and Practice Standards
The pharmacist-in-charge's world
Operational questions test whether you know which duties belong to the pharmacist and which may be delegated. The pharmacist-in-charge is accountable for adequate staffing, security of the prescription department, sanitation, equipment maintenance, current policy and procedure manuals, and the continuous quality improvement (CQI) program Virginia requires to detect and prevent dispensing errors.
Personnel rules
Pharmacy technicians must be registered and work under pharmacist supervision; Board regulation fixes the technician-to-pharmacist ratio and what additional personnel a pharmacist may supervise, so learn the current numbers rather than a remembered figure. Interns are registered and may perform pharmacist tasks only under supervision and only to the extent permitted.
Nondelegable acts
Anything requiring professional judgment stays with the pharmacist: final verification of a dispensed prescription, resolving drug therapy problems identified in a drug utilization review, counseling, compounding verification, and the decision to refuse to fill. Technicians may receive and enter prescriptions, prepare labels, count and pour, and manage inventory.
Traps
- A technician "double-checking" another technician's fill is not pharmacist verification.
- Ratio calculations count technicians on duty, not just those at the counting tray.
- A pharmacy may not dispense without a pharmacist physically present.
Worked example
A busy shift has one pharmacist, several registered technicians, and an unregistered trainee who has "almost finished" the application. The trainee may not perform technician functions. If the ratio cap has been reached, adding another technician requires adding a pharmacist; substituting an intern for a technician does not solve a ratio problem.