PHARMACY

Standard Operating Procedure

ASSEMBLING AND LABELLING PRESCRIPTIONS

Purpose

To ensure the safe and effective assembly and labelling of prescribed items (including an Owings Procedure for incomplete supply).

Scope

The procedure covers the labelling and assembly of all prescriptions, including ‘Specials’. It does not cover extemporaneous preparation of items.

Procedure / Process

Assembly:

  1. Check that relevant protective clothing, if appropriate, is worn where necessary and that hands have been washed
  2. Read the prescription and select the correct product. Pay particular attention to medicines with similar names which may be in close proximity, e.g. amlodipine, amiloride
  3. For oral dose forms, pay particular attention to ensuring the correct strength has been selected
  4. For oral forms, check that the correct formulation has been selected – SR, EC, LA etc. are all different
  5. For topical preparations, pay particular attention to ensuring that the correct formulation has been selected (cream/ointment, eye drops/ointment, etc.)
  6. Check the expiry date on the product
  7. Select the correct number of calendar/patient packs OR
  8. Select the appropriate bulk pack and count out the correct number of dosage units using a clean triangle/counting aid
  9. Do not touch or handle medicines whilst counting. DO NOT TOUCH those that can cause sensitisation, e.g. cytotoxics (e.g. MTX), finasteride
  10. If insufficient quantity is in stock and patient is waiting for their prescription to be processed, refer to the “Owings” procedure below. If the patient is not present, place a note on the prescription of what is not in stock and ensure that the stock is ordered.
  11. If using patient packs, check that all the packs are full and do not contain half strips or loose tablets. If the box contains loose strips or tablets, check these correspond with what is supposed to be in the box
  12. If necessary, transfer the medicine to another container, using child resistant closures (CRC) when appropriate
  13. If transfer to another container is necessary, check whether this compromises stability or expiry of the product
  14. If the patient has requested non-CRCs, ensure that plain tops are used and annotate the prescription accordingly
  15. Ensure all CDs and fridge lines are clearly identified so that they can be processed immediately and stored appropriately
  16. Re-order stock, using the appropriate wholesaler or special manufacturer
  17. If the prescription is private, calculate the price to be paid including VAT, using dispensary ordering system and annotate the prescription form accordingly
  18. Endorse the prescription accurately with the required information for the item dispensed

Owings

Where there is insufficient stock to fill the prescription or the stock needs to be ordered – inform the patient/representative and make them aware of their options. These are:

  • if they will return when the prescription is complete
  • if they intend to take what is available
  • if they would prefer to take their prescription elsewhere

Action points

  1. If the patient is returning when the prescriptions is complete, order the stock required and inform them when it will be ready to collect
  2. If the patient chooses to take what is available issue an owing ticket for the remainder of the item, order the stock required and continue to the labelling procedure. Inform the patient when the balance will be ready for collection.
  3. If the patient or representative wishes to take their prescription elsewhere then politely give them the signed prescription

Assembling existing owings

  1. When replacement stock arrives, locate the prescription and “owing note”. This is located in the owings box or CD box if applicable.
  2. Using the actual prescription as a reference carefully gather the medicines, checking the name, strength, formulation and quantity for each item and place into a dispensing basket.
  3. Assess whether it is appropriate to label, check and bag the item(s) now or whether it would be best to wait for the patient to return for the balance. (Some medicines have a short expiry upon reconstitution).
Labelling
  1. Generate the label by scanning the product using the pharmacy IT system or by manually entering the prescription details
  2. Check that the label corresponds with the prescription form, and attach it to the assembled item, initialling the label
  3. Ensure the pack contains the relevant patient information leaflet (PIL) if appropriate
  4. Check that the assembled item matches the prescription and that the label matches the prescription
  5. If dispensing from bulk packs, keep the dispensed item with the bulk pack until the whole prescription has been checked for accuracy
  6. Leave the assembled and labelled items, together with the stock pots or empty containers, in the prescription tray and transfer to the checking area for checking by the relevant person
  7. For items with special storage requirements (eg fridge items, CDs), consider placing them in a separate area so that they will be checked and returned to the appropriate storage area as soon as possible

Labelling owings

  1. Where there are new owings, and the patient is waiting for their medication – generate an owings label
  2. Attach a copy of the Owings label to the patient side of the Owings docket and keep this with the dispensed items ready for the patient.
  3. Attach another copy of the Owings label to the pharmacy part of the Owings docket to be attached to the prescription which is placed in the Owings box after the rest of the medication is given to the patient. Inform the patient of a collection date and time for the balance of their medication.

Prescriptions requiring a special order

  1. Inform patient of the likely waiting time
  2. Order the ‘special’ item from the appropriate supplier. A list of telephone numbers is located in the [insert location of information]
  3. Affix a dispensing label to the product, ensuring batch number and expiry dates are not obscured, in accordance with the above labelling instructions
  4. The prescription can now be subjected to checking in accordance with the pharmacy SOP: Accuracy checking.

Responsibility

Pharmacist, dispensers

Review Procedure

This procedure will be reviewed following:

  • Changes in the law affecting dispensing
  • Changes in DDA/GPhC or other guidelines affecting the dispensing process
  • Any adverse dispensing incident.
  • In the absence of any of the above, on or before the date shown below

Known Risks

  1. Unfamiliar products
  2. Unfamiliar names, egg rINNs (dosulepin is the rINN for dothiepin)
  3. Assembling items from labels, not from prescriptions
  4. Ignoring Dispens-IT and overriding by selecting “No Barcode”
  5. Similar packaging
  6. Products with similar names, egg co-amilozide, co-amilofruse
  7. Not marking half-full boxes
  8. Distractions
  9. Quieter periods. Research shows that fewer errors occur when the dispensary is busy
  10. Working long hours without a break

Date of Preparation: / Date next review due
Prepared by:
Signature: / Date review takes place and signature of reviewer
Version number:

I have read and understood this standard operating procedure.

Name / Position held / Signature / Date