Regional Patients’ Own Drugs Checking Programme for Pharmacy Technicians

N. Ireland

Regional Patients’ Own Drugs Checking Programme

Content / Page Number
Introduction / 3
2 POD Programme
2.1 Aims
2.2 Candidate entry criteria
2.2.2 Desirable entry criteria
2.2.3 Mentor criteria
2.3 Skills developed through the programme / 3
4
4
4
4
2.4 Responsibilities / 5, 6
2.5 Overview of POD programme / 7
2.7.1Pre-course work
2.7 Workshop
2.8 POD training within the Trust
2.9 In-house interviews
3 Observations
3.2 Candidate logs
3.2 CPD documentation
3.3 Referral
3.4 Error reflection
4 OSCE at NICPLD
5 Final appraisal
5.1 Appeals
5.2 Accreditation
5.3 Reaccreditation
5.4 Periods of absence
5.5 Change of Trust
5.6 Evaluation of the programme
5.7 Contact details / 8
8
9
9
9
10
10
10
10
11
11, 12
12
13
13
13
14
14
14
Appendix 1 Terminology used / 15
Appendix 2 Examples of errors / 16
  1. Introduction

Medicines Management in hospitals encompasses the entire way that medicines are selected, procured, delivered, prescribed, administered and reviewed to optimise the contribution that medicines make to producing informed and desired outcomes of patient care.

Audit Commission 2001.

This programme has been requested by the Clinical Lead Pharmacists in N. Ireland to develop the skills of hospital pharmacy technicians when checking patient’s own drugs,thereby supporting the role of pharmacists on the wards and ensuring that skill mix within the ward setting is optimised. Representatives of all Trusts in Northern Ireland have been involved in the consultation of this programme which has been supported by all Trust Pharmacy Managers.It is a two phased programme that is made up of tutorials and demonstration of competence through work based activities.

The programme is aimed at pharmacy technicians who wish to become accredited and also pharmacists who wish to become mentors. We recommend that technicians and their mentors recognise that this accreditation aims to allow the technician to work with PODs at any stage of the patient journey, and that the role is more than simply checking as it requires those technicians to have effective communication skills to ensure the patient information told to the technician,when required, matches the kardex information which is checked against the drugs that the patient has brought in from home.

The programme conforms to the National Framework for Medicines Management Pharmacy Technicians who are currently working in the United Kingdom (UK).

The programme in Northern Ireland has been developed in consultation with the Medicines Management Teams throughout the province and has been adapted from programmes already established in Wales and the South East Pharmacy Education teams.

  1. Patients’ Own Drugs Programme

2.1 Aim

The aim of the Patients’ Own Drugs Programme is to:

  • provide pharmacy technicians in Northern Ireland with a regional programme for Patients’ Own Drugs Programme which conforms to the National Framework for Medicines Management Pharmacy Technicians
  • equip pharmacy technicians with the communication and accuracy skills required to effectively check a patient’s drugs
  • aid the development of professional relationships and interaction between pharmacy technicians, pharmacists, patients, colleagues and healthcare professionals within the ward setting
  • support appropriate skill-mix within pharmacy.

2.2 Entry Criteria

2.2.1Essential entry criteria for candidates

Pharmacy technicians in Northern Ireland (NI) may apply to enroll on this programme if they meet the following criteria:

  • candidate is a qualified pharmacy technician
  • candidate must be registered with NICPLD
  • candidate must have at least three months experience as a qualified pharmacy technician working in NI in a hospital setting
  • candidate has carried out a ward based role for a minimum of three months
  • candidate has identified a designated mentor who has supported their application
  • candidate agrees to work within the limitations and remit of their own ability and has demonstrated that they know when to refer to their mentor for guidance.

2.2.2Desirable entry criteria for candidates

Further desirable entry criteria include that the candidate is:

  • an Accredited Checking Pharmacy Technician (ACPT)
  • a pharmacy technician who has completed ‘The First Steps of Training for Medicines Management in Northern Ireland’.

2.2.3Mentor criteria

The individuals nominated as mentors to pharmacy technicians undertaking the POD programme must :

  • be a qualified and registered pharmacist ora qualified pharmacy technician with the required two years’ experience as an accredited POD checker
  • have experience of mentoring staff according to the specific requirements of their Trust
  • have a Medicines Management role within the Trust

2.3Skills development throughout the programme

This programme is designed to promote the development of the specific skills required of anyone checking patient’s own drugs in practice. Throughout the course of the programme, candidates should demonstrate improving competence in the following areas:

• effective communication skills

• effective interpersonal skills

• effective time management skills

• effective problem solving skills

• the ability to provide medicines related information

• the ability to accurately transcribe legible information

• an awareness of the issues relevant to working within a patient focused environment

• the ability to apply key clinical skills

• the ability to comply with the NICPS and local Trust policy for patient’s own drugs

• the ability to operate within the remit of their job role.

All of these skills will be assessed by the mentor or witness pharmacist or pharmacy technician during the process of observations. Candidates must be deemed competent in all these areas before completion of their accreditation.

2.4Responsibilities

Responsibilitiesthroughout the programme

During the course of the programme, NICPLD, the Trust, the mentor and the candidate all have defined responsibilities to ensure that a supportive learning environment is provided for the candidate and to facilitate the completion of the accreditation.

2.4.1 Responsibility of NICPLD

The role of the Northern Ireland Centre for Pharmacy Learning and Development is to support the candidates, mentors and all individuals involvedin the delivery, activity practices and documentation audit trail. A detailed list of the full range of NICPLD’s responsibilities is also listed in the Learning Contract (POD admin 6).

  • promote the POD programme through advertising in the NICPLD brochure and online at the NICPLD website
  • process approved applications for candidates and mentors
  • provide training by experts in the field of checking the suitability of patient’s own drugs for re-use
  • to maintain copies of candidate’s progress throughout the programme
  • to support the mentors with the POD OSCE by facilitating this at NICPLD
  • to advise individuals of the remaining criteria requirements upon successful completion of their POD OSCE
  • to support individuals who fail to meet the criteria and offer guidance
  • to provide guidance to mentors and candidates regarding queries throughout the programme
  • to issue a certificate of completion when candidates have successfully submitted the required documentation
  • to review the reaccreditation documentation submitted by candidates within a two year time frame to ensure POD checkers maintain their competencies
  • to mainatian a data base of all trainee and qualified POD checkers in NI
  • to review and update the regional programme on a yearly basis

2.4.2 Responsibility of the Trust

Pharmacists have overall responsibility for the pharmaceutical services being provided to patients with the Trust Pharmacy Manager having ultimate responsibility for the quality of the service provided. It is the role of the Trust to ensure that anyone involved in the delivery or implementation of this programme has the required resources and support to successfully complete their role. Trusts are also required to support all participants particularly with regard to ensuring equality and diversity being maintained before, during and after training.

2.4.3 Responsibility of the mentor

Each nominated mentor must commit to:

  • attending the POD workshop at NICPLD
  • signing and adhering to the terms of a learning contact for each candidate that they are mentoring (POD admin 6)
  • providingthe support required such as access to the MEP and PSNI Code of Ethics and all other relevant guidance to ensure that on completion of the programme each candidate has developed the necessary skills to deliver this role
  • meeting regularly with the candidate to provide support and guidance
  • undertaking formative assessments in the workplace. This includes observing the candidate, giving feedback, assessing the accuracy of their work and documentation required for completion of this programme
  • liaising with NICPLD to ensure completion of this programme within the time frame of not less than 3 months but less than one year.

2.4.4 Responsibility of the candidate

Pharmacy technicians are responsible for their own professional actions and must work within their own Trust’s Standard Operating Procedures (SOPs) and the Northern Ireland Clinical Pharmacy Standards. They should also consult the Medicines Ethics and Practice Guide and the PSNI Code of Ethics for guidance relating to professional conduct. The role of the pharmacy technician is to provide support to the pharmacist and to ensure that the patient receives care which is safe and effective. Please note that throughout this document the term ‘candidate’ refers to the qualified pharmacy technician.

2.5Diagram 1 –Overview of the Patients’ Own Drugs Programme

2.6 Pre-course work

Pharmacy technicians wishing to register for this POD programme must complete the application form online and once they have received confirmation of a place, complete the pre-course work before the workshop date.

The pre-course work includes:

  1. candidate must accompany a pharmacist on at least one routine ward visit.
  2. candidatesmay use the observation form (Pod admin1) during the routine visit.
  3. candidate must complete a reflection of their visit using POD 2.
  4. candidates must read and understand the professional standards and guidance required for any member of the pharmacy team to work in a ward setting. These are described in detail in the Northern Ireland Clinical Pharmacy Standards which is available in all Trusts from the Clinical Lead.
  5. candidate should study the pre course reading as advised by their mentor.
  6. candidates must provide an up-to-date CV which should be stored in their portfolio.
  7. candidates must provide an up-to-date job description which provide details of their medicines management role.

All pre-course documentation must be brought to the NICPLD POD workshop where it will be discussed. During the course of the workshop, candidates will receive a portfolio in which to store all their documentation/evidence relating to the programme.

2.7 Workshop

2.7.1Candidate workshop

Candidates are required to attend a one-day workshop at NICPLD and on completion of this workshop should be able to:

  • assess the suitability of Patients’ Own Drugs for re-use, storage or destruction
  • understand the importance of effective interpersonal andcommunication skills
  • demonstrate effective referral to other health-care professionals
  • know the assessment criteria for the portfolio
  • describe the patient journey and the importance of seamless care in the context of PODs
  • realise how to produce a portfolio of evidence to meet the programme criteria
  • understand how to reflect on practice throughout their portfolio via the completion of reflections and CPD cycles.

2.7.2 Mentor workshop

All mentors are required to attend a half day workshop at NICPLD and on completion of the workshop should be able to understand the support they are required to provide to the candidates undertaking the programme. The workshop provides a simulation of the real observations the mentor will be required to observe and allows the candidate and mentor to use the documentation required to document the assessment criteria has been met.

2.8 POD training within the Trust

It is essential that all candidates read and understand their relevant Trust Standard Operating Procedures (SOPs) that apply to the role of a POD checker. They should also discuss with their mentor appropriate SOPs relating to working in a different environment. These may include:

  • Emergency and Health & Safety procedures when working on a ward
  • Chart endorsement
  • Standards applied to nurses regarding the administration of medicines (local and national policies)
  • Intervention and error reporting
  • Dealing with complaints
  • Dealing with violent or aggressive patients
  • Local Trust security issues
  • Infection control policy

This list is not restrictivebut offers examples of relevant procedures which may inform candidates of systems and procedures outside of the pharmacy environment relevant to their practice.

2.9In-house interviews

During the course of the programme, candidates are required to have two in-house interviews with their mentor. The interviews must provide a progress review of the candidate;the first interview (POD 4) will take place prior to commencing the log of POD checks.

The second interview (POD 6) will take place upon completion of the following criteria:

  • Minimum of 50 POD checks
  • Two observations by their mentor
  • Successful completion of their OSCE or have applied to NICPLD for place on next OSCE

All interview documentation must be faxed or emailed to NICPLD.

Please note

Comments such as ‘very satisfied’ or ‘doing well’ do not meet the required reflection of the candidate’s performance. Interviews with insufficient information will be rejected by NICPLD, therefore requiring both candidate and mentor to resubmit their reflections on the candidate preparation or performance during their collection of evidence.

3Observations by mentor/witness pharmacist or pharmacy technician

When observing the candidate checking PODs, mentors or witnesses are required to use the NICPLD recording documentation (POD admin1). Each candidate must be observed on at least five occasions; observation 1 and 2 must be complete prior to their OSCE. The remaining observations must be completed before the final interview.

3.1Candidate logs - Information to record

Each POD check must be recorded on the NICPLD POD3 documentation and must include the following information:

  • Candidate/mentor signature
  • date
  • patient types (please note that a portfolio of evidence must cover at least three patient types)
  • medicine name, form, strength etc
  • if suitable or unsuitable for re-use (please note that a portfolio of evidence must provide documentation of evidence dealing with PODs assessed as unsuitable for at least five items)
  • detail of action- if the drug had to re-labeled or re-packaged etc
  • referral type for at least one referral
  • comments by candidate

The POD logs should be double checked by the mentor or witnessand must be kept for review by NICPLD at the OSCE and the final appraisal panel at their base. Please note that each bottle/box of medication is considered ‘one item’

3.2 CPD documentation

All candidates are required to document at least two CPD cycles of identified learning specific to the POD role at their base. This documentation must be faxed or emailed to NICPLD and stored in the candidate’s portfolio for review by the final assessment panel. Candidates will be supplied with blank CPD records to facilitate this task.

3.3 Referral

All candidates are required to demonstrate their ability to know their limits of authority and realise when they need to refer an enquiry, a patient or a POD check to a pharmacist or a more senior member of the medicines management team such as the lead pharmacy technician. Candidates are required to use POD7 to document this referral evidence.

3.4 Error reflection

All candidates are required to reflect on any errors they may have missed when checking PODs or any errors which may have occurred with a new supply of patient’s medicines. All errors must be recorded and stored in the candidate’s portfolio. Candidates are required to complete at least 100 POD checks at their base with no errors.

A candidate who misses an error is required to document this error evidence (POD5) and re-start their log of POD checks to ensure they complete an accurate 100 item log of POD checks with no errors.

Any candidate missing an error in their second attempt of the POD log must complete the error reflection (POD 5) and inform NICPLD. They are not permitted to proceed with the programme. Candidates must have approval from their Clinical Lead Pharmacist to re-apply for a place on the next training programme.

4OSCE at NICPLD

All candidates must attend NICPLD to undertake an Objective Structured Clinical Exam. (OSCE). OSCEs will be facilitated at NICPLD when there are at least three candidates ready to take part in an OSCE, with the first opportunity three months after the workshop and the final opportunity at the latest one month before the year time frame completion.

All candidates ready to take part in an OSCE should contact NICPLD when they have met the essential criteria which requires candidates to have completed at least 50 of the POD checks which have been double checked and at least two observations by their mentor.

The OSCE is a simulation of an interaction with a patient, where the POD checker is required to document the suitability of the medicines presented at each station. Some stations may not have a patient present but will have other patient information regarding their current medicines such as lists from their local pharmacy.

Candidates should discuss each drug with the patient, if present, check the drug is listed on the patient’s kardex and ensure the drug is fit for purpose. All anomalies must be documented by the candidate who will be assessed for their communication skills and ability to adhere to generic policies required whilst working in a patient environment.

The OSCE will consist of:

  • patients
  • a number of PODs at each station
  • a kardex at each station
  • a copy of the patient profile to provide background information on the patient
  • a copy of generic criteria which provides adviceof suitability of PODs for re-use
  • a blank page to facilitate the transcribing of the drugs with a column to note if they are suitable or not suitable for re-use.

All candidates will be informed on the day of the OSCE if they have met the assessment criteria were successful and the remaining evidence they require for completion (POD Admin5).