Fleagle Miller Rachael, Cesarz Joe, Rough Steve
J Am Pharm Assoc (2003). 2018 Nov-Dec;58(6):652-658. doi: 10.1016/j.japh.2018.06.018. Epub 2018 Aug 29.
The purpose of this study was to design, pilot, and evaluate a community "tech-check-tech" (TCT) program as a strategy for pharmacy practice advancement.
Community pharmacy with both mail order and outpatient pharmacy services.
The policies, technician training requirements, prescription eligibility requirements, and quality assurance measures necessary for the pilot were developed. The TCT workflows and procedures were integrated into the existing prescription dispensing framework at a pilot site. An analysis of pharmacist and technician checking accuracy was conducted with a 4-week data collection period for each role. To determine TCT technician accuracy, the TCT technician performed the first product verification check after the prescription was filled by a pharmacy staff member. If the TCT technician found an error, they documented the error and returned the prescription to the filling technician for correction. If the prescription was filled correctly, the TCT technician passed the prescription to a pharmacist for final verification. The pharmacist documented any incorrect prescriptions that the TCT technician verified. Pharmacist accuracy was measured through direct pharmacist observation. Direct observation was also used to measure and record pharmacist and technician prescription checking time. The data were then used to evaluate pharmacist time savings as a result of community TCT, while ensuring prescription dispensing accuracy.
TCT was piloted in a community pharmacy.
An analysis of pharmacist and technician checking accuracy was conducted with a 4-week data collection period for each role. To determine TCT technician accuracy, the TCT technician performed the first product verification check after the prescription was filled by pharmacy staff. If the TCT technician found an error, they documented the error and returned the prescription to the filling technician for correction. If filled correctly, the TCT technician passed the prescription to a pharmacist for final verification. The pharmacist documented any incorrect prescriptions that the TCT technician verified. Pharmacist accuracy was measured through direct pharmacist observation. Direct observation was also used to measure and record pharmacist and technician prescription checking time. This data was then used to evaluate pharmacist time savings as a result of community TCT, while ensuring prescription dispensing accuracy.
A TCT workflow was piloted successfully in the community pharmacy setting. Technicians were at least as accurate as pharmacists, as validated with statistical analysis (99.95% [95% CI 99.89%-99.99%] versus 99.74% [95% CI 99.61%-99.87%]), and patient safety was maintained. Time studies allowed for the quantification of potential pharmacist time savings (23 days per year) resulting from the implementation of a community TCT program.
This study demonstrates the feasibility of a TCT program in the community pharmacy setting.
本研究旨在设计、试行并评估一项社区“技术核对技术”（TCT）项目，将其作为推进药学实践的一项策略。
提供邮购和门诊药房服务的社区药房。
制定了试行所需的政策、技术人员培训要求、处方资格要求和质量保证措施。TCT工作流程和程序被整合到试点药房现有的处方调配框架中。在为期4周的数据收集期内，对药师和技术人员的核对准确性进行了分析，每个角色各收集4周数据。为确定TCT技术人员的准确性，在药房工作人员配好处方后，TCT技术人员进行首次药品验证核对。如果TCT技术人员发现错误，他们会记录错误并将处方返还给配药技术人员进行更正。如果处方配药正确，TCT技术人员将处方交给药师进行最终验证。药师记录TCT技术人员验证的任何错误处方。通过直接观察药师来衡量药师的准确性。直接观察还用于测量和记录药师和技术人员的处方核对时间。然后，这些数据被用于评估社区TCT带来的药师时间节省情况，同时确保处方调配的准确性。
TCT在一家社区药房进行了试行。
在为期4周的数据收集期内，对药师和技术人员的核对准确性进行了分析，每个角色各收集4周数据。为确定TCT技术人员的准确性，在药房工作人员配好处方后，TCT技术人员进行首次药品验证核对。如果TCT技术人员发现错误，他们会记录错误并将处方返还给配药技术人员进行更正。如果配药正确，TCT技术人员将处方交给药师进行最终验证。药师记录TCT技术人员验证的任何错误处方。通过直接观察药师来衡量药师的准确性。直接观察还用于测量和记录药师和技术人员的处方核对时间。然后，这些数据被用于评估社区TCT带来的药师时间节省情况，同时确保处方调配的准确性。
TCT工作流程在社区药房环境中成功试行。经统计分析验证，技术人员的准确性至少与药师相当（99.95%[95%置信区间99.89%-99.99%]对99.74%[95%置信区间99.61%-99.87%]），并且患者安全得到了保障。时间研究对实施社区TCT项目可能节省的药师时间（每年23天）进行了量化。
本研究证明了TCT项目在社区药房环境中的可行性。
