How to become a Pharmacy Assistant The Pharmacy Team and Practices (Part II)

3.1 Introduction

The pharmacy profession has enjoyed a long and illustrious history, which has led to innovation and evolution in the last two decades. Pharmacy assistants and technicians are now emerging as competent workers who are able to perform many of the tasks which were traditionally executed by pharmacists.

Technology is slowly changing the landscape of the pharmacy profession. Bar codes, computers and robotic medication dispensers have resulted in an expanded role for pharmacy workers and they are moving away from the more conventional task of medicine dispensation alone. Clear computer printing, for example, has reduced the medication errors that resulted from illegible handwriting of doctors. Pharmacy assistants are skilled and competent paraprofessionals, who are responsible for the reading and interpretation of the physician's instructions, entering the information on the computer, affixing correct labels onto medicine containers, providing complete material to the patient and updating stocks, amongst several other functions.

Working as a pharmacy assistant requires a working knowledge of arithmetic and proportions. This is because you will have to calculate fractions, percentages and convert measurements, in order to compute dosage. Similarly, a basic knowledge of business maths (addition, division, multiplication and cost prices) will help you to calculate discounts and mark-ups.

A pharmacy environment can be stressful and fast-paced. The work is exciting and fulfilling and you get the opportunity to help people achieve their health goals. Pharmacy assistants require a range of interpersonal skills, which will help them in their profession. Social orientation, the ability to work as a part of a team, the ability to listen and the potential to remain calm under stressful conditions.

FACT

According to research statistics, there are currently about 11,688 community pharmacies in the UK.

Source: content.digital.nhs.uk

3.2 Vision for Pharmacy Workers and Pharmaceutical Care

The UK government and the NHS expect the pharmaceutical sector to play an active part in the development and implementation of healthcare schemes in the UK. The following section elaborates on the future role of pharmacy in the UK. Pharmacy teams will be expected to be on the front line, with respect to patient care. The transformation will involve a paradigm shift, from a supporting role to a leading role in patient care.

Pharmacy teams will emphasise on maximisation of cost-effectiveness of medicines. The healthcare initiatives also expect pharmacies to play pivotal roles in urgent and emergency care sectors, such as accidents and in primary care. Pharmacy teams (pharmacist, pharmacy technicians, assistants, etc) will be trained differently, in order to prepare them for their expanded roles.

The new roles for pharmacy teams are expected to be impacted by technological changes in pharmacy development (robotic dispensation, increasing computerisation and so on), changes in socio-economic behaviour of patients, changes in spending and consumer behaviour, as well as introduction of new policies by the NHS and the UK government.

Pharmacy supporting staff members (such as pharmacy assistants) play a key role in delivering patient care in different settings. They must possess competent communication skills and must be able to work in multi-professional teams. As a pharmacy assistant, you may often be faced with complex situations that may require resilience and integrity to resolve. It must be your objective to live up to the highest standards of professionalism and must demonstrate accountability to your employer. This is because the employer is ethically and legally responsible for the services provided at the pharmacy. It is mandatory for pharmacy assistants to develop excellent communication skills, in order to minimise medication and other errors.

3.3 The Pharmacy Team

Traditionally, pharmacy is defined as the art of preparing, compounding and dispensing medicines in accordance with the prescriptions of a certified medical practitioner. Pharmacy assistants are skilled, knowledgeable and competent members of the pharmacy team, who are in charge of preparing, dispensing and supplying medicines to patients.

In general the pharmacy team consists of the pharmacist and support staff members, such as of pharmacy technicians and assistants. In community pharmacies, you may also have counter assistants who interact directly with the public.

Large and busy practices

Pharmacists often manage large and busy practices, where the efficiency and competence of supporting staff plays a crucial role in the successful discharge of duties. Pharmacy assistants usually perform administrative and clerical duties, such as maintaining pharmacy premises, stocking shelves, updating stocks and typing medical labels. Pharmacy assistants also enjoy increased interaction with customers, because their duties involve answering the telephone, greeting customers and locating merchandise on the shelves.

Pharmacy assistants are now commonly located within community, retail, hospitals and ambulatory services and other medical practices. They are performing an expanded variety of roles that were traditionally executed by pharmacists. However, there is a strong potential for further expansion of roles, especially in the areas involving patient interaction. Pharmacy assistants are now being trained for management and leadership roles.

Those aspiring to become a pharmacy assistant can look forward to enjoying good career growth and the prospect of moving on to higher levels of seniority. Pharmacy assistant training now includes a set of basic skills considered essential for successful execution of duties. These include clinical knowledge, IT literacy (you can expect to use a computer to perform most of your duties), communication and customer relationship skills. Pharmacy assistants have worked alongside pharmacists and have been actively involved in the discharge of

pharmacy related duties under the supervision of the pharmacist.

Pharmacists are becoming increasingly involved in providing assistance to patients in primary care, urgent care and elder care facilities and consequently, there has been a significant transfer of responsibilities to pharmacy assistants.

For example

It is now common for pharmacy assistants to manage hospital pharmacies and to ensure maximum utilisation of skills and resources. Emerging key roles for pharmacy assistants include providing medicines to patients for the duration of their hospital stay, examining medication reconciliation for patients upon admission and assessment of the drugs prescribed, for efficacy and safety.

The UK government has been supportive of expanding the role of the pharmacy assistant from a supplier/dispenser of medicines to a role involving the management of patient care. The expanded role includes the provision of health literacy to the public. The ability to engage with the public was viewed as a crucial contributing factor to the success of the role. Pharmacy assistants undertake a wide range of responsibilities.

Here we take a closer look at the responsibilities of pharmacy assistants in community pharmacies:-

-Reading, interpreting and dispensing prescribed medications.

-Providing information and guidance to patients on how to use or consume the medication.

-Providing information and guidance regarding over the counter drugs (that do not require prescriptions) and management of minor ailments.

-Stock management and control.

-Using the pharmacy computer and database systems, to maintain records of patient prescriptions.

3.4 Roles and Responsibilities of a Pharmacy Assistant in a Hospital Pharmacy

Although the responsibilities may be similar, pharmacy assistants can execute roles and enjoy different opportunities for growth. The following is undertaken by pharmacy assistants in hospital pharmacies - this is in addition to the duties listed above.

Assisting in the manufacture of sterile as well as non-sterile drugs, from raw materials.

For example

A patient could be allergic to some of the raw materials used in a drug. In such cases, the pharmacy assistant can compound or mix other drug components (under the guidance of the supervisor), to create a new drug that meets the needs of the patient. Compounding will protect the patient from an allergic reaction. It may also be the assistant's job to label and package the compounded drug.

Verification and dispensation of prescription medicines

The pharmacy assistant may also have to verify prescription dosages with the primary care provider and count the pills, tablets, etc. If the hospital pharmacy uses an automated pill dispensing machine, then the assistant should load and monitor the machine. Before giving the medicines to the patient or caregiver, the assistant should check with the pharmacists for approval.

-Providing information to healthcare professionals, as well as to the public.

-Management of medications in the hospital wards.

-Supervising and coaching trainees.

-Quality control, such as checking drugs for expiry dates.

Whenever stocks are ordered, the pharmacy assistant may be in charge of arranging the stocks, as well as verifying that the quantities delivered correspond with the quantities recorded on the purchase orders. This is also a good time to weed out expired old stocks.

-Communicating closely with the healthcare professionals for dispensing equivalent replacement drugs, in case of non-availability of stocks.

-Monitoring adverse effects of drugs, under the supervision of the pharmacist.

-Interacting with hospital staff and patients.

Pharmacy assistants perform a variety of administrative tasks and are usually in charge of communicating with doctors, nurses and paramedics. In some cases, pharmacy assistants may also have to fill out patient medication charts and complete other forms of paperwork, such as requisition  forms.

Pharmacy assistants are also employed in the armed forces, prison facilities and ambulatory services. Their role is similar to that of a pharmacy assistant working in a community pharmacy. In most cases, pharmacy assistants are actively involved in internal audits of GP care services.

Overall, the role involves recording medications for patients, checking dosages and completing medication charts. They are also in charge of monitoring stocks and updating stocks on the pharmacy computer system. Pharmacy assistants can also advise patients on all aspects of drug usage, as well as administration routes and dosage.

The personal skills required by Pharmacy Assistants may be summarised as follows:

1. A general interest and motivation in the wellbeing of others - an innate tendency to be helpful.

2. The ability to establish and develop good working relationships.

3. Effective and articulate oral and written communication skills (this is a field where one cannot afford to make mistakes).

4. The ability to work with others as a part of a team.

5. The aptitude to remain calm during emergencies.

6. The potential to follow instructions to the letter.

7. Physical stamina and strength.

8. Basic typing skills, to enter information on to the pharmacy computer system.

9. Interest in keeping yourself updated with the latest products and developments in the field of healthcare and pharmacy.

Task related skills

Task related skills include calculating insurance for pharmacy related transactions, double checking prescriptions for accuracy, before dispensing medication to the consumer, reliability in entering medical histories and contacting insurers to clarify coverage.

3.5 Interpersonal Skills

Pharmacy assistants are often the face of the pharmacy and interact directly with customers. Key interpersonal skills would include customer service, explaining medication, costs and payment options to customers, clarifying doubts and queries regarding the prescription, maintaining a professional demeanour, familiarity with medical and pharmaceutical terms, preserving client confidentiality and referring questions to the pharmacist.

The pharmacy assistant should demonstrate the ability to adapt and must be able to maintain a calm and professional demeanour under stress. For example, if you happen to work in a hospital pharmacy, you may often face customers who are irritable or stressed out. In addition, you must be able to show a willingness to accept new responsibilities, as this will help the pharmacist to focus on additional duties. Social orientation is a key interpersonal trait - this implies that you must be able to display a pleasant attitude towards people and must enjoy being around people. Pharmacies are usually managed by teams and as a pharmacy assistant, you should able to cooperate with others.

Activity

Estimated time 10-15 minutes

Take some time to think about the following questions:

What interpersonal traits would be useful to a pharmacy assistant? How would it help provide a higher standard of service to the public?

As a pharmacy assistant, you will need a range of technical skills, to help you perform successfully at your job. Some important technical skills include:-

-Knowledge of pharmacy calculations, medical terms and abbreviations.

-Maintenance of pharmacy equipment and records.

-Monitoring supply of drugs, as well as an inventory for expired drugs.

-Preparation of labels for drug bottles.

-Interpretation of pharmaceutical literature and prescriptions.

-Replenishment of automatic medication dispensers.

-Resolution of discrepancies in bills (with regard to consumers, suppliers and so on).

-Working with packaging machines and selecting appropriate packaging materials.

-Proficiency in pharmacy software systems.

-Marketing strategies, because you may be involved in product demonstrations and may have to use conventional sales techniques when interacting with consumers.

Working as a pharmacy assistant can be rewarding, as well as stressful at times. Customers will often demand a fast service, but at the same time, you need to be careful and precise. Let's take a closer look at some important aspects of working in a fast-paced, dynamic pharmacy environment.

Whilst the different skills have been listed above, we take a more detailed look:-

Attention to Detail

The primary objective of anyone working in a pharmacy environment is to be able to dispense medication accurately. Precise dispensation of medication can mean the difference between life and death. You need to dispense the right medication (this requires special attention, especially between similar sounding names), in the right dosage. Pharmacy assistants need to be alert and should avoid absent-mindedness or lack of concentration. Alertness and concentration is required when dispensing medications and when recording patient information.

For example

Writing down the wrong date on the prescription in the records may cause mistakes in serial prescriptions. Prescription drugs have the potential to benefit or harm the patient, depending on dosage, side- effects and so on. As pharmacy assistants are in charge of reading, filling and recording prescriptions, they need to pay attention to detail.

In other words, there is no room for error in this occupation - errors may lead to adverse effects, reversal of recovery, or even death in extreme cases. Constant alertness and attention to detail can help to protect the safety of patients. Active listening skills will also help you to pay attention to detail, because you will be able to understand the requirements of the patient. Do not interrupt the patient when he is explaining and do not indulge in side conversations.

3.6 Computer Literacy

Pharmacy assistants should also enjoy a good level of computer literacy. Nowadays, pharmacies operate with the help of computers and the internet. Prescriptions, for example, are often sent using the internet. Similarly, the computer is used to store patient data, record prescriptions and monitor inventory. As a pharmacy assistant, you will also be expected to use the computer to store and process insurance transactions, as well as for purchasing and billing purposes.

For example

The bar codes on the bottles and other compounds must be read by the computer, in order to be recorded accurately. This will help to provide a clear picture of the stocks on hand and the drugs that need to be ordered. Computerised recording of drugs also helps to confirm that the correct drugs have been stored, recorded, retrieved and dispensed to the customer. Computer controlled devices also help in the accurate dispensation of medications and reduce the likelihood of error.

Medicines and drugs are often associated with multiple forms of identification, including generic name, brand name and so on. In addition, there could be a product or category wise classification of medicines in the pharmacy. By using a computer to identify a medicine, you can avoid the confusion that may arise from multiple names.

In addition, computerised recording of prescriptions helps to identify prescriptions that are due for refills (especially in the case of patients with chronic health conditions) and the record will also show the medical care provider who is to be contacted in case of any problems. Computerised operations make it easier to manage business operations in a pharmacy setting (as an assistant, you can expect to be involved in several aspects of business operations). It becomes much simpler to record, track and verify information - and it also helps to minimise human error.

For example

A computer printed label is much more legible than a handwritten one and there are fewer chances of the patient or caregiver misreading the instructions. Monthly sales reports and accounts can help to review the financial performance of the pharmacy. You will be able to verify the drugs that generate a greater demand, the busiest business hours, time taken to fulβil a patient request and staff performance.

Moreover, the IT industry has provided the pharmacy profession with useful software and applications that contain useful information regarding drug interactions and effects. Such applications are updated on a more frequent basis than hard copies. The added information provided by such applications can help you to make better work related decisions.

Pharmacy assistants will be expected to perform several clerical jobs. For this, you would need to be well versed with word processing, internet, βile and record management, stenography and transcription (if required), as well as designing forms and so on. Most importantly, using the computer for important operations also helps to free up valuable time that can be spent on maximising patient outcomes and resolving problems. Thus, it is extremely important for pharmacy assistants to achieve a competent level of computer literacy.

Activity

Estimated time 10-15 minutes

Read the question below and spend 10 minutes writing down your thoughts:-

How can computer literacy help streamline your work as a pharmacist?

3.7 Basic Maths Skills

As a pharmacy assistant, you would need to calculate dosages and make up prescriptions. This would involve a good working knowledge of mathematical subjects like percentages and fractions, as well as units of measurements (grams, ml, etc). Medicines come in different forms (pills, syrups, powders, suspensions, ointments, gel and so on).

As a pharmacy assistant, you may often be required to convert medicine dosages from ml to insulin units and so on. You may also need to measure out liquid medications precisely. Thus, you should be able to read the divisions on a measuring device.

For example

If you are employed in a hospital pharmacy, you may have to calculate drip rates for intravenous fluids. Hospital pharmacy assistants in general will come across more complicated mathematical calculations. You may need to calculate doses based on body weight, etc. Although computers help to streamline mathematical calculations for pharmacies, it pays to have a good working knowledge of numbers.

A sound knowledge of basic maths skills will help to minimise errors and help to improve accuracy levels during dispensation. Pharmacy assistants may be required to dispense medication according to body weight. This is very common if you are dispensing medication for infants or pets. Even minor errors in conversion and calculation may result in serious adverse effects. A pharmacy assistant should also be competent with mathematical operations such as addition, subtraction, multiplication and division.

For example

A patient may ask for eight strips of an OTC drug, or may request only three tablets out of a strip. In such cases, you should be able calculate charges, etc. You may also have to calculate dosage for a specific number of days, along with the frequency of dosage (for example, two teaspoons, three times a day for 5 days).

Similarly, you may have to perform dosage calculations from prescriptions that contain Roman numerals. Familiarity with basic business maths can boost your ability to calculate product inventory, discounts and mark-ups. Most pharmacy assistants need a working knowledge of arithmetic and proportions.

MODULE SUMMARY

Pharmacies are operated by pharmacy teams. With increasing emphasis on becoming important players in the field of healthcare, pharmacy assistants are being entrusted with higher responsibilities. Most of the administrative and clerical duties in a pharmacy are managed by pharmacy assistants. However, their job role also entails familiarity with medicine dispensation, labelling and interacting with customers over the telephone, as well as face to face.

Depending upon the pharmacy environment, duties may vary slightly. Pharmacy assistants working in a hospital pharmacy, for example, may need to be familiar with drip rates and so on. They may also have to complete patient charts. Pharmacy assistants working in a community pharmacy may have an increased opportunity to explain the benefits and side-effects of medication and to clarify queries. Technical skills for a pharmacy assistant would include a working knowledge of arithmetic and proportions. You will need to understand measurements, percentages and fractions, as you may have to calculate dosage for a number of days. Similarly, you may have to calculate dosage according to body weight.

Pharmacy assistants are also considered the face of the pharmacy and interact directly and indirectly with customers. Desirable interpersonal traits would include social orientation, communication, the ability to work in a team, an innate motivation to help others and the ability to keep calm in stressful situations. Working in a pharmacy environment can be exciting and dynamic, but you will need to develop an eye for detail. Even momentary inattention or lack of focus can result in errors that may have far-reaching consequences. It is important to listen to the customer and ensure that you can follow instructions accurately. You must also verify medicine dispensations under the pharmacist, before giving it to the patient or caregiver.

Basic computer skills can help you to perform your job in multiple ways. You can use the computer system to monitor stocks, to identify medicines correctly (without confusion regarding generic name, brand name and product code, etc) and to track automated dispensing machines. A basic knowledge of maths also helps you to calculate mark-ups and discounts correctly.