Letters to the editor

April 18, 2005

Regarding the U.S. Navy employee pharmacist who refused to allow technicians to check his work, as reported in your March 21 issue, I believe that pharmacists and technicians should always work together for patient safety. As stated in the title of the 1999 Institute of Medicine report, to err is human.

Regarding the U.S. Navy employee pharmacist who refused to allow technicians to check his work, as reported in your March 21 issue, I believe that pharmacists and technicians should always work together for patient safety. As stated in the title of the 1999 Institute of Medicine report, to err is human.

That a technician is required to check prescriptions should not be misconstrued by the pharmacist to be a comment on his or her professional skills or a threat to his/her official legal status. Instead, it should be viewed as a useful approach to double-checking prescriptions that are filled. To me, it's common sense to use techs to check Rxs filled by pharmacists. As the old adage goes, "Two heads are better than one." I do want to note that, wherever I have worked, we haven't needed a rule or regulation for pharmacists and technicians to check each other. We just do it. We are a team.

I have worked with pharmacy technicians in both the community and hospital setting for almost 30 years, and am grateful for their assistance in my mission of pharmacy care.

The U.S. Navy makes a good point about double-checking, but double-checking isn't the crux of the matter here. Having a standard operating procedure (SOP) stating that a pharmacist can dispense a prescription only after a technician checks it makes the practice of a pharmacist's dispensing a prescription without the check by a technician a punishable offense! Does an admiral have a chief petty officer double-check a command before it is issued?

Jacques Larroque, R.Ph.larroquecm@cox-internet.com

Double-checking before dispensing prescription drugs is essential for safety purposes. However, the final check in a civilian pharmacy setting in Pennsylvania is required to be performed by a pharmacist.

In the military-specifically the U.S. Army-pharmacy technicians are authorized to perform duties that only a pharmacist is authorized to perform in a nonmilitary setting. Army pharmacy technicians are trained to perform functions-preparing and dispensing of prescriptions-for military-eligible individuals whose Rxs have been written by military practitioners. Civilian-written prescriptions may be prepared by a military technician but must be dispensed by a pharmacist or another practitioner for military-eligible individuals.

I feel that the naval installation SOP is wrong and should be changed so that the final check/ second check is performed by a civilian/military pharmacist or other practitioner.

Gary T. Gardner, R.Ph.
Retired U.S. Army Reserves pharmacy officer
gtg181@worldnet.att.net

The pharmacist in Gulfport is placing his ego above patient safety. Having a technician provide a double-check is an added layer of safety and supersedes ego or hurt feelings. Our standard policy at Naval Hospital, Jacksonville, Fla., is that two sets of eyes review all prescriptions. It works.

Robert "Eddie" Fuller, Pharm.D., BCPS
CDR, MSC, USN
Pharmacy Department Head
R_E_Fuller@sar.med.navy.mil

Rules of common sense say that it is not a problem to have someone make a last check on a prescription before it is given to a patient. Patient safety is the supreme concern.

But the most important question to be asked is not who should do the checking but who is responsible-legally, financially, and under liability insurance-for that prescription.

Pharmacists are licensed in the state of official residence. The rules and regulations of the prevailing state are of paramount importance. The military pharmacy and medical corps usually follow a composite of various state rules and regulations.

Pharmacists in the military are of officer status. Civilian pharmacists serving at military locations are afforded the equivalent of officer status. Pharmacy technicians do not have officer status, whether civilian or military. Technicians have enlisted status.