Teck TalkCEMarENG v2 2/28/05 8:56 AM Page 1 Instructions 1 CEU FREE CE FOR TECHNICIANS Tech Talk CE is Canada s first national ongoing continuing education correspondence program specifically designed for technicians. It's brought to you by the publishers of Pharmacy Practice, who have been producing CE lessons for pharmacists for the past 10 years. Tech Talk CE is generously sponsored by Novopharm. A lesson will appear in each issue of Tech Talk, which appears bimonthly in Pharmacy Practice (January, March, May, July, September, November). 1. After carefully reading this lesson, study each question and select the one answer you believe to be correct. Circle the appropriate letter on the attached reply card. 2. Complete the card and mail, or fax Mayra Ramos at (416) 764-3937. 3. Your reply card will be marked and you will be advised of your results in a letter fromtech Talk. 4. To pass this lesson, a grade of 70% (7 out of 10) is required. If you pass, you will receive 1 CEU. Please allow 6-8 weeks for notification of score. Please note: Tech Talk CE is not accredited by the Canadian Council for Continuing Education in Pharmacy (CCCEP). THE NATIONAL CONTINUING EDUCATION PROGRAM FOR PHARMACY TECHNICIANS Pharmacy technician regulation and certification By Diane Reeder, BA, CPhT Statement of objectives Upon completion of this lesson, the pharmacy technician should be able to: 1. Describe the differences between certification and regulation. 2. Explain the standards of practice and how they relate to competencies. 3. Describe the benefits of accrediting pharmacy technician educational programs. Introduction An increasing need exists for pharmacists to trust the knowledge and training of pharmacy technicians. Educational standards are required to ensure that technicians have the skills to perform their work and that once in the workforce they maintain this knowledge and skill level by participating in continuing education and upgrading. There is also a clear and present need to ensure public safety. Regulation, standards of pharmacy technician practice, competencies required to practice and registration will support the goal of public protection. History of the profession The practice of pharmacy has been around for hundreds of years. But it wasn t until the mid-20th century that pharmacy support personnel began to be used. The first documented use of pharmacy support personnel was in the United States military in 1947. 1 Various titles have been used for people in this role pharmacy assistant, pharmacy aide, helper, clerk, pharmacy specialist and duties varied by work site, but largely consisted of counting March/April 2005 medication, and cashier and inventory duties. In the late 1960s and early 1970s, the need for standardized training and responsibilities became apparent. American Society of Health-System Pharmacists (ASHP) and American Association of Colleges of Pharmacy (AACP) responded by officially endorsing pharmacy technicians. In Canada, the first pharmacy assistant educational programs were offered in Ontario at Humber College and St. Clair College. In 1976, the Canadian Society of Hospital Pharmacists (CSHP) published a statement defining the functions of pharmacists and non-pharmacist personnel. In 1979, the American Association of Pharmacy Technicians (AAPT) was founded, followed by the Canadian Association of Pharmacy Technicians (CAPT) in 1983. Establishing professional associations to represent pharmacy technicians represented a step toward self-definition and technicians becoming responsible for their own profession. Throughout the 1980s and 1990s, various definitions and statements on training, duties and responsibilities of pharmacy technicians were published by numerous organizations. Certification became available nationally in the U.S. in 1995. In Canada, certification followed closely behind, in Ontario in 1996 and in Alberta in 2001. Evolution of the tech s role The responsibilities of today s pharmacy technicians are a far cry from what they were 20 or 30 years ago. According to an article written by ISMP (Institute for Safe Medication Practices), 2 the number of drugs on the market has grown 500 per cent in the last decade there are more than 17,000 names for pharmaceuticals marketed in North America. During this same time period, drug regimens have become more complex. With the advent of easily obtainable electronic information, consumers are much more knowledgeable about medications and are being encouraged to take more responsibility for their health. These factors contribute to the increasing need for direct pharmacist intervention in patient care. Further intensifying the issue is a pharmacist shortage. As a result, pharmacy technicians have assumed more duties An educational service for Canadian pharmacy technicians, brought to you by Novopharm www.novopharm.com
Teck TalkCEMarENG v2 2/28/05 8:56 AM Page 2 that traditionally were performed by pharmacists. Technical duties can vary along a continuum of supervised (over the shoulder) routine duties such as counting and pouring, answering the telephone and basic customer service to independent responsibilities such as teaching, managing or performing quality control functions. Duties performed by pharmacy technicians are largely employerdriven based on policies and requirements defined within the workplace. Additional factors may include variation of training, experience or qualifications among technicians, views of pharmacists with regard to how technicians should be employed, and variation in regulations set by licensing bodies. 3 As regulatory and professional organizations have endeavoured to define the functions and responsibilities of pharmacy technicians, educational institutions have also worked to maintain curriculum that would keep pace with expanding technician duties. Courses including sterile product training, computer order entry and database skills, technological advancements and innovations and others have been added. Many pharmacy technicians are moving into non-traditional roles within pharmacy that include: supervision and management of other pharmacy personnel, inventory procurement, home care, diabetes educator, compounding specialist, clinical CE Coordinator: Margaret Woodruff B.Sc.Phm., MBA Professor, Pharmacy Technician Program Humber College, Etobicoke, ON Author: Diane Reeder, BA, CPhT, President, CAPT Alberta Technical Manager, Outpatient Pharmacy Services, Calgary Health Region positions to support home parenteral therapy, HIV programs and ICU (to name a few). As the duties and responsibilities of technicians increase, there is a need to establish standards of practice and the competencies required to meet those standards. Certification The objective of certification is to identify the basic qualifications for practice that would give employers assurance that a pharmacy technician meets a specific educational standard. 3 Certification is defined as the process by which a nongovernmental agency or association grants recognition to an individual who has met certain predetermined qualifications specified by that agency or association. 4 In Canada, technician certification is voluntary, but some employers may require inhouse certification. Currently, there are two organizations that offer certification assessments for pharmacy technicians: Ontario College of Pharmacists (OCP) and Pharmacy Technician Certification Board of Alberta (PTCB Alberta). Both organizations offer a theory component only. At this time, to write the Ontario examination, the applicant must be a resident of Ontario and be a graduate of a recognized pharmacy technician program (or provide evidence of 3,500 hours of practical experience). To recertify, 600 work hours as a pharmacy CE Faculty Clinical Editor: Lu-Ann Murdoch, B.Sc.Phm. Reviewer: Debbie Benjamin, CPhT York Central Hospital in Richmond Hill, Director, Membership Services for CAPT 11 Northgate Dr. Bradford, ON technician every three years is required (plus a fee). The Alberta exam is open to applicants from across Canada, provided that the applicant is a graduate of a recognized pharmacy technician program. To recertify on an annual basis, evidence of 10 hours of continuing education is required (plus a fee). PTCB Alberta has plans to adopt a practical competency-based assessment sometime in 2005. Standards & Competencies A standard may be defined as any definite rule, principle or measure established by authority. 5 Standards of practice for pharmacy technicians would define the minimum qualification of knowledge and skills required to practice or perform as a pharmacy technician. Competencies are groups of skills, behaviours (attitudes) or knowledge that are applied as performance standards to a particular job or profession rather than to an individual employee. There are two types of competencies: knowledge and skills/behaviours, that are distinguished by how they can be measured. A knowledge competency can be measured by an objective test or question. A skill/behaviour (or attitude) must be demonstrated or observed. 6 To be competent is to be adequately or well qualified to perform a task. It is synonymous with ability. A person gains competency through education, training, experience or natural abilities. For information about CE marking, please contact Mayra Ramos at (416) 764-3879 or fax (416) 764-3937 or email mayra.ramos@rci.rogers.com. All other inquiries about Tech Talk CE should be directed to Laurie Jennings at (416) 764-3917 or laurie.jennings@pharmacygroup. rogers.com. Performance Performance is the accomplishment of a task in accordance with a set standard of completeness and accuracy. While a person may have the skills or knowledge (competency) to perform a task, it does not mean he or she will have the desire (attitude) to do so correctly (performance). In other words, competencies give a person the ability to perform, while attitudes give a person the desire to perform. 6 Only OCP, CAPT, Alberta have defined competencies for the pharmacy technician. CAPT Manitoba is considering adopting them. Accreditating Technician Training Programs Standardization of pharmacy technician practice cannot be accomplished without standardized training programs. Defined competencies for the pharmacy technician are a useful tool in assisting educational institutions to set objectives for their curriculum. In Canada, there is currently no objective third party organization that accredits pharmacy technician educational programs nationally. Both OCP and PTCB Alberta evaluate programs upon demand, but are not in a position to accredit them. The Pharmacy Technician Educators of Canada (PTEC) are in discussion with the Canadian Council for Accreditation of Pharmacy Programs (CCAPP) regarding inclusion of pharmacy technician educational programs under its mandate. Jurisdictional Scan Not all provinces have a CAPT chapter, the only national body representing Pharmacy Technicians at this time. The provinces with a CAPT chapter are: Nova Scotia Ontario (Windsor/District; London & District; Sudbury & District CE2
Teck TalkCEMarENG v2 2/28/05 8:56 AM Page 3 Manitoba (www.captmanitoba.ca) Saskatchewan (captsask@ yahoo.com) Alberta (www.captalberta. org) Each province/territory is at a different stage with respect to certification and regulation of pharmacy technicians. Since not all provinces have a formal organization representing pharmacy technicians, information about the occupation is often difficult to obtain. In 2001, Canadian Pharmacists Association (CPhA) conducted an environmental scan of pharmacy technicians, which represents the most comprehensive information available at this time. 8 The following is a short summary of known initiatives in each province. B.C. has prepared documents defining standards for pharmacy technician verification of sterile and non-sterile products and for delegation of technical functions to pharmacy technicians. CAPT Alberta, in conjunction with PTCB Alberta, has defined policy statements that include Standards of Practice, Competencies, Code of Ethics, Entry to Practice and Rationale for Self-Regulation. They plan to approach the Minister of Health and Wellness in 2005 to seek professional status and to establish a regulatory body to govern the practice of pharmacy technicians in Alberta. The Saskatchewan Pharmaceutical Society (SPhA) recognizes pharmacy technicians in its regulations and its bylaws. Formal training of technicians is required but may include on-the-job training. 8 CAPT Manitoba has made recommendations to the Manitoba Pharmaceutical Association that pharmacy technicians be recognized in the Manitoba Pharmaceutical Act as a separate and identifiable professional group, without distinction between pharmacy technicians in community and hospital practice. Currently, legislation recognizes certified hospital pharmacy technicians. OCP administers the voluntary certification program in Ontario and has plans for a future voluntary registration for pharmacy technicians. CAPT is involved with the establishment of the certification program. The New Brunswick Pharmaceutical Society is waiting for a national initiative to recognize pharmacy technicians in law. 8 Nova Scotia supports the idea of a voluntary certification program, with expansion as necessary as the program grows. 8 The Newfoundland Pharmaceutical Association is preparing to develop regulations outlining the role of pharmacy technicians. 10 No information is available about certification or regulation for Quebec, Prince Edward Island and the Yukon, Northwest, Nunavut Territories. 8 The Future of Regulation Recognizing pharmacy technicians as separate and distinct healthcare professionals and regulation, is being considered as a solution to concerns of public safety as a result of the increasing use of pharmacy technicians. Regulations are principles, rules or laws that are designed to control or govern conduct. Public Protection is the primary purpose of regulation. It ensures public protection by requiring all members of a profession to have minimum levels of competence (skills, knowledge and attitudes). Regulation also requires that anyone performing the duties of a particular profession must remain competent (by upgrading or taking refresher courses as required) and determines who may use a professional title (e.g., pharmacist, dentists, nurse, etc.). Only those individuals who have satisfied the educational and registration requirements of a profession can represent themselves to the public as members of that profession. 10 The provinces of Canada are constitutionally responsible for the administration and delivery of healthcare services. 11 Therefore, regulation of health professions is exclusively within provincial/territorial jurisdiction. Following recognition and the establishment of a provincial regulatory body representing a particular profession, regulations are created. The government produces legislation that empowers regulatory bodies to establish and maintain appropriate registration, continuing competence and ethical, technical and clinical standards, to which all members of the profession must adhere to ensure protection of the public. Regulations take effect only after government has approved them. Some ways that public protection is achieved is by establishing minimum requirements to become a specific health professional (entry to practice) and by requiring that minimum ethical, technical and clinical standards of practice are maintained. Minimum standards are enforced through programs such as continuing education. Investigations (sometimes leading to discipline) and incapacity assessments may become necessary when minimum standards are not met. 12 There are no provisions to regulate professions nationally. However, most established professions have mechanisms to promote voluntary cooperation between provinces. Registration To practice as a member of a regulated profession, an individual must be registered with the appropriate governing body and must maintain a licence issued by that body. A register or roster is a list of qualified people. To qualify for the register, a system would need to be in place to assess skills and knowledge (competencies). To maintain one s registration, evidence of practical experience and continuing education must be produced on a periodic basis. Liability Regulation brings with it accountability. Currently in Canada, pharmacists are ultimately responsible for all tasks carried out by pharmacy technicians. When pharmacy technicians become recognized as a separate and distinct healthcare profession, legal responsibility will follow. The pharmacy technician would assume liability, similar to the pharmacist. What this means, practically speaking, is that a technician would bear responsibility for any duties performed and potentially could be sued for negligence in the event of a medication error. This issue would need further study following regulation of pharmacy technicians. Conclusion There are many challenges ahead if pharmacy technicians are to become recognized as regulated health professionals. Minimum standards of knowledge (education) and skills (training) must be established for technicians. Entry to practice must include formal education and successful completion of a standardized examination of knowledge and skills. Certification is a vital step to personal assurance of knowledge and skills. Continuing education is a vital component to maintain one s competence. Through membership and active participation in our professional association, CAPT, we are meeting one of the defining criteria of a health care professional. 13 CE3
Teck TalkCEMarENG v2 2/28/05 8:56 AM Page 4 Establishment of a local chapter will provide local and provincial advocacy for certification and regulation. Voluntarily becoming certified, maintaining high practice standards, attending continuing education sessions and maintaining membership in CAPT lends credibility to the assertion that pharmacy technicians should be recognized as a distinct group of regulated health care professionals. Bibliography 1 From a presentation given by Rock Folkman, Chairperson, Pharmacy Technician Program, Red Deer College to the CAPT Alberta Annual Conference, September 2000. 2 Institute for Safe Medication Practices. A Call to Action: Eliminate Handwritten Prescriptions Within 3 Years! 2000. http:// www.ismp.org/msaarticles/wh itepaper.html 3 McGregor K, Millin B, Aro S, Samuelson A. An Information Paper on the Role of the Pharmacy Technician. CJHP 2001; Vol. 54, No. 4:293-6. 4 American Society of Health- System Pharmacists. 0412 UNI- FORM STATE LAWS AND REGULATIONS REGARD- ING PHARMACY TECHNI- CIANS Source: Council on Legal and Public Affairs), 2004. http://www.ashp.org/about ASHP/PolicyGovernance/policypositions.pdf 5 Merriam-Webster Online Dictionary. http://www.m-w. com/ 6 NC Department of Health and Human Services. Managing Employee Workplans, Definition of Competencies, 2002. http:// www.dhhs.state.nc.us/humanresources/workplan/competencies_definition.html 7 Clark, D. Introduction to Competencies, 1999. http:// www.nwlink.com/~donclark/ hrd/case/compet1.html 8 MacInnis M, Power B, Cooper J. Environmental Scan of Pharmacy Technicians. Canadian Pharmacists Association, 2001 http://www.pharmacists.ca/content/hcp/resource_centre/pra ctice_resources/pdf/pharmacy_technicians.pdf 9 McLeod C. NPhA and Ministry of Health Pair up to Regulate Techs. Tech Talk, 2003. 10 Maxston BE. Understanding the Health Professions Act, A Practical Guide for Colleges, their Members and Healthcare Stakeholders, 2003. 11 Canada Health Act Overview. http://www.hc-sc.gc.ca/ english/media/releases/2002/hea lth_act/overview.htm 12 CAPT Alberta. President s Message. The C.A.P.T. Sule, 2004. 13 CAPT-Manitoba. President s Message. Keystone CAPT, 2004. http://www.captmanitoba.ca/newsletters/captnews Dec04.pdf QUESTIONS 1. Certification is a. The minimum qualification of knowledge and skills required to practice or perform as a pharmacy technician b. The process by which a nongovernmental agency or association grants recognition to an individual who has met certain predetermined qualifications specified by that agency or association c A continuum of fully supervised routine duties d The establishment of standards of practice and competencies required to meet those standards 2. Competency a. Plus attitude equals performance b. Is the state or quality of being adequately or well qualified to perform a task c. Is a group of skills, behaviours (attitudes) or knowledge that are identified as performance standards for a particular job or profession d. All of the above 3. Regulation is necessary a. And is the same thing as registration b. To ensure public protection by requiring all members of a profession to practice safely, competently and ethically c. To determine the level of competence of a technician d. To ensure the job market remains viable 4. Standardization of practice requirements a. Will only apply to pharmacy technicians who work in hospitals b. Cannot be accomplished since pharmacy technicians work in so many different fields c. Defines the minimum qualification of knowledge and skills required to practice or perform the duties of a pharmacy technician d. Can only be accomplished through continuing education 5. CAPT a.. Represents the occupation of pharmacy technicians b. Was established in 1983 in Toronto c. Is the Canadian Association of Pharmacy Technicians d. All of the above 6. Registration is necessary a. To assist in the provision of public protection from unethical or unscrupulous practitioners b. To ensure unionized staff are recognized for the hours they have worked c. To provide continuing educational opportunities in pharmacy d. As part of an in-house quality assurance program 7. Training programs for pharmacy technicians are currently a. Accredited in Canada by the Canadian Council for Accreditation of Pharmacy Programs b. Accredited by the Pharmacy Technician Certification Board c. Not accredited in Canada d. Offering standardized programs of study across Canada 8. The role of a pharmacy technician can be described as a. Simple anyone who walks and breathes can do it b. Constantly changing; expanding to include duties formerly performed by pharmacists c. Supervised by a pharmacist, therefore, no one should worry about patient safety d. Completely lacking in responsibility or accountability to the tasks performed 9. Regulation and registration of pharmacy technicians a. Will automatically follow recognition of pharmacy technicians as a profession b. Require standards of practice and establishment of competencies to support them c. Does not require ongoing continuing education to maintain competencies d. Is equivalent to certification 10 Legal liability may become an issue for pharmacy technicians because a. Part of becoming a professional involves taking responsibility for your actions b. Medication errors are in the public spotlight c. The welfare of the patient must come first d. All of the above CE4
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Tech Talk BRCMarch 2/24/05 9:57 AM Page 2 MARCH/APRIL 2005 Presented by: Sponsored by: Pharmacy technician regulation and certification 1 CEU 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d Last Name First Name Business name Email address Address (Business) City Province Postal Code Type of practice Hospital Retail (independent) Retail (chain) Other (specify) Full-time technician Part-time technician Business telephone Are you a certified technician? Yes No Please help ensure this program continues to be useful to you by answering these questions. 1. Do you now feel more informed about pharmacy technician regulation and certification? Yes No 2. Was the information in this lesson relevant to you as a technician? Yes No 3. Will you be able to incorporate the information from this lesson into your job as a technician? Yes No N/A 4. Was the information in this lesson... Too basic Appropriate Too difficult 5. How satisfied overall are you with this lesson? Very Somewhat Not at all 6. What topic would you like to see covered in a future issue? Please allow 6-8 weeks for notification of score from Tech Talk. Fax: Mayra Ramos at 416-764-3937 Pharmacy Practice and Novopharm recognize and appreciate the importance of responsible use of information collected through their continuing education program. If you do not want to receive information or contact from Novopharm regarding products or programs please indicate below and Pharmacy Practice will honor your preference. [ ] No, I do not want to receive information from Novopharm