Tech-Check-Tech Pilot in a Regional Public Psychiatric Inpatient Facility

Abstract

Purpose A pilot project assessing the impact of utilizing well-trained, competency-assessed, certified pharmacy technicians (referred to as advanced practice pharmacy technicians or APPTs) to check unit dose medications prepared by other technicians is described. The pilot site, a regional inpatient public mental health facility, petitioned the North Carolina Board of Pharmacy for a waiver pursuant to Board Rule .2510 to conduct this pilot to compare the accuracy of APPTs to pharmacists in similar roles. Further, the pilot assessed clinical pharmacist time savings generated by improved personnel utilization and the subsequent redeployment by use of this time. Summary Four pharmacy technicians were trained and their competency assessed per the approved protocol. The project entailed 3 distinct components: (1) submitting the petition to the Board of Pharmacy and obtaining approval, (2) training pharmacy technicians and assessing their competency, and (3) incrementally implementing new work processes and project assessment. Clinical pharmacist time saved, in excess of 50 hours per month at full pilot implementation, was utilized in deploying increased patient-focused clinical services. The full pilot implementation was in place for 13 months, with a reported variance rate of 0.31 per month (95% CI, 0-0.77). Two variances were detected by nursing and corrected prior to reaching the patient (near misses). In 2 cases, the medication reached the patient; neither case led to patient harm. The mean number of pharmacist variances (near misses and reaching the patient) for the 12-month period immediately preceding the pilot implementation was 1.42 per month (95% CI, 0.95-1.88), while performing similar functions. Conclusion For this public inpatient psychiatric facility, the APPT variance rate was substantially lower than that for pharmacists in routine checking functions. This superior accuracy is consistent with other documented studies, however it is the first in a non-acute care setting, further demonstrating the potential for the utility of expanded technician roles.