Introduction
Nau mai, hoki mai, welcome back.
In this module, we will focus on pharmacy in a hospital setting, how to counsel patients, and how to communicate with other healthcare professionals. We will also return to the art of dispensing medication.
Karawhiua, give it heaps!
Welcome to Professional Practice 2. Over the following weeks, our focus is on continuing to develop your communication skills when collaborating with healthcare professionals. We will also be exploring the medicine management systems in hospital pharmacies.
Communication
Communication is an integral part of your role as a pharmacy technician. Throughout your programme, you've explored various aspects of communication. As a pharmacy technician, your ability to communicate effectively is paramount - you have the power to make sure that those you communicate with feel heard, informed and empowered. However, clear and concise communication is essential when interacting not only with patients but collaborating with colleagues or liaising with other healthcare professionals.
Kick this week off with some fun! Step into your pharmacy technician shoes and take this six-question pātaitai (quiz) to prompt your thoughts on communication skills.
Collaboration
Let's delve deeper into the importance of effective communication when collaborating with healthcare professionals.
Take a moment to reflect on what collaboration is and what it means for you as a pharmacy technician. Can you think of at least one recent example of a time when you collaborated in a pharmacy setting?
Select the (+) symbol to see some examples of collaboration.
- The process of people working together to achieve shared objectives or outcomes.
- As a pharmacy technician, collaboration involves professionals from different healthcare disciplines pooling their expertise, resources, and efforts to provide safe and effective care to patients.
- Collaboration promotes holistic and patient-centred care.
- Collaboration also promotes continuity of care across different healthcare settings.
Journal post
Collaboration
- Create a new journal post titled ‘Collaboration’.
- Reflect on your experiences in the pharmacy workplace to answer the following questions.
- Publish the post to ‘All course users’.
- Of course, save the permalink to your Index of Journal Posts for later reference.
Questions
- Who are the healthcare professionals that a pharmacy technician would typically collaborate with to deliver patient care?
- What would be the consequences of poor or ineffective collaboration between a pharmacy technician and other healthcare professionals?
- Who would be impacted and how?
- What do you think are the key factors involved in successful collaboration between a pharmacy technician and other health care professionals?
Communication skills
In the previous activity, you may have identified effective communication as a key factor involved in successful collaboration between healthcare professionals. Effective communication is essential for sharing accurate information, discussing patient care plans, and addressing any care concerns or issues that may arise.
What do you think about using effective communication skills with other healthcare professionals? Complete the following activity to explore this.
Forum activity
Interacting with healthcare professionals
- Share your thoughts on the following questions in the class forum: Week 36 – PP 2: Interacting with healthcare professionals. Explain your reasons and opinions.
- Make sure to revisit the forum later in the week to check your classmates’ comments. This will provide you with a broader perspective and may change your thoughts. Feel free to comment on any comments that resonate with you.
Questions
- Do pharmacy technicians use different communication skills, techniques and behaviours when interacting with patients and their families compared to when interacting with other healthcare professionals? Why or why not?
- What communication skills are most important for pharmacy technicians to use when interacting with other healthcare professionals?
- How can pharmacy technicians use these communication skills effectively?
Effective communication in action
To help develop your understanding of effective communication, read the following scenario and pinpoint instances demonstrating effective communication skills, techniques and behaviours. Consider the communication skills you are familiar with as you analyse the scenario and take notes on the examples you identify. Remember to consider both verbal and non-verbal techniques!
Tip
To refresh your memory of communication skills and techniques, look back at the content and your journal posts and notes from Week 20, Professional Practice 1.Scenario
collaboration and communication
Sarah, a pharmacy technician, and Alex, a pharmacist, are at work in a community pharmacy. A patient, Eva Johnson, comes to the pharmacy to pick up her prescription for blood pressure medication and a new antibiotic. Sarah notices that Eva’s prescription has been flagged for a potential drug interaction. Sarah approaches Alex to discuss the situation.
Sarah: Hi Alex, have you got a moment to discuss Eva Johnson’s prescription that she has just handed me?
Alex: Yes, sure thing, Sarah, I’m free now.
Sarah: I just wanted to bring to your attention that Eva is picking up her blood pressure medication today, but she's also been prescribed a new antibiotic, which may interact with her current medication.
Sarah then goes on to provide Alex with information about Eva’s prescription history and the new antibiotic. As she talks, Alex listens attentively, nodding his head. He studies the prescription that Sarah hands him, then says:
Alex: Thanks for bringing that to my attention. You’re right. We do need to look into this. Can you please verify the details of the antibiotic and its potential interactions using the pharmacy's drug information resources and come back to me?
Sarah: Yes, I’ll look that information up now and come back to you with it.
Sarah retrieves the relevant information and confirms that the antibiotic indeed has a moderate interaction with Eva’s blood pressure medications. She returns to Alex, who is talking to another staff member. She stands to the side and waits until his conversation is over and says:
Sarah: Hi again, Alex; I’ve got that information about Eva’s medications. Based on what I found, it looks like the antibiotic could increase the blood pressure-lowering effect of Eva’s medication, potentially leading to hypotension. Should we contact the prescriber to discuss alternative options?
Alex: Okay, so the antibiotic will interact with the antihypertensive she’s currently taking.
Sarah: Yes, that’s correct.
Alex: Yes, I agree we do need to contact the prescriber. It’s important that we address this interaction promptly to avoid the risk that her blood pressure drops to unsafe levels. I’ll contact them now to discuss it.
Sarah: Great, thanks for that.
Alex: Could you please let Eva know that I’m checking her prescription? Maybe suggest she comes back this afternoon if she doesn’t have time to wait now?
Sarah: Yes, I’ll talk to Eva now.
Click on the (+) to see our notes on this scenario and compare them to yours.
- Throughout the interaction, Alex and Sarah maintain a friendly tone as they communicate and address each other by their first names.
- They use appropriate language that is polite and respectful, for example, "Thanks" and "Please".
- Sarah checks that Alex is free for a discussion. This shows professionalism and courtesy. She acknowledged Alex’s time and workload, showing consideration for his availability before initiating the conversation.
- Sarah clearly and accurately communicates detailed information, ensuring Alex has all the necessary information.
- Alex demonstrates active listening by nodding (non-verbal feedback) and pays attention to the written prescription to fully understand what Sarah is communicating.
- Sarah notices that Alex is busy and demonstrates respect by waiting until he is free before continuing their collaboration.
- Alex checks he has correctly received the information from Sarah by summarising the key points of information back to her. Sarah is then able to confirm he has understood her correctly. This ensures there are no misunderstandings.
How did you get on with this activity? Did you come up with some of the same examples in the list? Did you come up with different examples? For some extra fun and to understand a different perspective, compare your list with a classmate's.
Summary
In summary, the essential communication skills, techniques and behaviours when pharmacy technicians effectively collaborate and interact with other health professionals include the following:
- Professionalism: Maintaining a respectful and courteous attitude during interactions.
- Being clear and accurate: Expressing thoughts, ideas and information in a clear, accurate and understandable manner.
- Appropriate language: Using appropriate and professional language to convey messages effectively.
- Active listening: Paying attention and demonstrating understanding during interactions.
- Questioning: Asking relevant questions to gather necessary information.
- Clarification: Seeking clarification when information is unclear or ambiguous.
- Checking understanding: Paraphrasing and summarising information ensures that the sender knows the message has been received correctly and gives them the opportunity to clarify if there are any mistakes.
- Summarising: Succinctly restating key points or information to ensure understanding.
- Paraphrasing: Rewording information to convey the same meaning in a different way, enhancing clarity and comprehension.
- Non-verbal language: Other language cues (such as body language) that support and enhance verbal communication and show active listening and understanding.
- Empathy: Listening, understanding and empathising with the concerns and needs of colleagues.
- Adaptability: Being flexible and adaptable to different communication styles and preferences.
- Cultural competence: Respecting cultural differences and adapting communication to be culturally responsive.
- Mutual trust and respect: Building and maintaining trustful and respectful relationships with colleagues, fostering effective collaboration and communication.
Self-directed learning activity
Communication Reflections
This week, think of yourself as a detective, gathering clues to understand effective communication and collaboration in the workplace. You will observe the communication around you, take note of specific communication techniques and reflect on your observations.
- Spend some time in your workplace observing how your colleagues communicate and collaborate with one another in face-to-face and remote communication situations.
- Remote communication situations include telephone, written, and video calls.
- Take note of the following:
- Greetings.
- How they address each other. For example, by first names, titles, or last names?
- Where communication occurs, consider the physical location and whether they are in the presence of others.
- Verbal and non-verbal language.
- Specific communication skills or techniques used.
- Reflect on your observations and describe the following:
- Was the communication and collaboration effective?
- What did you learn from your observations about communication and collaboration between health professionals?
- Did you observe any communication skills that you could implement in your daily work practice?
- Upload your reflections to a new journal post titled 'Communication Reflections'.
- Save the permalink to your Index of Journal Posts. You'll want to access this mahi (work) later!
That’s this week’s session completed. Next week, we continue to explore communication. Ka kite koe i muri mai, see you then!
Welcome to Dispensing 2. This topic will explore non-aseptic compounding.
Reconstitution and compounding
Let’s start by comparing and contrasting reconstitution and compounding:
| Reconstitution | Compounding |
|---|---|
|
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Terminology
As we delve into this subject, you'll come across familiar terminology, practices, and procedures previously covered during Week 20: Introduction to Dispensing when discussing the reconstitution of medications.
While you'll encounter some familiar terminology, you'll also encounter many new words and terms, so make sure to add them to your personal glossary for future reference. You may like to try writing it in your own words as well. This practice is an effective learning technique that enhances your understanding.
Now, test your understanding of some of the more familiar terms with a pātai tere (quick quiz).
Compounding
Compounding refers to practices and procedures for preparing customised medications tailored to the unique needs of individual patients. It involves combining pharmaceutical ingredients to create medications in specific dosage forms, strengths, and formulations that are not readily available commercially.
Compounded medications may be prepared in advance or made to order based on a prescription from a healthcare provider. It can be performed in pharmacies, compounding laboratories, or specialised facilities by pharmacists or trained pharmacy technicians under the supervision of the pharmacist.
Extemporaneous compounding
Extemporaneous compounding is a specific type of compounding that involves the on-the-spot preparation of medications in response to an immediate patient's need. This process allows for flexibility in dosage forms, strengths, and ingredients to meet the unique requirements of patients who may not have commercially available options suitable for their condition.
Pharmacists or pharmacy technicians (under supervision) perform extemporaneous compounding using available ingredients, equipment, and compounding techniques in the pharmacy dispensary.
A word about words!
Have you noticed the use of the words ‘product’ and ‘finished product’? What do you think these words mean in the context of compounding? Do ‘product’ and ‘finished product’ mean the same thing?
Jot down your thoughts before selecting the (+) symbol to reveal the answer.
- The term "product" can generally refer to any stage of the compounding process, including raw materials, active ingredients, excipients, and any other components.
- The term "finished product" specifically refers to the final compounded formulation that has undergone all stages of production, including packaging in a final container.
Non-aseptic compounding
As a pharmacy technician, you are expected to have the skills to prepare non-sterile products (medicines) using non-aseptic compounding techniques. The practices and procedures involved are crucial to guarantee that the finished products are suitable for their intended purposes and do not pose any risk to patients due to insufficient safety, quality, or effectiveness.
Examples
Examples of products prepared through non-aseptic compounding include:
- Oral solutions
- Suspensions
- Capsules and tablets
- Topical creams
- Ointments.
Techniques
There are different techniques for non-aseptic compounding, including:
- Mixing two or more miscible liquids.
- Dispersing or dissolving a solid in a liquid.
- Preparing a suspension using a mortar and pestle.
- Powdering a solid in a mortar and pestle.
- Preparing an ointment or cream by incorporating an active ingredient using an ointment slab and spatula.
We will explore each of these techniques as we move through this topic. Right now, let’s discuss the documentation related to non-aseptic compounding.
Documentation
In the same way that you need a recipe before you can start baking a cake, you need a formula before you can start compounding. These formulas are called ‘master formulas’.
Master Formula
The master formula is a detailed document that outlines the specific ingredients, quantities, and procedures required to prepare a compounded medication.
The master formula typically includes information such as:
- The names and amounts of each ingredient.
- Instructions for mixing or blending the ingredients together.
- Details about equipment or utensils needed.
- Any special considerations or precautions to be taken during the compounding process.
- It may include information about the compounded product's labelling, storage, and stability.
The formulas for compounding an oral liquid from a solid dose form (tablet, capsule, powder) are called New Zealand standardised oral formulation batch sheets. These batch sheets can be found on the Pharmaceutical Society of New Zealand’s webpage. They can also be accessed from links in the relevant NZF medication information.
By providing clear and precise instructions, master formulas help ensure consistency, accuracy, and safety in the compounding process, helping to minimise the risk of errors or variability between batches of compounded medications.
Record of compounding
A copy of the master formula is used to make a record of compounding that contains the following details:
- The date of preparation.
- The name of the compounder
- Quantities of ingredients used.
- Total quantity prepared.
- Batch numbers of ingredients used.
- A unique identifying batch number.
- The expiry date of the finished product.
- Label sample.
Job Sheet
A job sheet is automatically generated and kept by the computer software. It provides a history of the finished product. It is necessary to trace the original batch numbers of ingredients in case of recall or to look back if there is a problem with the product to make sure it was made properly.
Batch
A batch is a defined quantity of a compounded medication or product that is produced at one time. It involves mixing or combining the necessary ingredients according to a defined formula or recipe to create a homogeneous mixture (a great term for your glossary!).
A batch number is a distinctive combination of numbers and/or letters which identifies a batch. This number helps to trace and identify the product's manufacturing history, including the materials used, production date, and any relevant quality control information.
You will learn about formulas and documentation for non-aseptic compounding in class and get the opportunity to practice with the pharmacy software.
Self-directed learning activity
Use your self-directed time to review what you learned this week. Comb through this week's content again and pause at any terms that you're still unfamiliar with. Add these to your personal glossary for future reference.
Optional activity
If you want to level up your learning, complete this optional activity.
- Choose one term that you've added to your glossary.
- Share it in the class forum: Week 36: Dispensing 2: SDL. Include:
- The term's definition.
- The term's definition (written in your own words).
- Check out your classmates' definitions. They may have picked up terms you missed or created a definition that you find easier to retain.
Challenging yourself to translate a term or concept into your own words forces you to connect it to your current knowledge. This is an effective learning method!
Mahi pai, good work. You have now completed Week 36 of Dispensing 2.
