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Pay attention to detail

April 14, 2021
Lessons learned: always exercise proper skill and judgement in the provision of pharmacy services.

A recent Hearing Tribunal issued its written decision on the merit and orders regarding the conduct of a pharmacy technician who was found during a two-year period to have made numerous serious dispensing errors, despite the errors being identified to her and her employer providing her with ongoing training, education, and support. The Hearing Tribunal found that the pharmacy technician’s conduct demonstrated a pattern of lack of knowledge or a lack of skill or judgement in her provision of pharmacy technician services.

In this matter, the Tribunal imposed substantive penalties even though the pharmacy technician admitted to all of the allegations and took responsibility for her conduct. Should she not have done so, it is likely that the penalties would have been more significant. The Tribunal also noted that there had not been any previous findings of unprofessional conduct against the pharmacy technician and considered this to be a mitigating factor in penalty. The Tribunal ordered

  • a condition the pharmacy technician practise under direct supervision for a minimum of one year,
  • the pharmacy technician must provide a copy the Tribunal’s written decision to every pharmacy employer and every licensee of every pharmacy in which she is hired for a period of three years, and
  • full costs of the investigation and hearing to a maximum of $7,000.

Rationale for the Tribunal’s decision is reflected in its following statements:

Pharmacy technicians must provide competent care as their actions impact the health and safety of members of the public. [The pharmacy technician] failed to provide such competent and safe care and her conduct was serious. 

.… … … 

[The pharmacy technician’s] conduct was also not an isolated incident but a pattern of misconduct over a two-year period. Her conduct was significant as there were several different events and different patients. If members of the public were aware of [the pharmacy technician’s] conduct, they may not pursue required care or have serious reservations about doing so. 

… … … 

[The pharmacy technician] was also provided with several opportunities to improve her performance and received appropriate and timely educational support and training. Nonetheless, she failed to meet the expectations of a pharmacy technician. The Tribunal considered this to be an aggravating factor. 

Pharmacy technicians and pharmacists – review your duties to your patients and profession 

  1. Review and discuss with colleagues your fundamental professional obligations in dispensing medications. Principle 1 of the Code of Ethics and Standards 6 and 7 of the Standards of Practice for Pharmacists and Pharmacy Technicians will provide you with valuable guidance in this respect.
  2. Maintain your professional competence at all times. Undergo regular and frequent self-assessments and fully commit to, and participate in, ongoing professional development and educational opportunities. Review Principles 9 and 11 of the Code of Ethics.
  3. Be an active participant in ACP’s Continuing Competence Program. Don’t just strive to meet the minimum requirements.
  4. Don’t cut corners when it comes to providing patient care, especially for vulnerable patients.
  5. Understand that pharmacy technicians and pharmacists must take personal responsibility for maintaining their skills and exercising sound judgement. Although pharmacy professionals most often practise within a pharmacy team, a reliance on others to identify and correct errors cannot be a norm.
  6. Do not allow your personal circumstances to negatively effect your professional obligations to consistently practice with skill and exercise sound judgement. Ask for and accept help when needed.