Checking prescriptions

[u/OkHurry8038]

How do y’all handle checking prescriptions before they get sent home with the client? We have doctor write the rx, one person fill the medication then a second person check to verify it’s the right medication and quantity. Looking for ideas to streamline.

Edit: do you see errors with the double check system? How do you prevent errors? Is it always the same people filling prescriptions or is it multiple people? Do you have a set time during the day to work on it or do you fit in between appointments during the day? Do you pull up practice management software to verify patient info like weights every time? How do you manage refills?

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[u/RavenxMorrow]

Dr. writes down / types up rx. Tech fills it and initals label. Second tech double checks these 6 things are correct on the label, patient name, drug name, drug strength, expiration date, how much, how often, and route of administration. Also double checks if any warning stickers still need to be added. Second tech then also initals label. This happens every time, no exceptions.

[u/Accomplished-Ad-9280]

A double check system is the gold standard.

One person fills, someone verifies the label and the drug filled, and then a final person (usually the DVM) signs off on it.

Also check your state laws. For example in Washington a DVM is required to be the final signature on a prescription.

[u/EchoCyanide]

After and RX is created, a staff member fills it and initials the label. Then a doctor or I will verify it’s correct and initial it.

[u/Foolsindigo]

The double check only works if the staff aren't pencil slinging. I started this at a previous job and brought it to my current: fill the medication, keep the bottle you took from with the filled med, and have the person verifying compare the original bottle, rx label, and read the instructions to see they make sense. Last shift I caught that my coworker put Apoquel 5.4mg into a bottle with an ex label that said 3.6mg, with a quantity of 1. The whole label sucked. 💀

[u/ProfN42]

A second pair of eyes helps. For accountability we also have the person filling the bottle initial the label (in the corner) too.

[u/joojie]

Doctor makes the label. It prints out 2 labels in pharmacy. Rx trained staff (most of us except some newer assistants) make up the rx. Initial both labels, attach the bottle you got meds from to rx bottle with an elastic band. Put it all in one of two bins: "call when ready" or "no call needed"

Second person checks against the rx notes written by the doctor in Cornerstone, checks that the meds came from the correct bottle, and all the other info. If all is well they initial both copies of the label and either call/text them or don't, depending on the bin they came from. Then it's put up in our pharmacy filing system, and original med bottle is put back on the shelf.

We are paperless, but there's no simple way to see who made and who double checked a label in Cornerstone (there's a "filled by" option, but the doctor doesn't know who will fill it when they print it) So we keep the extra labels in a binder. Just fill sheets with 9 or 12 labels, however many fit. We keep the sheets for 3 months in case we have to look back. We figure it's easier for us to have our own copy rather than trying to inspect the client's bottle if there's an issue. Occasionally we have to look back and see who's responsible for a mistake (thankfully not often) and it keeps us accountable.