Dispensing Practice Guidelines 2019 JUNE

TerminologyFor some terms used in these guidelines, other terms with equivalent or similar meanings may be equally appropriate in tiveA person who can act on behalf of another person for thepurposes of the My Health Record system, including viewinginformation, setting access controls and making registrationdecisions, as defined by the My Health Records Act 2012EQUIVALENT OR RELATED TERM7SOURCEClinical incidentAn event or circumstance that resulted, or could have resulted,in unintended and/or unnecessary harm to a person, and/or acomplaint, loss or damage. A clinical incident can be related tosafety, usability, technical, privacy or security issues.6For specific guidance on clinical incidents associated with the MyHealth Record system, refer to the latest version of the PSA MyHealth Record Guidelines for Pharmacists6Controlled drugA medicine in Schedule 8 of the Standard for the UniformScheduling of Medicines and Poisons or designated as a Schedule 8substance by state and territory regulationSchedule 8 medicine, Schedule 8poison8CounsellingA two-way communication process between the pharmacist andthe patient in which the pharmacist ascertains the needs of thepatient, and provides them with the information required to safelyand effectively use medicines and therapeutic devicesCommunication with patients orcarers3Dispensaryassistant/technicianA suitably trained individual who assists a pharmacist in thepreparation, dispensing and supply of medicines, and other tasksin a pharmacy business or pharmacy department4DispensingThe review of a prescription, and the preparation, packaging,labelling, record keeping and transfer of the prescribed medicine.It includes counselling of a patient, their agent or another personwho is responsible for the administration of the medicine to thatpatient4Health literacySkills, knowledge, motivation and capacity of a person to access,understand, appraise and apply information to make effectivedecisions about health and health care, and take appropriateaction6Healthcare ProviderIdentifier—Individual (HPI-I)A unique 16-digit number used to identify individual healthcareproviders who deliver health care in the Australian setting9Healthcare ProviderIdentifier—Organisation(HPI-O)A unique 16-digit number used to identify organisations thatdeliver health care in the Australian setting9IndividualHealthcareIdentifier (IHI)A unique 16-digit number used to identify individuals who receiveor may receive health care in the Australian health system9Medication-relatedproblemAn event or circumstance involving drug treatment that actuallyor potentially interferes with the patient experiencing an optimumoutcome of medical careAdherence issue, adverse drug event,adverse drug reaction, drug-relatedproblem, medication error10My Health RecordAn online summary of an individual’s key health information,controlled by the consumer and maintained by the AustralianDigital Health Agency as System OperatorDigital health record, e-health record,personally controlled electronic healthrecord (PCEHR)11My Health RecordsystemThe infrastructure and operational support for delivering My HealthRecordsDispensing Practice Guidelines I Pharmaceutical Society of Australia Ltd.11

TERMDEFINITIONEQUIVALENT OR RELATED TERMSOURCENon-pharmaciststaffAll pharmacy staff excluding provisionally or generally registeredpharmacistsPatientA person who uses, or is a potential user of, health services,including their family, carer(s) or agentConsumer, healthcare recipient, client12Patient healthcarerecordA record of information in the dispensing software relevant tothe patient’s health, including clinical history, clinical findings,investigations, information given to the patient, their medicationand other managementDispensing record, medication profile,medication record, patient profile,patient record4Patient identifiersItems of information accepted for use in patient identification,including patient name (family and given names), date of birth,gender and address.13Specific patient identifiers allow matching of a patient’s record indispensing software with a patient’s Individual Healthcare Identifier(IHI) in the My Health Record systemPharmacist OnlymedicinesSubstances whose safe use requires professional advice but thatshould be available to the public from a pharmacist without aprescriptionSchedule 3 medicines, Schedule 3poisons8PrescriberA health professional authorised to undertake prescribing withinthe scope of their practiceDoctor, dentist, general practitioner(GP), nurse practitioner, optometrist,other approved non-medicalprescriber, specialist, veterinarian14SensitiveinformationAny type of personal information that, if disclosed or handledinappropriately, can leave an individual vulnerable todiscrimination, mistreatment, humiliation or embarrassment.15For example, it may encompass any information that defines orinfers race or ethnic origin; political opinions; religious beliefsand affiliations; philosophical beliefs; sexual preferences andorientation; criminal record; or health, genetic or biometricinformationSupply of medicines The act of providing medicines to a person or third party for use by14the person onlySystem OperatorThe participant with responsibility for establishing and operatingthe My Health Record system. The System Operator is currently theAustralian Digital Health Agency9Therapeutic goodIn relation to evaluation, assessment and monitoring by theTherapeutic Goods Administration, therapeutic goods are broadlydefined as products for use in humans in connection withpreventing, diagnosing, curing or alleviating a disease, ailment,defect or injury; influencing, inhibiting or modifying a physiologicalprocess; testing the susceptibility of people to a disease or ailment;influencing, controlling or preventing conception; or testing forpregnancy. They include things that are used as an ingredient orcomponent in the manufacture of therapeutic goods, or to replaceor modify parts of the anatomy16Dispensing Practice Guidelines I Pharmaceutical Society of Australia Ltd.7

IntroductionDispensing is a fundamental component of pharmacy practice,17facilitating the safe provision of prescription medicines anddevices as part of the medication management pathway.18Dispensing includes all the activities that occur between thetime the prescription is presented in a pharmacy and the timethe medicine is supplied to the patient.19 It involves “the reviewof a prescription and the preparation, packaging, labelling,record keeping and transfer of the prescribed medicine includingcounselling to a patient, their agent, or another person whois responsible for the administration of the medicine to thatpatient”.⁴Separation of dispensing from prescribing facilitates anindependent review of a prescription before the patient beginstreatment.20 When dispensing, a pharmacist must make thehealth and wellbeing of the patient their first priority, anddemonstrate responsibility and accountability for all decisionsmade and actions taken.18Dispensing Practice Guidelines I Pharmaceutical Society of Australia Ltd.Dispensing should reflect and uphold the principles of quality useof medicines (QUM). QUM involves21: selecting health management options wisely by consideringthe place of medicines in treating illness and maintaininghealth choosing suitable medicines, if a medicine is considerednecessary using medicines safely and effectively to achieve the bestpossible results.

The dispensing processWhen dispensing medicines, pharmacists should ensure that⁴: the prescription is valid, according to relevant legislation the patient’s identity is confirmed and recorded accurately inthe dispensing software the medicine is clinically appropriate for the patient information is provided to ensure safe and appropriate use ofthe medicine.Dispensing activities should be guided by a standard operatingprocedure that outlines the3: steps involved in the dispensing process (see Figure 2) responsibilities of pharmacy staff members in the dispensingprocess training plan for staff involved in the dispensing process risk management plan (see Box 4).Throughout the dispensing process, pharmacists have aresponsibility to: apply their expertise use professional judgement to protect and promote the safety,health and wellbeing of patients protect patient privacy and confidentiality, including thehandling of sensitive information maximise therapeutic outcomes, in partnership with patientsand prescribers.Dispensing Practice Guidelines I Pharmaceutical Society of Australia Ltd.9

Figure 2. The dispensing processThe dispensing processStep 1Receiving a prescriptionAscertain authority to prescribe and validity of prescriptionStep 2Reviewing prescribed medicines Correctly identify the patient and obtain supplementary information Determine the prescriber’s intentions, including the dosing instruction Review the medication history Obtain relevant patient information from other sources, includingstate/national digital platformsStep 3Considering supply arrangements Make decision to supply or decline supply Comply with legal and professional obligations for specific supplyarrangements (e.g. scheduling of medicines, PBS-subsidised oremergency supply)Step 4Communicating with the prescriber, as requiredCollaborate with the prescriber to ensure medicine safetyStep 5Recording and documentation Input prescription data accurately into dispensing software Document medicine-related problems where appropriateStep 6Selecting or preparing the medicine Select or prepare the medicine Use a barcode scanner if packaging includes a barcodeStep 7Labelling Label the medicine Use cautionary advisory labels where appropriateStep 8Supplying and counselling Check and recheck all dispensing for accuracy and completeness Confirm patient identity Counsel the patient, where appropriateStep 9Following up with patient or prescriberas requiredReference: Adapted from Pharmacy Board of Australia⁴10Dispensing Practice Guidelines I Pharmaceutical Society of Australia Ltd.

Reviewing prescribed medicinesThe pharmacist has a professional responsibility to reviewmedicines prescribed for patients to ensure that they reflectthe prescriber’s intentions, and are consistent with QUM andthe pat

Documenting medication-related problems 18 . desired behaviour or minimum standards of good practice how duties and responsibilities may best be fulfilled. . 5Pharmaceutical Defence Limited Guide to Good Dispe