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Letters to the Editor
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Dispensing
Open-plan dispensing is like working in a fast-food joint
From Miss P. B. Olutola, MRPharmS
I recently worked in an open-plan dispensary and it was almost a nightmare
trying to get any work done without being constantly interrupted about
one thing or another.
I noticed that patients tended to approach you and interrupt you regardless
of whether you were in the middle of counting 84 tablets or not. I found
that patients standing directly in front of me and watching my every
move while I was dispensing was unnerving. It was a busy store and the
fact that there were two pharmacists and three health care assistants
did not help. It felt like I was working in a fast-food joint dispensing
medicines while the grill was still on making more burgers.
With regards to the issue of privacy when counselling, this was also
an uncomfortable experience for some of the patients because other people
were right behind them waiting for prescriptions and I sometimes had
to whisper to overcome this.
There might be a place for open-plan dispensing but the disadvantages
should also be considered.
Patricia Olutola
Borehamwood,
Hertfordshire
Patient privacy must be considered
From Ms S. McFarlane
John Horncastle writes (PJ, 31 January, p120) criticising open-plan
dispensaries because waiting patients sometimes intervene, often unnecessarily,
while their prescription is being dispensed. As a preregistration trainee,
I undertake extra duties as a dispenser in a pharmacy which has an open-plan
dispensary and I support Mr Horncastle’s claim that the set-up
could lead to dispensing errors and stress in the work-place.
Recently I had a patient look over me as I dispensed her prescription,
which she claimed was incorrect, and demand I supply her with an alternative
that she could see on the shelf. Not only is this intimidating to the
dispenser but it causes distraction and subsequent increased likelihood
of error.
I believe there is also a strong argument against the open-plan dispensary
whereby patient confidentiality is breached — other customers can
see the dispensing process and what is being dispensed, as can the receiving
patient. This seems insignificant for simple aspirin tablets, but what
about our incontinent patients or those receiving Levonelle? Surely their
privacy should be considered.
Sharon McFarlane
Lanarkshire
Let people approach the dispensary singly
From Mr A. Sidhu, MRPharmS
I agree with Ravin Kasavan (PJ, 7 February, p153) that open-plan dispensaries
should be used as a tool for greater accuracy and efficiency. May I suggest
that members of the profession who dislike these open-style areas due
to issues with confidentiality should implement better crowd management
procedures. Having a group of people gawp at you while working can easily
be prevented by encouraging people to approach the dispensary one at
a time. Many open-plan dispensaries already have such systems in force
to facilitate this.
Amandip Sidhu
Pinner, Middlesex
Are there any guidelines on CRCs?
From Dr M. A. Charalambous, MRPharmS
A recent Law
and Ethics Bulletin on child-resistant
closures (PJ, 31
January, p134) pointed out that it is a requirement of the Royal Pharmaceutical
Society’s Code of Ethics that dispensing must be in a reclosable
CRC unless “(a) the medicine is in an original pack or patient
pack such as to make this inadvisable”.
I would like to know which products as original packs we can exclude
from the regulations. Does the Society have any practice guidelines to
help pharmacists decide which products can be dispensed with or without
CRCs. Simply using the description “patient pack” or “original
pack” is not enough and the Society needs to set out exact guidelines.
After all, a practising pharmacist can be accused of professional misconduct
by omitting to use a reclosable CRC having judged that it was not needed
when, in fact, it was (in someone else’s judgement).
M. A. Charalambous
Nottingham
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SUE KILBY, head of practice, Royal Pharmaceutical Society, replies:
The Law and Ethics Bulletin was published in response to a number
of complaints received at the Society over the issuing of dispensed
medicines without CRCs.
The Code of Ethics refers to those products that the manufacturer
advises should be kept within the original non-CRC packaging (an
example would be those containers
that have internal desiccants) or where transferring a medicine from an original
non-CRC container would be a retrograde step, perhaps as a result of the loss
of valuable patient information that may appear on a container.
In these circumstances, the pharmacist is required to make a professional judgement
and will need to weigh the relative benefits and risks of supplying in an original
non-CRC.
If the use of a non-CRC is either requested by a patient or deemed appropriate
by the pharmacist, the patient should be advised to keep the medicine in a
safe place in order to minimise the risk of accidental ingestion. It is advisable
to keep a record of all patients’ or carers’ requests for non-CRCs
on the patient medication record in the event of any dispute. |
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The
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