Category: Professional Posters
Purpose: To provide a brief overview of the pharmacy technician career ladder at a multi-hospital health system and describe the importance of having a controlled substance audit and compliance specialist technician (CS ACST). Career ladders help promote technician involvement and growth in the pharmacy profession. One particular position within our career ladder is the role of the CS ACST. This pharmacy specialist technician focuses on controlled substance (CS) medication diversion monitoring and detection. The CS ACST also helps the pharmacy manager maintain compliance with the Drug Enforcement Agency (DEA) and the North Carolina Board of Pharmacy (NC BOP).
Methods: Our pharmacy technicians are required to maintain NC BOP registration and certification with the Pharmacy Technician Certification Board (PTCB). Once desired leadership traits are displayed and competences are obtained, a technician may be promoted to an advanced technician position. Advanced technicians who have specialized skills with expert level knowledge of an area may apply for a role as a specialist technician, limited number of specialists available. Technicians who have an associate degree in pharmacy technology, completed the appropriate training program, and pass the required assessments may apply for a role as a validation technician. This provides technicians an opportunity to grow skills and expand ownership within a specific niche of pharmacy. Specialist technicians exist for medication histories, sterile and non-sterile compounding, distribution training and automation, and CS auditing and compliance. The CS ACST monitors CS activity within the pharmacy department and throughout the hospital, maintains compliance with regulatory boards, and proactively researches diversion. The CS ACST is also a part of the medication diversion oversight committee (MDOC), consisting of representatives from employee health and wellness, employee education, pharmacy, security, human resources, and nursing. An auditing report generated by a third-party vendor is used to guide the CS ACST in investigating employees with statistically higher than average activity. Once a concern is discovered, the CS ACST reaches out to the MDOC and department leaders to escalate.
Results: During an average month, the CS ACST reviews 306 CS discrepancy resolutions for appropriateness, weekly CS inventory verification for 110 automated dispensing cabinets (ADC), 68 CS sale transactions, 238 receive transactions, and 222 expire/waste/recall transactions, including reconciliation with the reverse distributor. After reviewing these activities, the CS ACST will follow up with all stakeholders when clarifications on incomplete or inappropriate processes are observed. Numerous other routine audits are performed including monitoring closed nursing unit activity, ADC user access management, and manual medication administration record review for locations that do not have an ADC. The CS ACST researches suspicious CS activity including reconciling medication administration records (MAR) with ADC transaction for numerous users every month. The CS ACST also works closely with the pharmacy manager as the point person for any suspected/confirmed cases of diversion.
Conclusion: With the implementation of a career ladder in a large health system, this introduced new opportunities for pharmacy technicians to grow, develop their skills, and improve their leadership qualities. The creation of the CS ACST acknowledges the importance of maintaining complete, accurate, and compliant documentation of CS. Federal agencies and healthcare organizations are pushing for more stringent control and increased regulations around CS. A pharmacy technician dedicated to this work provides a necessary resource to take a step in the right direction.