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Oregon News: Duty of Pharmacy Staff to Report Unsafe Conditions
Published in the August 2009 Oregon State Board of Pharmacy Newsletter
The February 2009 Board of Pharmacy Newsletter carried Item No. 450: Duty to Report, in which the pharmacist’s duty to report suspected violations of pharmacy laws or rules was reviewed. Similarly, the duty to report conditions that, in the pharmacist’s judgment, are considered to be potentially unsafe is reviewed in this article.
Community pharmacies are busier than ever, and every pharmacy experiences heavy workload days during which staffing is low, customer traffic accumulates, and waiting lines increase. Days occur in which the community or institutional pharmacy receives more interruptions and phone calls than usual, medication orders pile up, and the work does not flow smoothly. We have all been there. It is inevitable for every pharmacy to experience this from time-to-time and we learn to adapt. A serious problem exists when this becomes the norm rather than the exception, when the “bad days” seem to be more like “regular days” or seem to outnumber the “good days.”
Ensuring patient safety is a professional responsibility of every pharmacist, as well as every pharmacy as a licensed drug outlet, and failure to do so may be considered unprofessional conduct by the Board. This expectation includes providing appropriate levels of appropriately trained staff and a work environment that promotes patient services and quality health care. The Board expects licensees to be proactive and take steps to prevent errors from occurring. Items to consider when evaluating your practice include the following:
- understaffing leading to delays in patient service;
- mistakes and near misses;
- frequent backups in filling prescriptions;
- constantly losing prescription paperwork;
- inadequate employee training; and
- any environment or practice that causes employees to question the safety of themselves or patients.
It is not the Board’s intention to impose rules that infer or restrict the amount of work a pharmacist may perform in a shift or a day. Because each pharmacist feels competent at his or her own pace, the Board believes that it is best left to the individual to use his or her professional judgment to determine what is safe and appropriate. The Board also believes that setting limits on numbers of prescriptions or number of hours will not be beneficial.
The Board’s intention is to see that each pharmacy operates in a manner that best serves the patient and ensures the highest possible level of safety. In addition, the Board encourages pharmacists to be vigilant about potentially unsafe conditions and take any necessary steps to prevent potential problems.
Under ORS 689.455, it is the duty of every pharmacist and technician to report to the Board if they feel they are being asked to work under conditions that are leading to unsafe or potentially unsafe patient care.
By Kevin DeClercque, PharmD Candidate, Pacific Universityand Joseph Ball, RPh, Chief Investigator, Oregon State Board of Pharmacy
