Pharmacist Workload-North Carolina Board of Pharmacy

At the regular March meeting of the North Carolina Board of Pharmacy the members discussed its policy on dispensing errors in relation to pharmacist workload. By consensus the members instructed staff to handle prescription dispensing errors in the following manner.

Reports of prescription dispensing errors will be investigated in due course and, if probable cause is determined, a hearing or pre-hearing conference will be scheduled. If the error occurred at a location where more than I50 prescriptions per pharmacist per day were filled on the date of the error then both the pharmacist and the permit will be cited for the disciplinary proceeding. Each case would be considered individually on the facts involved. All should be aware that the Board would presume under these circumstances that, if a sanction is issued, both the pharmacist and the permit should receive the same penalty. For example, if the Board issued a 7 day active suspension of the pharmacist's license to practice then a 7 day suspension of the permit would also be issued.

In arriving at the 150 prescriptions per pharmacist per day threshold the Board used information presented at the NABP Health Law Officers Conference in Savannah in November of 1996. Experts on this program gave a range of not more than 10 to 20 prescriptions per hour as established levels for safe dispensing. A vice president for one national chain store stated that their standard was 5 minutes per prescription for technical functions only which did not include patient counseling and prospective drug utilization review. Their standard, then, would be something less than 12 prescriptions per hour.

Application of this data to work schedules leads to the derivation of the I50 prescription threshold. It is common for pharmacists to split a 12 hour schedule with one working 9 to 3 and another from 3 to 9. This is a relatively short shift and using the lower number of 10 prescriptions per hour (6 hours x 10 Rx per hour) produces a 60 prescription figure. Some other pharmacists work a 12 hour shift and using the higher number of 20 prescriptions per hour (12 hours x 20 Rx per hour) yields a 240 prescription figure. Averaging these two results (60+240)+2 produces tile 150 prescription threshold.

This is a further delineation of the Board's intent in adopting rule .1811 which states "Pharmacists shall not dispense and permit holders shall not allow a pharmacist to dispense prescription drugs at such a rate per hour or per day as to pose a danger to the public health or safety.." Input from pharmacists was obtained from an item in the October 1996 Board Newsletter which follows.