Innovation Enhances Clinical Learning Experiences for Pharmacy Technology Students

This article is co-authored by Nita Johnston, PharmD, MS, of Moses H. Cone Hospital.

Pharmacy technicians work under the direct supervision of licensed pharmacists and perform many pharmacy-related functions. They’re able to work in a wide variety of places, including community pharmacies, health-system pharmacies, long-term care facilities, mail-order pharmacies, and even the military.

As the profession continues to grow, demand for skilled, trained, and highly competent pharmacy technicians will climb. To gain required skills and competency, interested individuals should consider obtaining an associate's degree from an accredited college.

The program at Forsyth Technical Community College offers both a diploma and an associate’s degree, but the associate’s degree will ultimately allow the technician to participate in greater roles at various organizations. Programs like Forsyth’s provide didactic learning from textbooks as well as clinical rotations across various health care settings. These clinical rotations and didactic learning opportunities help prepare students for successful futures as pharmacy technicians.

By obtaining a higher level of education, the pharmacy technician will be qualified to perform more advanced tasks along with the daily duties they currently perform. As pharmacists’ focus shifts to clinical aspects of patient care, operational activities will be required of technicians, and pharmacy technology programs can help technicians gain the knowledge, skills, and additional competency needed to perform these tasks.

This month, I’ll graduate from Forsyth Tech with my associate’s degree in pharmacy technology. I’ve gained both knowledge and experience in my pursuit of this degree.

As a certified pharmacy technician for the past 20 years, I wanted to be innovative in shaping my rotation experiences in a manner that developed both my clinical and operational skills. I started my clinical rotations this past February at Moses H. Cone Hospital, and part of the requirements was to write about my experiences as a pharmacy technology student.

Rotation Overview

In the 4 weeks I spent at Moses Cone, I was able to use my creativity and innovation in multiple projects that supported the clinical work of the pharmacy department, all with the support of my preceptor.

One project I was particularly proud of was designing a wallet medication identification card for patients to document their medications. Another project was designing a medication history patient satisfaction metric for ongoing data collection and evaluation. I was also able to assist our clinical coordinator on a missing medication project that revealed some re-education needs for our nursing staff.

I worked with the transitions of care pharmacist to update the medication reconciliation standard of practice “how to” videos and PowerPoint slides for new learners. I conducted data collection for MATCH, a medication assistance through Cone Health indigent care program. I created a medication history technician survey using SurveyMonkey, and I developed a “how to” process for investigational medications. There was an amendment to the protocol for one of the research studies, and I updated the training sheet.

I could see the engagement and innovation of not only the pharmacy team, but also the other members present at various meetings that I attended with pharmacists. Those meetings included the institutional review board meeting, the pharmacy and therapeutics committee planning meeting, and the Cone Health Antimicrobial Management Program meeting, which reviewed antibiotics and the appropriateness of their use.

I also attended a medication safety quality meeting, where certain medication errors or adverse events were reviewed. I learned how to read a financial report and input the data into a graph. I attended a cardiac rehab class taught by a pharmacist, and along with the patients, I learned about cardiac medications and how they work in the body.

Medication Safety

During my time with the safety pharmacist, I reviewed some of the incidents that had been put into the data collection system by various health care team members, and I learned the different levels of harm.

The Alaris pump is a piece of equipment that nurses use to infuse intravenous medications for patients. The innovation that “smart pumps” provide to improve patient safety was very interesting to learn about.

I learned how to program the pump, use the guardrails, and set up multiple drips at a time. I was able to use this knowledge with one of our research groups. In the operating room, I assisted the certified registered nurse anesthetist with the Alaris pump with the appropriate rate settings for the investigational medication.

Infectious Disease

I rounded with several infectious disease pharmacists both internally at the hospital and at the Regional Center for Infectious Disease. Topics for my clinic learning included patient assistant programs for infectious disease diagnosis and other insurances processes, which allowed me to follow up on the status of patients after completing forms properly for Medicaid and the patient assistant program.

On one of my clinic days, I prepared a medication calendar for a patient, which included the name of the medication, dose, and how often the patient took the medication. We provided this medication calendar to the patient because there were changes to the home regimen. I know some patients prefer visual learning, so I went a step further and added pictures of each of the medications on the calendar.

I learned about different lab levels that pharmacists review when trying to determine the best course of treatment. I enhanced my knowledge of HIV medications and called the drug company for available information on crushing and/or dissolving its products.

My inpatient time with the infectious disease pharmacist allowed me to learn about culture reports and how the pharmacist determined if the discharged antibiotic was appropriate or required changing. If the medications had to be changed, the pharmacist and I discussed medications that were needed, presented the options to the emergency department physician, and then the patient was contacted for the new antibiotic.

Research

During the time I spent with one of the research groups at Moses Cone, I learned the procedures that the research nurses complete when they enroll a patient in a study. I prepared the investigational medication that a patient was randomized to and watched the research nurse administer the medication.

One of the most important research aspects for the patient is the informed consent form. I had the opportunity to sit in while one of the research nurses explained the study to a patient to see if the patient would like to sign the informed consent form to enroll in the trial.

Pediatrics

When the pediatric pharmacist stated, “Pediatric patients are not small adults,” it revealed something I hadn’t quite thought of before my rotation.

I reviewed pediatric patient charts and participated in multidisciplinary pediatric rounds. We talked about the pediatric emergency response team and the pharmacist’s responsibilities with pediatric codes. I learned how medications are metabolized in children differently than adults, and I reviewed the available drug references for dosing guidelines.

Team rounding consisted of medical students, medical residents, an attending physician, nursing, pharmacy, and others. On rounds, they discuss patient age, diagnosis, t past medical history, and current problems. This was a wonderful learning experience and I could appreciate the pharmacist’s role in verifying medications, recommending dose changes, and giving feedback on the patient’s care plan.

Heart Failure

During my clinical rotation with the heart failure team, I sat in with the pharmacists at the heart failure clinic and observed as they discussed each patient’s medications. I could see a big role for pharmacy technicians in capturing the most accurate and up-to-date medication history for reconciliation by the pharmacist, nurse, and/or physician. These patients are on multiple medications and require intensive surveillance to prevent readmission.

Operating Room

I had the opportunity to observe some patient surgery cases, including a right rotator cuff surgery. One rewarding aspect was the attention the physician gave me, explaining everything he was doing and all about the bones. My anatomy and physiology class at Forsyth prepared me for this, so I was able to understand and discuss with him what he was doing.

Conclusion

By taking classes at Forsyth, I realized how everything ties together. These classes and my clinical experiences helped me grasp the importance of medications and their place in various diseases.

I used my month-long rotation in a creative and innovative manner to enhance my learning and develop additional skills. For instance, I participated in some tech-check-tech activities with the pharmacist checking behind me, and this may be a role that I will gravitate towards after graduation.

Pharmacy technician growth will continue, and my involvement in the pharmacy technology program and clinical rotations has allowed me to determine which skills will be needed in the future. I’ve learned that pharmacy technicians need exceptional customer service, analytical, listening, math, and organizational skills.

As the roles of pharmacists move toward chronic disease management, pharmacy technicians will need to take on greater responsibilities in operations and distribution. They’ll need to become masters of technology and develop administrative and human resource skills on top of their current roles. All of this can be achieved by completing a pharmacy technology program and making the most of clinical experiences.