Beruflich Dokumente
Kultur Dokumente
tech talk ce
the national continuing education program for pharmacy technicians 1 CEU free
Answer online for instant results at www.canadianhealthcarenetwork.ca april/may 2011
Approved for
A
1 CE unit
pproved for 1 CE unit
by the Canadian Council
Ethical Principles for
Pharmacy Technicians
on Continuing Education in
Pharmacy. File # 1065-2010-
167-I-T Tech. Not valid for CE
credits after Dec. 23, 2013.
tech talk ce
information in order to make an autonomous principle in mind as they would like to make
choice. The best way to achieve this is a positive difference in the lives of their 1.2 Uphold and act on ethical
principles Competency Elements
through patient counselling. The technician patients. The Code of Ethics for Members
1.2.1 Be accountable to patients
can play a key role in facilitating the dialogue of the Ontario College of Pharmacists states 1. Advocate on behalf of patients
between a patient and the pharmacist so this principle clearly in the preamble, “They 2. Involve patients in decision making
that the patient receives all the necessary are obliged to act in the best interest of and 3. Respect patients’ rights to make their
information to make that choice. When advocate for the patient.”5 Helping patients own choices
4. Consider patient-specific
counselling is completed effectively, the in achieving the best outcome from their
circumstances
patient usually sees the benefits of a medication; anticipating and helping
1.2.2 Question, report and assist in the
medication and is much more likely to make patients navigate through complicated drug
resolution of potential and actual unsafe,
a well-informed decision about their health plans; promoting health and wellness in illegal, unethical, or unprofessional
Educat i o n
care. Autonomous decisions must be made community seminars are all examples of actions or situations
voluntarily as patients should not be coerced beneficence in action. The pharmacy 1. Identify, report, and correct errors,
into a decision that they are not comfortable technician has a tremendous role to play in omissions and unsafe practices or
situations.
with. Sometimes patients may not have the promoting positive outcomes both for the
2. Identify and report conduct that is
capacity to make their own decisions, such patient and for the profession. illegal, unethical, or unprofessional to
is the case with Alzheimer’s disease, severe the appropriate authorities.
head injury or coma. Therefore, it is Case 2 analysis: Jason has a number of 3. Document the incident and actions
necessary to have someone else making choices available to him. He can simply tell taken
decisions on behalf of the patient. The the nurse that the order won’t be ready until 1.2.3 Demonstrate personal and
C o n t i n u i n g
converse to autonomy is known as later or he can work to resolve the issue in a professional integrity
1. Accept responsibility and
paternalism. It occurs when health timely fashion. Working for the best
accountability for actions and
professionals see themselves as knowing outcome of the patient would suggest that decisions
what is best for the patient without giving Jason should forego some of his lunch break 2. Show sensitivity to and respect for
consideration to the patient’s values and in order to help the patient who is suffering. patient’s dignity, values and diversity
beliefs.3 There are many cultures that still By this action, Jason is keeping the best 3. Maintain appropriate professional
boundaries
practice healthcare under the paternalistic interest of the patient at the centre of care.
4. Practice within personal limits of
approach; the doctor is always right and the knowledge, skills and abilities
patient should never question authority. The Principle of Nonmaleficence
Autonomy, however, gives patients the right Case 3: Dr. Winston has called the
to choose and gives them a voice in the pharmacy to say that the wrong strength of nonmaleficence by participating in the
healthcare decisions and ultimately hydroxyzine was administered to one of his analysis of what went wrong and finding
ownership of their own health. patients. The prescription was written for 10 ways to ensure that the error does not
mg and 25 mg was dispensed. The patient happen again. Sharing the learning from a
Case 1 analysis: Julie has not been given received two doses before the error was medication error also supports the principle
enough information to make an informed, detected. Aside from drowsiness, the of preventing harm.
autonomous choice about her health care. patient suffered no other ill effects. The
Sandeep must recognize this deficiency RPhT pulled the original prescription from Case 3 analysis: The RPhTs in this case
and ensure that effective counselling can the files and confirmed with the other RPhT have already taken the first step in
take place. In this way Julie will be able to that they had independently checked and preventing further harm by admitting they
participate in the choices surrounding her released the 25 mg strength instead of the released the incorrect medication. It might
health care and Sandeep will be respecting 10 mg strength. have been tempting to simply ‘look the
the patient’s autonomy to participate in The principle of nonmaleficence is that of other way’ since the patient suffered little
these decisions. preventing harm.3 This principle has its harm. Disclosing the error to the patient,
origins in the Oath of Hippocrates where it informing the pharmacist and following up
The Principle of Beneficence is stated, “above all else do no harm.” with the doctor would be reasonable first
Case 2: Jason, a RPhT, has had a very Checking for drug interactions, checking for steps to managing this incident. Upholding
hectic morning and is looking forward to a overdoses, checking for harmful side the principle of nonmaleficence would
well-deserved lunch break when a nurse effects, checking for early or late on refills guide the technicians to investigate what
from the ward calls to ask for the narcotic are activities that technicians conduct each went wrong and determine if procedures
delivery. She is caring for a patient in day that prevent harm to patients. could be put in place that would prevent
extreme pain and is waiting in anticipation Medication safety is one of the cornerstone this and other similar errors from
for the order. The pharmacy is short-staffed activities of this principle. Technicians have happening in the future. Documentation of
and the order is far from ready. an obligation to their patients to see that their findings is essential and sharing this
The principle of beneficence can be prescriptions are filled in a safe manner. In information with other members of the
described as ‘doing good’ or working in the the event that an error does occur, the healthcare team will help to develop an
best interest of the patient.4 Most technician can further the principle of atmosphere of patient safety.
may not be willing to disclose sensitive with patients and patients will come to already been in consultation with Mr. Zenn’s
personal information if they feel that their rely on their technicians as a valuable prescribing physician and the increased
information is not protected. Technicians healthcare resource. Honesty can dose has been noted and authorized. Julia
as they perform their daily responsibilities sometimes prove to be difficult. How proceeds to complete the prescription and
will have access to personal health much information has to be disclosed. a second technician performs the
information. Most provinces have enacted Does a patient need to know everything? independent refill check. The prescription is
legislation that describes procedures on This is where professional judgment plays filled correctly and accurately and Julia has
the collection, use and disclosure of a role and consultation and collaboration documented her discussion with the
personal health information. Unfortunately, with the pharmacist will be essential. The pharmacist about dosage in the patient file.
C o n t i n u i n g
legislation does not capture every possible technician and the pharmacist must use When Mr. Zenn returns to pick up his
instance that involves the use of personal judgment to determine the boundaries of medication, Julia discovers through
health information. Many hospitals and disclosure to a patient. conversation that he is a bus driver
pharmacies have taken the legislation one responsible for 40 children each day.
step further by drafting policies and Case 5 analysis: The technician and the
procedure to address circumstances that pharmacist have an obligation to the patient Case 6 analysis: There are many ethical
may arise in the workplace. Essentially, to be truthful and honest about the principles in this case. Julia has done a
patients demand and expect that their medication that has been prescribed. As good job at upholding the principle of
personal health information will be discussed in Case 1, the patient must be nonmaleficence by checking the dose of
respected and only used for treatment given all the information to make her lorazepam and possibly preventing an
purposes. Any use or disclosure outside autonomous choice. But how much overdose. She has consulted with the
the workplace would be considered a information is enough? The technician has pharmacist and documented the result of
violation of this principle. an obligation to let the pharmacist know that discussion. She has completed the
that concern over the side effects may independent check of the prescription with
Case 4 analysis: Cathy is in an awkward affect patient compliance. In this way, the another registered technician by working
position of having access to personal health pharmacist is in a better position to in the best interest of the patient
information and feeling the pressure from a determine how to present the information (beneficence) and within her scope of
friend to disclose this information. Cathy during counselling in such a way so as not practice. However, she has now received
must quickly recognize that disclosure of to alarm the patient. For example, the new information that will challenge her on
this information would violate the principle of pharmacist may indeed forgo giving the nonmaleficence and confidentiality. She
confidentiality. Most pharmacies have patient information sheet and discuss the sees the potential for harm to the school
documentation in place that employees information verbally with Elizabeth. In this children as a result of the use of lorazepam
must sign that reinforces that they must way, the pharmacist can be truthful and and she realizes that in order to prevent
uphold this principle at all times. Cathy has honest and yet still address issues that the potential harm she may have to break
an obligation to let her friend know that the patient may need to know in the event of a confidentiality; would this be in the best
personal health information that James side effect. At the same time, the principle interest of the patient as Mr. Zenn could
disclosed to her cannot be released unless of autonomy will be respected as the lose his job as a consequence.
James agrees to it. Since James has left the patient will be given appropriate information Julia has a decision to make. She can
store, Cathy must decline to answer her about her medication. do nothing and stay silent. She could
friend’s question and preserve the contact the school board and disclose
confidentiality of his prescription and his When Principles Collide what she knows or she could consult with
personal health information. The Code of Ethics and the ethical the pharmacist on an appropriate course
principles described within it provide of action, which may include a discussion
The Principle of Veracity guidance and direction in the professional with the physician. By saying nothing Julia
Case 5: Elizabeth is an elderly, frail patient lives of pharmacy technicians. But what upholds confidentiality but may fail to
who relies on her daughter for assistance happens when ethical principles oppose prevent harm. By disclosing to the school
with her medication. Elizabeth’s daughter each other. How does one decide which board she violates confidentiality and
tech talk ce
prevent harm. In consulting with the of the ethical principles already discussed, becoming registered technicians, they too
pharmacist she maintains confidentiality, they are applicable in many situations. must realize that they must act with
does not jeopardize Mr. Zenn’s job but has Some will involve patients directly; others professional integrity if they hope to achieve
not addressed the potential for harm. It will involve conduct with other healthcare their professional designation.
would seem at this point Julia’s best providers and colleagues. The technician is
option is to consult with the pharmacist. obliged to act with honesty in all Conclusion
Together they may feel comfortable in professional circumstances; to maintain The Registered Pharmacy Technician has
discussing these concerns with Mr. Zenn confidentiality; to work in the best interest of an essential role to play in the healthcare
and allowing the patient to participate in patients and the profession; to prevent system. It is imperative that technicians
the healthcare decision (autonomy) while harm and to respect autonomy. Thus, the understand the professional obligation
still preserving confidentiality and working ethical principles work together and are they have to both patients and colleagues.
Educat i o n
to reduce any potential harm. evident as the technician displays Technicians will face ethical decisions
professional integrity. every day. Determining the most
Putting It All Together as appropriate course of action takes time
Professional Integrity Case 7 analysis: Elizabeth is facing pressure and experience. Using tools such as the
Case 7: Elizabeth has just spent her from colleagues to discuss the elements of Code of Ethics and good decision making
weekend completing the Pharmacy the Qualifying exam. While she could be skills the technician can face the everyday
Examining Board of Canada’s Qualifying completely honest about her experience in decisions with confidence and
exam. While sitting at the lunch table at the exam (e.g., it was challenging but a fair professionalism. Consultation with other
work, her colleagues who are still working test of my abilities), disclosing details of healthcare professionals will help the
C o n t i n u i n g
through the process start to question her. questions and content would be technician to make good decisions.
“What should I study? Do we really need compromising the exam and wouldn’t be in Keeping in mind the basic principles of
to know all that math? What sort of the best interest of her profession. autonomy, beneficence, nonmaleficence,
questions did they ask? What were the Elizabeth needs to take a strong stance confidentiality, and veracity will serve a
stations like?” against this type of pressure to ensure that technician very well.
Acting with professional integrity involves those who follow her are given a fair exam
References are available at
pulling all the ethical principles together to and able to demonstrate the competencies www.CanadianHealthcareNetwork.ca,
allow colleagues and patients to recognize required by their own merit. The other CE section, Quick search CCCEP
# 1065-2010-167-I-T
the professionalism of a technician working technicians have a role to play in this case
QUESTIONS Please select the best answer for each question or answer online
at www.CanadianHealthcareNetwork.ca for instant results.
1. Ethics can be described as: c) Self determination 6. Which of the following activities
a) A set of principles that assist a d) Maintaining confidentiality is an example of the principle
technician with his/her conduct e) Working within the scope of practice of beneficence?
b) Being concerned with right and a) Phoning the doctor to obtain a refill
wrong choices 4. Which of the following is true on a medication for a patient
c) Seeking to find a morally desirable regarding the principle of autonomy? b) Putting the drug order away
action a) Patients must always take the advice c) Printing the narcotic report
d) Usually involving making decisions of the health professional d) Updating the drug records in the
e) All of the above b) Patient counselling is an effective computer with new prices
way to assist patients in making e) Filling out the paperwork for narcotic
2. Ethical principles are documented choices about their care destruction with the Office of
in which of the following? c) Patients must agree with the health Controlled Substances in Ottawa
a) Standards of Practice professional’s recommendation
b) NAPRA Competencies for Canadian d) The technician must always agree 7. Which activity demonstrates the
Pharmacy Technicians at Entry with patients about their decisions principle of nonmaleficence?
to Practice e) Patients should only be given a a) Notifying the pharmacist that the
c) Code of Ethics limited amount of information patient has a drug allergy
d) Oath of Hippocrates b) Notifying the pharmacist that the
e) The Health Professions Procedural 5. Michael has been asked to give a patient is late for a refill
Code presentation to a group of seniors c) Completing documentation of a
about the provincial drug plan. Which medication error
3. Autonomy is best described as: ethical principle is he upholding? d) Confirming the calculation of a dose
a) Working in the best interest of a) Confidentiality b) Autonomy e) All of the above
the patient c) Beneficence d) Veracity
b) Preventing harm e) None of the above 8. Mr. Jones has asked for a printout
for income tax purposes for himself 10. W hich statement best describes 13. Professional integrity involves which
and his wife. Which of the following the principle of veracity? of the following?
actions would be most appropriate? a) Maintaining records as confidential a) Upholding the principle of
a) Print Mr. Jones’ record at all times confidentiality at all times
b) Print both Mr. and Mrs. Jones’ record b) Being truthful and honest about b) B eing truthful and honest with patients
and get the pharmacist to sign it how long it will take to prepare a c) Assisting patients in making choices
c) Print Mr. Jones’ record and contact prescription about their healthcare
Mrs. Jones for permission to print her c) Withholding the patient information d) Working to achieve the best possible
record and give it to Mr. Jones leaflet from a patient outcomes for patients
d) Deny the request because it is not d) Consulting with a pharmacist about a e) All of the above
E ducat i o n
a) Release the information as this would c) Confidentiality d) Veracity 15. Acting with professional integrity
be in the best interest of the patient e) Both a) and d) involves which of the following?
b) Explain that these records are a) Accepting responsibility for one’s
confidential and can’t be released to 12. Janet has been asked to be on a own actions and decisions
those not involved in the care committee to develop CE programs b) Showing respect for a patient’s
c) Ask the pharmacist to release the for technicians. If she accepts, dignity, values and diversity
information to the nurse which ethical principle best c) Maintaining appropriate
d) Ask the nurse to consult with the describes her actions? professional boundaries
physician a) Veracity b) Confidentiality d) Practising within personal limits
e) Ignore the request c) Beneficence d) Autonomy of knowledge skills and abilities
e) None of the above e) All of the above
Ethical Principles for Pharmacy Technicians Now accredited by the Canadian Council on Continuing Education in Pharmacy
For information about CE marking, please contact Mayra Ramos at (416) 764-3879 or fax
(416) 764-3937 or email mayra.ramos@rci.rogers.com. All other inquiries about Tech Talk CE should be directed
to Rosalind Stefanac at (416) 764-3926 or rosalind.stefanac@rci.rogers.com.
Educat i o n
Communication Skills in Pharmacy Practice 5th ed.
Baltimore: Wolters Kluwer Lippincott Williams and
Wilkins 2008.
4. Canadian Nurses Association. Everyday Ethics:
Putting the Code into Practice 2nd ed. Ottawa. 2004.
5. The Ontario College of Pharmacists. Code of Ethics
for Members of the Ontario College of Pharmacists
2006 available at http://www.ocpinfo.com/client/
ocp/OCPHome.nsf/web/Code+of+Ethics (retrieved
September 5, 2010.
C o n t i n u i n g