Maximizing Technician Roles in Sterile IV Compounding

January 2010 - Vol. 7 No. 1

Pharmacy technicians have been providing invaluable services within the pharmacy under the supervision of pharmacists, as long as pharmacists have been in the business of providing medication therapy to patients. As the pharmacy profession has progressed from a dispensing role to more clinically focused positions, technicians are increasingly being placed in less traditional roles in the pharmacy (see Table 1 below). Given the current economic climate surrounding health care, taking full advantage of the skills of well-trained, qualified technicians can be a cost effective solution to handling many non-clinical functions within the pharmacy. One area of pharmacy operations where technicians can provide such a solution is  sterile compounding.

Enhancing Technician Roles in Sterile Compounding
Technicians are already used regularly for sterile compounding duties, and in the pursuit of achieving USP Chapter compliance, many hospitals have introduced new roles for technicians in this area. In fact, some hospitals have been able to add to the pharmacy workforce to help comply with USP by justifying additional technician positions comprising duties traditionally held by pharmacists such as conducting training and competency assessments.

Lead Pharmacy Technicians
One way to maximize technician skills in the sterile compounding area is to establish a lead technician for sterile compounding. In general, lead technicians are charged with managing an area in the pharmacy and/or other technicians. Typical duties that accompany this leadership position include training, documentation, and quality assurance for either the location within the pharmacy or the personnel. For example, a lead IV technician may not only be responsible for training and competency assessment of other technicians in the area, but also for stocking levels and regulatory oversight of the area.

Another option is to appoint a training specialist as opposed to a lead technician. This person would be responsible for the training of new hires as well as ongoing training required to meet The Joint Commission and state boards of pharmacy regulations.

Compliance Technicians
With pharmacists increasingly being placed in medication safety officer positions at their institutions, regulatory affairs or compliance technicians also are gaining popularity. In this role, technicians assist with medication safety officer duties including documentation, policy and procedure oversight and updates, dissemination of new information or policies and procedures to staff, quality assurance, training and testing staff, and collecting background information for use in FMEAs. Technicians in this position may be charged with assisting in all areas of the pharmacy, not just the IV sterile compounding area. The quality assurance technician role is similar to that of the regulatory affairs or compliance technician. However, this technician also may perform site quality testing elements and high-risk medication testing and tracking as required by USP Chapter . This individual also could serve as the department liaison with environmental services to ensure that department is adequately trained to keep the sterile compounding areas clean.

Fixed Positions
Since training and competency documentation are key to ensuring the highest standards are met when compounding sterile preparations, some organizations have made the sterile compounding technician positions stationary, meaning that these technicians do not rotate through other areas in the pharmacy. While this does streamline competency testing and documentation, it is important to keep in mind that this can pose a staffing challenge as sick leave and holidays still need to be covered by someone who has been adequately trained to perform these duties.

Making the Case for New Positions
While these unique technician positions can help a pharmacy run more efficiently, considering the current economic environment, many institutions may not have the funds available for new roles. To build a case for new positions at your institution, include points such as the benefits to patients and personnel, the regulatory implications of not adding the new positions, and the cost benefits.
To justify the position, it may be necessary to get creative about how the person hired is deployed. For example, if you are part of a health system, consider creating a system-wide position. The technician would travel between sites to conduct training and periodic quality assurance testing; their responsibilities do not have to be limited to sterile compounding either.

Training Considerations
When it comes to the training of technicians performing any duties within the sterile compounding area, at the very least, they need to be held to the USP Chapter training requirements for compounding sterile products. These baseline skills can then be built upon depending on the duties to be performed. For instance, if the technician will be responsible for overseeing all of the media fill testing, they should not only pass their own media fill test, they also should be witnessed proctoring a media fill test appropriately to another employee and completing proper documentation.

Outlining Responsibilities
If the technician role is a leadership position, then it is important to clearly outline which staff the employee will be responsible for. For example, if a pharmacy technician is the sterile compounding training technician or compliance technician, designate which staff members they will be training and testing. It is possible that the technician may even be overseeing some of the pharmacists’ training. With that in mind, check the regulations in your state, as some state regulations prohibit a pharmacy technician from training a pharmacist to make sterile compounds and signing off on new hire competencies. If this is the case, then perhaps the technicians only train technicians and pharmacists train both pharmcists and technicians. Either way, managers should clearly delineate this role to the trainer and the trainees. A less obvious example of this is a pharmacy technician who is responsible for quality assurance monitoring. Indirectly, the technician may oversee the work that is being done by a pharmacist if the pharmacist is compounding sterile products. Check your state regulations to be sure this is allowed.

Keep in mind that while it is important to clearly define roles to the individual in the position, it is just as important to communicate the new roles and responsibilities of the individual to the entire pharmacy staff.

Pharmacy technicians are a valuable resource, and using these individuals to their fullest potential can allow pharmacists to take on more clinical responsibilities in the hospital, help cut costs, and streamline pharmacy operations. As the roles of technicians continue to push traditional boundaries, it is important to make sure that proper education and training and the support of pharmacy administration are available to ensure the success of individuals in these
new positions.

Angela T. Cassano, PharmD, BCPS graduated from Campbell University and completed a pharmacy practice and a specialty internal medicine/pediatrics residency at Virginia Commonwealth University/ Medical College of Virginia Hospitals. She has held positions as a clinical pharmacist in pediatrics, clinical assistant director, and assistant health system director of quality assurance and drug safety. In 2005, she founded Pharmfusion Consulting, which focuses on quality and regulatory assurance, medication safety and technology, clinical programs, and operations solutions.



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