2.4 Pharmacy Technicians, Technician Trainees & Supportive Personnel

2.4 Pharmacy Technicians, Technician Trainees & Supportive Personnel

The blueprint tests the scope and limits of non-pharmacist personnel. Utah's framework is in §§ 58-17b-305, 305.1, R156-17b-303a, 303c, 601, 607, and the Vaccine Administration Protocol.

Two license levels

Pharmacy technician trainee (§ 58-17b-305.1)

A trainee applicant applies, pays the fee, completes a criminal background check (unless DOPL exempts it), shows no disqualifying condition, and proves enrollment in a DOPL-approved training program. The trainee:

• practices only under the direct supervision of a pharmacist;
• may do any licensed-technician task except hospital tech-check-tech checking; and
• is subject to a ratio of one trainee per pharmacist, or two trainees per pharmacist if a licensed pharmacy technician or intern is working the same shift (R156-17b-601(4)).

Licensed pharmacy technician (§ 58-17b-305)

To become licensed, the applicant must finish an approved training program and pass the exam within the time the rules set.

• Program (R156-17b-303a(3)). It must be accredited by ASHP or ABHES, conducted by a program DOPL approves with the board, or conducted by a branch of the Armed Forces. It must include at least 180 hours of directly supervised practical training in a licensed pharmacy while the student holds a trainee license, and have written supervision and evaluation protocols.
• Exam (R156-17b-303c(6)). Pass the PTCB or ExCPT exam. The certificate must be valid and active.
• Two-year deadline (R156-17b-303a(4)). A trainee must finish the program and pass the exam within two years after getting the trainee license, unless DOPL and the board approve more time for good cause shown by exceptional circumstances. Otherwise the person must repeat the entire training program.
• Out-of-state technicians who don't qualify by endorsement may qualify with at least 1,000 hours of technician practice in the past two years (or equivalent experience) plus current PTCB or ExCPT certification (R156-17b-303a(6)).
• A pharmacist whose license is on disciplinary probation may not be licensed as a technician or trainee during that probation.

What a licensed technician may do (R156-17b-601(1))

A licensed technician works under the general supervision of a pharmacist (§ 58-17b-102(57)) and may do any task involved in physically preparing and processing prescriptions, including:

• receiving written prescriptions and taking refill orders and refill authorizations;
• entering and retrieving data in the patient profile, preparing and affixing labels, retrieving stock, counting and pouring, and placing medications in containers;
• compounding;
• counseling on OTC drugs and dietary supplements under the supervising pharmacist's direction;
• receiving new prescription orders by telephone or electronically, but only if the original communication is recorded so the pharmacist can review it as transmitted (for example, a voicemail);
• transferring prescriptions (R156-17b-612(5)); and
• in a Class B hospital, checking certain medications filled by another technician (ADC fills, cart fill, crash-cart trays, unit dosing), if the technician has at least one year of experience and six months at that hospital, and the hospital has training and competency records (kept during employment and for three years after), a list of authorized technicians, an error-reporting system, an immediately available supervising pharmacist, supporting technology such as barcode scanning, and written policies.

What a technician may NOT do (R156-17b-601(2))

1. receive a new prescription or medication order, except the recorded telephone or electronic order described above;
2. clarify a prescription with a prescriber;
3. perform drug utilization review;
4. perform the final review of a prescription;
5. dispense; or
6. counsel a patient about a prescription drug.

Vaccine administration by technicians

A technician may administer vaccines and emergency medications by pharmacist delegation under the Vaccine Administration Protocol (R156-17b-601(3)) if the technician:

• has completed the training in R156-17b-621 (current BLS, injection technique training, and anaphylaxis management);
• is under the direct, on-site supervision of the delegating pharmacist; and
• completes two hours of immunization CE each renewal cycle after the initial training.

The technician may not further delegate administration to anyone else.

Staffing ratios

• Utah sets no fixed numeric ratio of technicians to pharmacists.
• Instead, the PIC must ensure the pharmacy does not operate with a ratio that "results in, or reasonably would be expected to result in, an unreasonable risk of harm" (R156-17b-603(3)(r)).
• Requiring a pharmacy or pharmacist to operate with such a ratio is unprofessional conduct (R156-17b-502(22)).
• The numeric ratios are for trainees (1:1 or 2:1) and interns (2 per shift, 5 at outreach events).
• At a remote dispensing pharmacy without a pharmacist physically present, no more than two licensed technicians may staff the site, and each must have at least 500 hours of experience (R156-17b-614g).

Supportive personnel (R156-17b-607)

Unlicensed supportive personnel may do tasks not related to drug preparation or processing: ordering and restocking, cashiering, billing, filing, receiving a written prescription and handing it to licensed staff, housekeeping, and delivering a pre-filled prescription to a patient. They may not enter information into a patient profile or accept verbal refill information. A pharmacist must be present in the area and immediately available to supervise them, except for deliveries. A person whose pharmacy license is revoked or suspended may not work as supportive personnel. Everyone employed in a pharmacy who has contact with the public must wear a visible name-and-position badge (§ 58-17b-603).

Scenarios

• Voicemail order. A new amoxicillin prescription is left on the pharmacy voicemail. A licensed technician may transcribe it for pharmacist review, because the original is recorded.
• Live call while the pharmacist is counseling. For a live, unrecorded call from the prescriber's office, the prescription should be taken by a pharmacist or intern (R156-17b-612(2)).
• Two trainees, one pharmacist, no other staff. This violates the trainee ratio. A second trainee is allowed only when a licensed technician or intern is on the same shift.