Pharmacy Pharmacy Informatics and Technology 2 — Questions and Answers
Question 1: Computerized Provider Order Entry (CPOE) with CDS reduces medication errors primarily by:
- Eliminating all verbal and telephone orders
- Replacing illegible handwritten orders with standardized electronic orders and real-time safety alerts (Correct answer)
- Preventing physicians from ordering controlled substances
- Automatically selecting the least expensive drug for each indication
Correct answer: Replacing illegible handwritten orders with standardized electronic orders and real-time safety alerts
CPOE eliminates transcription errors from illegible handwriting and integrates CDS alerts for interactions, allergies, and dose ranges at the time of ordering — the medication safety impact of CPOE + CDS is well established.
Question 2: A pharmacy tech notices the robot dispensing system (e.g., ScriptPro) dispensed the wrong NDC for a medication. The FIRST step is to:
- Continue dispensing and report the error at the end of the shift
- Stop the dispensing run, quarantine affected prescriptions, and notify the pharmacist immediately (Correct answer)
- Restock the correct drug and assume no error occurred
- Call the patient to apologize before the pharmacist is involved
Correct answer: Stop the dispensing run, quarantine affected prescriptions, and notify the pharmacist immediately
Automated dispensing errors must be halted immediately. The pharmacist must be notified, affected prescriptions quarantined for review, and the system corrected before resuming operations — patient safety is the priority.
Question 3: A National Drug Code (NDC) number has three segments. What do they represent, in order?
- Drug class, manufacturer, and dosage form
- Labeler (manufacturer), product (drug, strength, dosage form), and package size (Correct answer)
- DEA schedule, therapeutic class, and lot number
- Generic name code, brand code, and expiration format
Correct answer: Labeler (manufacturer), product (drug, strength, dosage form), and package size
NDC format: Labeler Code (4–5 digits) – Product Code (3–4 digits, identifies drug/strength/form) – Package Code (1–2 digits, identifies package size/type). Total 10 digits (11 with leading zeros per FDA standard).
Question 4: Which pharmacy technology uses robotics to automate the filling and counting of oral solid medications in retail/outpatient settings?
- Automated dispensing cabinets (ADC)
- Pneumatic tube systems
- Automated tablet/capsule counting and packaging robots (e.g., ScriptPro, Parata) (Correct answer)
- CPOE systems
Correct answer: Automated tablet/capsule counting and packaging robots (e.g., ScriptPro, Parata)
Oral solid dispensing robots (ScriptPro, Parata, Kirby Lester) automate counting, filling, capping, and labeling of most common oral medications, reducing filling errors and freeing pharmacists for clinical activities.
Question 5: A pharmacy's use of 'smart pumps' for IV infusions helps prevent medication errors by:
- Automatically ordering replacement IV bags
- Using dose error reduction software (DERS) to alert nurses when programmed rates exceed pre-set drug limits (Correct answer)
- Replacing pharmacist review of IV orders
- Monitoring patient vital signs during infusion
Correct answer: Using dose error reduction software (DERS) to alert nurses when programmed rates exceed pre-set drug limits
Smart infusion pumps with DERS (drug libraries) alert clinicians when programmed doses exceed pre-defined limits (soft or hard stops), catching programming errors before they reach the patient.
Question 6: Medication reconciliation is a process performed at transitions of care (admission, transfer, discharge) to:
- Bill insurers for all medications dispensed during hospitalization
- Compare a patient's current medication orders against all medications the patient has been taking to identify and resolve discrepancies (Correct answer)
- Generate a list of all drugs available in the hospital formulary
- Automatically refill chronic medications after discharge
Correct answer: Compare a patient's current medication orders against all medications the patient has been taking to identify and resolve discrepancies
Medication reconciliation compares a patient's home medication list to their current orders at every care transition, catching omissions, duplications, interactions, and dosing errors that commonly occur during handoffs.
Pharmacy Pharmacy Informatics and Technology 2
Computerized Provider Order Entry (CPOE) with CDS reduces medication errors primarily by: