In February 2006, Christopher and Kelly Jerry endured every parent’s worst nightmare when, during what was supposed to be her last course of chemotherapy treatment at Cleveland’s Rainbow Babies and Children’s Hospital, their 2-year-old daughter, Emily, unexpectedly died.
The cause of Emily’s death was an overdose of sodium chloride. Her treatment called for sodium chloride 1% solution, but the pharmacy technician who compounded it instead used a solution with a 23.4% concentration. During an investigation, it was discovered that though the technician had worked at the hospital for years, she didn’t know an overdose of sodium chloride was fatal. It also turned out that the technician had never received formal training because Ohio state law at the time did not require it.
The tragedy led the Jerrys to push for state legislation requiring regulation of pharmacy techs, and in January 2009, they were present when Gov. Ted Strickland signed what has become known as Emily’s Law, giving Ohio some of the nation’s strongest regulations of the pharmacy tech profession.
But as shown by a state-by-state scorecard released March 25 by the Emily Jerry Foundation, which Christopher Jerry founded with the goal of minimizing human error in medicine, many states [still] do not have pharmacy tech regulations. The scorecard assigns academic-style letter grades of A through F based on states’ requirements for education and training, certification, registration, licensure and continuing education. It is designed to show which states are succeeding and which ones are failing in the foundation’s view. It also reserves a special distinction, zero, for those states in which pharmacy techs remain essentially unregulated: New York, Pennsylvania, Michigan, Wisconsin and Hawaii.
Though final authority over requirements for pharmacy techs ultimately rests at the state level, the Pharmacy Technician Certification Board has sought to set national standards for certification. Most recently, the PTCB announced that over the next seven years, it would phase in changes to its certification program that would include mandatory background checks, accredited education requirements and changes in acceptable continuing education programs for recertification, changing requirements that have remained largely unchanged since the board’s 1995 founding.
Starting in 2014, as part of the 20 hours of CE required for recertification, certified pharmacy technicians will have to complete one hour of medication safety CE in addition to the hour of law CE they must already take. Then, in 2015, the board will require all 20 recertification CE hours to be specific to pharmacy technicians, and the number of CE hours from college courses will be lowered from 15 hours to 10 hours by 2016 before being phased out by 2018. “The reason for putting best practices out there is to help the policy decision-makers to use best practices that will give us consistency,” American Pharmacists Association chief strategy officer Mitch Rothholz told DSN Collaborative Care.
The National Association of Chain Drug Stores takes a similar view. “We support requirements for training and evaluating of pharmacy technicians, but do not believe a one-size-fits-all approach would best serve patient safety,” a spokeswoman for the group told DSN Collaborative Care. “Pharmacy technicians must be trained to operate within their particular practice setting. NACDS supports state licensure or registration of pharmacy technicians.”
The Emily Jerry Foundation’s scorecard is designed to raise the bar for pharmacy techs “across the board,” Christopher Jerry told DSN Collaborative Care. Jerry said the goal was not to denigrate or undervalue the role of pharmacy techs, but to increase their core competencies. He said he had seen a shift in the on-the-job training required by the retail chains, and that chains were striving for better standards and core competencies. “[Pharmacy techs’] jobs are very important,” he said. “There’s no pharmacy that would be able to operate in the United States without them.”
Rothholz added that pharmacy techs were important to free up time for pharmacists so the latter could spend more time focusing on patient services.