When my career as a pharmacist began, I thought that checking prescriptions was one of the most important tasks that pharmacists performed. Was I ever wrong! It is the most important task that we perform.

An error can potentially have catastrophic outcomes. Grossly misfilling just one out of 200 prescriptions (one half of one percent error) during the course of a shift could cause you to loose your license or even worse a patient to loose his/her life! Any dispensing error that gets past the pharmacist and into the hands of a patient will take a minor miracle to prevent such events. High volume community pharmacists must deal with this immense pressure every day.

Early in my pharmacy career I was not fully aware of this pressure. It took my first day as a licensed pharmacist to even come close to realizing this. My first shift working as a pharmacist was on a Sunday I had arrived at the store nice and early eager to begin my upcoming career. I had just graduated near the top of my class, I knew the medications, I knew how to counsel patients, I knew my stores inventory management system inside and out, I even knew how to work the register, but (I discovered quickly) there was one thing I did not know - how to check a prescription! Interns, by law, are not allowed to check prescriptions so I had no practice. It was this first day that I realized just how important it was to check prescriptions.

Since then I have dedicated myself to creating a system that would allow me to accurately verify a prescription time and time again. What got me through that first day though (and many others following) was a thought process that I still use today, almost a decade later I verify prescriptions using the same order that I would use to enter the information from the script into the computer. All the other details were a matter of trial and error that all stem off of this central thought process.

I continued with only this method for a few years with success, but still, occasionally, I would miss something. It was not until I thought about the sequence of comparing the script to the vial that I really turned the corner this was my first big breakthrough. I discovered you must look at the script, then interpret it, then think about what you would type into the computer, and then, and only then, look at the labeled vial. This system brought my dispensing errors to a fraction of where they were (to where they should be).

This sequence concept later carried over into another area as well. The very first step in checking any prescription is choosing which prescription to check. I always look at the label on the script first, and then find the corresponding vial by looking at the drug name printed on the vial, and not by looking at the contents of the vial (thats the second step).

I have had one more revelation when it comes to checking prescriptions, and that is the concept of minute details and the patients perception of you. Minute details are those errors that would not harm the patient; however, the prescription is still not 100% correct (i.e. calling a pill a tablet instead of a capsule, or grammatical errors). If the label (the only part of the prescription filling process that a patients sees) looks good, reads well, and satisfies all patient requests, then the pharmacist looks good in the eyes of the patient which, in turn, builds a trusting relationship - that is the power of the patients perception of the pharmacist.

Being a very meticulous person by nature, I had made notes of everything that I did and learned. A 7 step procedure was created where I wrote down everything that I think about and do while checking a prescription in order to train my interns and, from that source, published a book to pass along to new pharmacists. How to Check Prescriptions with Accuracy and Ease in Less Than 1 Week is the product of my experience.

After years of trial and error, I now instruct my technicians that if they are unsure about something with a prescription, then they should just guess because I have such confidence in my procedure. No errors will get by me and into the hands of my patients.