Documentation and Record Keeping Flashcards
7 cards from real APC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Documentation and Record Keeping flashcards as text
A pharmacist discovers that the S8 register balance does not match physical stock. What should be done FIRST?
Answer: Conduct an immediate investigation, document the discrepancy, and notify the relevant authority as required by state legislation
S8 discrepancies must be investigated and documented immediately, and reported to the relevant state health authority within the required timeframe.
Which of the following best describes a 'dispensing record' as required by Australian pharmacy legislation?
Answer: A record of each dispensed item including patient, prescriber, medicine, quantity, date, and dispensing pharmacist
A dispensing record must capture patient, prescriber, medication details, quantity, date, and the responsible pharmacist's identity for each supply.
A patient requests access to their own dispensing history. Under the Privacy Act, what is the pharmacist's obligation?
Answer: Provide the patient access to their records, unless a specific exception applies
The Privacy Act grants individuals the right to access their own personal health information held by a pharmacy, with limited exceptions.
When transferring a prescription between pharmacies, which information MUST be documented on the transferred prescription?
Answer: Date of transfer, transferring and receiving pharmacy details, quantity already dispensed, and remaining repeats
Transfer documentation must include the date, both pharmacies' details, quantity already dispensed, and remaining repeats to prevent oversupply.
A locum pharmacist dispenses a medicine under their own name in the dispensing system rather than the supervising pharmacist's name. Why is this important for documentation?
Answer: Professional accountability requires the dispensing record to correctly identify who is responsible for each supply
Accurate identification of the dispensing pharmacist ensures professional accountability and enables tracing of decisions if questions arise later.
What is the significance of 'brand substitution' notation on a dispensing record?
Answer: It documents that a different brand was supplied under the PBS brand substitution provisions, with the prescriber's or patient's consent noted
Brand substitution notation documents that a PBS-approved alternative brand was supplied and records any required consent, ensuring transparency and traceability.
Under Good Pharmacy Practice standards, how should corrections to handwritten dispensing records be made?
Answer: Draw a single line through the error, write the correction, and initial and date the change
A single line through the error, with correction, initials, and date, maintains the integrity of the original record while clearly showing the correction.