EVENT GUIDELINES
Pharmacy Practice

New for 2014-15
Pharmacy Practice is a brand new skill event designed just for Colorado HOSA members.
The event has been prepared by the University of Colorado Skaggs School of Pharmacy
Purpose:
To provide the Health Science student with an opportunity to develop and demonstrate knowledge
and skills in pharmacy practice.
Description
of Event:
This event will consist of two rounds of competition. Round One will be a written, multiple choice
test of knowledge and understanding. The top scoring competitors will advance to Round Two for
the performance of selected skill procedure(s) identified in a written scenario. The scenario will
require the use of critical thinking skills. The performance will be timed and evaluated according to
the event guidelines.
Dress Code:
Competitors shall wear proper business attire or official HOSA uniform, or attire appropriate to the
occupational area, during the orientation and written test. Competitors will wear attire appropriate
to the occupational area during the skill procedure(s). Bonus points will be awarded for proper
dress.
Rules and
Procedures
1.
Competitors in this event must be active members of HOSA-Future Health Professionals,
in good standing in the category in which they are registered to compete (Secondary or
Postsecondary/Collegiate). Competitors should compete in skill events at the highest
level of their training.
2.
Competitors must be familiar with and adhere to the “General Rules and Regulations of the
National HOSA Competitive Events Program (GRR)."
3.
The test will consist of fifty (50) multiple choice items.
Round One: Written Test Plan
History and Profession of Pharmacy ............................... 7.5%
Pharmacology for Technicians .......................................... 15%
Pharmacy Law and Regulations ....................................... 15%
Sterile and Non-Sterile Compounding ............................... 10%
Medication Safety ........................................................... 12.5%
Pharmacy Quality Assurance .............................................. 5%
Medication Order Entry and Fill Process ........................... 15%
Pharmacy Inventory Management ................................... 7.5%
Pharmacy Billing and Reimbursement ............................. 7.5%
Medication Formulation Usage ........................................... 5%
4.
All competitors shall report to the site of the event orientation at the time designated. The
Round One test will immediately follow the orientation. No proxies will be allowed for the
orientation.
5.
Test Instructions: There will be a maximum of 60 minutes to complete the test. There will
be a verbal announcement when there are 15 minutes remaining for the test period.
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EVENT GUIDELINES
NOTE: States/regions may use a different process for testing, to include but not limited to
pre-conference testing, online testing, and testing at a computer. Check with your
Area/Region/State for the process you will be using.
6.
All official references are used in the development of the written test. The specific
reference selected for each procedure is listed in the Facilities, Equipment and Materials
section of these guidelines.

Ballington, Don and Anderson, Robert. Pharmacy Practice for Technicians. Paradigm
Education Solutions. Latest edition.

Ballington, Don and Laughlin, Mary. Pharmacology for Technicians. Paradigm
Education Solutions. Latest edition.

Dosage Form Use Document – from CU Skaggs School of Pharmacy

www.pocketnurse.com for demo dosage forms and other supplies for procedures
7.
The test score from Round One will be used to qualify the competitor for the Round Two
skill procedures, and will be used as a part of the final score for the event.
8.
For national competition, one, two or three skill procedures will be selected and may be
evaluated as stand-alone skills, or in combination. The procedures approved for this event
are:
Procedure I:
Procedure II:
Procedure III:
Procedure IV:
Procedure V:
Procedure VI:
Procedure VII:
Procedure VIII:
Identify Problems or Missing Items on Prescriptions
Interpret Prescriptions and Dispense Correctly
Donning Aseptic Gear in Sequential Order
Aseptic Technique
Non-sterile Compounding – Suspension/Solution
Non-sterile Compounding – Two Ointments
Non-sterile Compounding – Ointment with Tablets
Patient Education: Proper Dosage Form Usage
* Two of the procedures in red will be piloted at the 2015 Colorado State Leadership
Conference.
9.
The selected procedure(s) for Round Two, in the form of a written scenario, will be
presented to the competitor at the start of the skill to be performed. One or more
procedures may be combined in the scenario. The scenario will be the same for each
competitor and will include a challenging component that will require the competitor to
apply critical thinking skills.
10.
The scenario is a secret topic. Professional ethics demand that competitors DO NOT discuss
or reveal the secret topic until after the event has concluded. Competitors who violate this
ethical standard will be disqualified.
11.
In case of a tie, the highest test score will be used to determine the rank.
12.
Competitors must complete all steps of the procedure listed in the guidelines even if the
steps must be simulated/verbalized. Steps may NOT be simulated/verbalized when the
equipment/materials are available.
13.
The competitor must earn a score of 70% or higher on the combined skill procedure(s) of
the event (excluding the test) in order to be recognized as an award winner at the NLC.
14.
The timing for the skill will begin when the scenario is presented. Competitors will be
stopped at the end of the time allowed for a selected procedure(s).
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Competitor Must Provide:
 Event guidelines (orientation)
 Pens and #2 lead pencils with eraser
 Calculator
Required Personnel
1.
2.
3.
4.
5.
6.
7.
8.
9.
One Event Manager per event
One Section Leader per section
One judge per procedure selected per section (with expertise in the specific skill area)
Proctors for testing
One-two event assistants per section
One-two patients as required by the scenario (per section)
Holding room attendants(s)
Timekeepers (if necessary)
One QA to provide quality assurance for the event by ensuring that the guidelines
are followed and all event documents are complete.
Facilities, Equipment and Materials (Per Section)
General






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Clinical and/or laboratory stations for selected procedures
Access to sink for selected procedures
Holding rooms or areas for competitors
Written scenario (one copy per competitor and judge)
Patient and judge scripts as needed
Pencils for judges
Stopwatch
Rating sheets – one per judge per competitor
Evaluation Forms – competitor, judge, and personnel
#2 lead pencils with eraser to complete evaluations
Round One: Written Test (Reference: All resources)
 One test copy per competitor
 Scantron /answer forms
Round Two:
Procedure I
Identify Problems or Missing Items on Prescriptions (Reference: Ballington, Chapter 6)
 Pencil/eraser
Procedure II Interpret Prescriptions and Dispense Correctly (Reference: Ballington, Chapter 6)
 Pencil/eraser
 Counting tray/spatula
 Two medication vials of each size (10 dram, 20, 30, 40, 60)
 Labels (4 per competitor)
 Demonstration medications
o Keflex 500 mg, #30
o Cephalexin 500 mg, #30
o Norco 5/325, #150
o Hydrocodone/Acetaminophen 10/325, #150
o Polytrim ophthalmic drops, 10 mL bottle
o Poly-dex ophthalmic drops, 5 mL bottle
o Triamcinolone 0.1% cream, 80 g tube
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o
Triamcinolone 0.1% ointment, 80 g tube
Procedure III Donning Aseptic Gear in Sequential Order (Reference: Ballington, Chapter 11)
 Tape to represent different rooms
 Sink access
 Soap or hand sanitizer
 Barrier devices (gloves, gown, shoe covers, mask, hair net)
Procedure IV Aseptic Technique (Reference: Ballington, Chapter 11)
 Isopropyl alcohol and sterile water in spray bottles
 Paper towels
 Horizontal hood (counter space with backdrop)
 Powdered and liquid medication vials
 Sterile water vial
 Safeline Vial Access Cannulas (pocketnurse.com)
 Alcohol swabs
 250 mL NS or D5W bag
Procedure V Non-sterile Compounding – Suspension/Solution (Reference: Ballington, Chapter 8)
 Pencil/eraser
 Paper
 Crushable Tablets (at least 15-20 per competitor)
 Counter space
 Mortar and pestle
 50 mL and 100 mL graduated cylinders
 One vial of varying sizes (2 oz., 3 oz., 4oz.)
 Sink access
Procedure VI Non-sterile Compounding – Two Ointments (Reference: Ballington, Chapter 8)
 Pencil/eraser
 Paper
 Two different ointments, one labeled as 2% and the other 10%
 Counter space
 Weighing scale
 Wax paper or similar item (to be able to weigh product)
 Either mortar and pestle or compounding slab with spatula
 Container for final product
 Sink access
Procedure VII Non-sterile Compounding – Ointment with Tablets (Reference: Ballington, Chapter 8)
 Pencil/eraser
 Paper
 Ointment
 Crushable tablets (at least 10-15 per competitor)
 Counter space
 Weighing scale
 Wax paper or similar item (to be able to weigh product)
 Mortar and pestle
 Compounding slab with spatula
 Container for final product
 Sink access
Procedure VIII Proper Ophthalmic Drop Usage (Reference: Safemedication.com, How to Use Eye Drops Properly)
 Eye drops
 Tissue or cloth
 Sink access
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Icon Key

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Competitors must meet a 70% mastery score on skills
in this event.
The orientation includes an event element.
Competitors must bring pencils/pens.
Round One scores are used to advance competitors to
Round Two at the NLC.
Includes a secret topic that may not be discussed or
revealed to others until the event has concluded.
Event Flow Chart
Orientation
50-item test in 60 minutes
Scan Tests
Top competitors advance to
Round Two
Competitors perform skills
Competitor not
recognized at
Awards
Session
No
Did
competitor earn
70% of skill
points?
Yes
Add competitors’ test
score to his/her skill
score for final tally.
Rank top 10
competitors according
to their final score.
Sample Round One Test Questions
1.
Professionals and consumers can report serious adverse drug reactions to
A. the DEA.
B. the PTCB.
C. MedWatch.
D. the NABP.
2.
What is a common side effect of narcotics?
A. swelling.
B. constipation.
C. wheals.
D. wheezing.
3.
Why are many patients with asthma reluctant to use inhaled corticosteroids?
A. They dislike the dosing regimen.
B. They fear potential side effects.
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EVENT GUIDELINES
C. They object to the taste.
D. They think corticosteroid inhalers are too difficult to use.
PHARMACY PRACTICE
Competitor #: _______________
Procedure I
1.
Judge's Signature: _______________________________
Identify Problems or Missing Items on
a Prescription
Reference: Ballington, Chapter 6
Time: 8 minutes
Possible
Allocated
Prescription #1
Smith, John
5555 W Auraria Ct
Denver, CO 80219
Rx: Fentanyl 100 mcg patch #90
1 patch Q3 days for 1 month
b
a
#1 Healthcare Offices
303-555-5656
(No Written date)
d
Refills: 0
c
2.
Dr. M. Johnson, MD____________
(No DEA Number)
a. Unacceptable quantity
1
b. Missing address of doctor’s office
1
c.
No DEA number
1
d. Missing date written
1
Prescription #2
a
John
5555 W Auraria Ct
Denver, CO 80219
720-546-3255
DOB: 08/15/56
Rx: Testosterone depot 100 mg/mL #10 ml
Inject 2 mL (200mg) Q2W
b
#1 Healthcare Offices
1357 E. Bonner St
Denver, CO 80219
303-555-5656
7/27/2014
d
(No Indication)
Refills: 0
c
Nick Johnson, MD____________
DEA: AJ3462841
a. Missing last name
1
b. Missing route of administration (PO, IM, SQ, IV, etc.)
1
c.
1
Invalid DEA number
d. Missing indication for medication use
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Items Evaluated
3.
Possible
Allocated
Prescription #3
Bullock, Seth
2415 E. Colfax Ave
Denver, CO 80219
Colorado Alpine Care
4110 Washington St.
Denver, CO 80209
303-550-5676
07/11/2015
Rx: Adderall XR 30 mg #6
Ṫ daily PRN PA
a
d
x Dispense as written
Refills: 1
b
Sean Stevenson, MD
No DEA Number
c
a. Written date cannot be in the future
1
b. No refills allowed
1
c.
1
No DEA number
d. Missing route of administration (PO, IM, SQ, IV, etc.)
4.
1
Prescription #4
Bullock, Seth
2415 E. Colfax Ave
Denver, CO 80219
c
Colorado Alpine Care
4110 Washington St.
Denver, CO 80209
303-550-5676
(7/29/2014)
Rx: Hydrocodone/APAP 5/325 (Percocet) # 20
Ṫ tab by mouth PRN, stop 1 week from today
b
d
Refills: 10
a
Sean Sternson, MD
DEA: AS2441753
a. Unacceptable amount of refills
1
b. Signa needs verification as the written date is longer than 1
week ago
1
c.
1
Drug name error (Not Percocet)
d. Missing frequency
TOTAL POINTS -- PROCEDURE I
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PHARMACY PRACTICE
Competitor #: __________________
Procedure II
1.
2.
Judge's Signature: ___________________________
Interpret Prescriptions and Dispense
Correctly
Reference: Ballington, Chapter 6
Time: 13 minutes
Possible
Allocated
Prescription #1
a. Prescription number
1
b. Patient name
1
c.
1
Date of initial dispensing
d. Correct drug strength and formulation
2
e. Correct signa
2
f.
1
Prescriber name
g. Name and address of pharmacy
1
h. Correct amount dispensed
1
Prescription #2
a. Prescription number
1
b. Patient name
1
c.
1
Date of initial dispensing
d. Correct drug and strength
2
e. Correct signa
2
f.
1
Prescriber name
g. Name and address of pharmacy
1
h. Correct amount dispensed
1
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EVENT GUIDELINES
Items Evaluated
3.
4.
Possible
Allocated
Prescription #3
a. Prescription number
1
b. Patient name
1
c.
1
Date of initial dispensing
d. Correct drug and strength
2
e. Correct signa
2
f.
1
Prescriber name
g. Name and address of pharmacy
1
h. Correct amount dispensed
1
Prescription #4
a. Prescription number
1
b. Patient name
1
c.
1
Date of initial dispensing
d. Correct drug and strength
2
e. Correct signa
2
f.
1
Prescriber name
g. Name and address of pharmacy
1
h. Correct amount dispensed
 #1 tube of 80 grams
1
TOTAL POINTS -- PROCEDURE II
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PHARMACY PRACTICE
Competitor #: ___________________
Procedure III
Judge's Signature: ___________________________
Donning Aseptic Gear in Sequential
Order
Reference: Ballington, Chapter 11
Time: 8 minutes
Possible
Allocated
Note to Judge: Directions are sequential and points should not be given for steps done out of order.
1.
Take off earrings, hand jewelry, and cosmetics
2.
Place gear in the following order:
2
1: Place shoe cover
2. Place hair cover
3
3. Place face mast
* One point for every item that is put on in the correct order
3.
Hand cleansing with soap (up to the elbows)
2
4.
Place gown
2
5.
Apply sterile, foamed alcohol to hands and allow to dry
2
6.
Place sterile powder-free gloves
1
TOTAL POINTS -- PROCEDURE III
12
**If a student jeopardizes the patient's or his/her own safety or fails to perform a critical technique and does not
take immediate action to correct the error, the total points for the procedure or specific subpart(s) will be deducted.
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PHARMACY PRACTICE
Competitor #: __________________
Procedure IV
Judge's Signature: ___________________________
Aseptic Technique
Reference: Ballington, Chapter 11
Time: 12 minutes
Possible
1.
Spray hood first with sterile water, followed by isopropyl alcohol. Alcohol
must remain in contact with the surface for 30 seconds prior to
compounding any products.
2
2.
Wipe hood in an up/down motion from top to bottom (for horizontal hood)
2
3.
Wipe the top of the vial(s) and 250mL solution bag port with alcohol swab
1
4.
Powder Vial: add appropriate amount of diluent, remove needle, mix until
powder is completely reconstituted, wipe vial with alcohol swab before
reinserting needed, and then draw out correct amount of medication
3
Allocated
Liquid vial: draw up equivalent volume of air into the syringe, once needle
is in the vial, depress the syringe to inject air into vial, withdraw appropriate
amount of medication
Ampule: Tap ampule to verify medication is at the bottom, wrap an alcoholsoaked swab around the neck of the ampule and snap the neck, use
filtered needle to withdrawal correct amount of medication, and switch
needle to an unfiltered needle.
5.
Insert medication into the correct port on the 250mL bag
1
6.
Pull syringe back to the correct mL of medication you injected into the
250mL bag
2
7.
Put all vials, 250mL bag, syringes, and needles on table outside of hood.
1
8.
Spray hood with isopropyl alcohol
1
9.
Wipe hood in an up/down motion from top to bottom (for horizontal hood)
2
10.
Did the student’s technique block airflow in the hood at any point? (i.e. did
hands/fingers/other body parts come between the air filter and the needle
inserting into vial/bag)
4
TOTAL POINTS -- PROCEDURE IV
20
**If a student jeopardizes the patient's or his/her own safety or fails to perform a critical technique and does not
take immediate action to correct the error, the total points for the procedure or specific subpart(s) will be deducted.
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PHARMACY PRACTICE
Competitor #: __________________
Procedure V
Judge's Signature: ___________________________
Non-sterile Compounding –
Suspension/Solution
Reference: Ballington, Chapter 8
Time: 10 minutes
Possible
1.
Correct written instructions
2
2.
Wash hands
2
3.
Appropriate amount of tablets
2
4.
Grind down tablets with mortar and pestle
1
5.
Mix powder with liquid and pour into graduated cylinder
1
6.
Add liquid to achieve desired amount
2
7.
Transfer final product into correct dispensing container
2
8.
Wash tools when done
1
9.
Wash hands
2
TOTAL POINTS -- PROCEDURE V
Allocated
15
**If a student jeopardizes the patient's or his/her own safety or fails to perform a critical technique and does not
take immediate action to correct the error, the total points for the procedure or specific subpart(s) will be deducted.
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PHARMACY PRACTICE
Competitor #: __________________
Procedure VI
Judge's Signature: ____________________________
Non-sterile Compounding – Compounding
Two Ointments
Reference: Ballington, Chapter 11
Time: 8 minutes
Possible
1.
Correct written instructions
2
2.
Wash hands
2
3.
Correct amount of Medication Ointment A
2
4.
Correct amount of Medication Ointment B
2
5.
Mix on compounding slab with spatula or with mortar and pestle
1
6.
Ointment is mixed mostly uniform
2
7.
Transfer final product into dispensing container
1
8.
Wash tools when done
1
9.
Wash hands
2
TOTAL POINTS - PROCEDURE VI
Allocated
15
**If a student jeopardizes the patient's or his/her own safety or fails to perform a critical technique and does not take
immediate action to correct the error, the total points for the procedure or specific subpart(s) will be deducted.
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EVENT GUIDELINES
PHARMACY PRACTICE
Competitor #: __________________
Procedure VII
Judge's Signature: ___________________________
Non-sterile Compounding –
Compounding Ointment with Tablets
Reference: Ballington, Chapter 8
Time: 10 minutes
Possible
1.
Correct written instructions
2
2.
Wash hands
2
3.
Use appropriate amount of tablets
2
4.
Grind down tablets with mortar and pestle
1
5.
Mix powder and partial amount of lotion base with spatula on
compounding slab
2
6.
Add lotion base until desired amount
7.
Mixture is reasonably smooth, particles not too rough
1
8.
Transfer final product into dispensing container
1
9.
Wash tools when done
1
10.
Wash hands
2
TOTAL POINTS -- PROCEDURE VII
Allocated
16
**If a student jeopardizes the patient's or his/her own safety or fails to perform a critical technique and does not
take immediate action to rectify the error, the total points for the procedure or specific subpart(s) will be deducted.
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PHARMACY PRACTICE
Competitor #: __________________
Procedure VIII
Judge's Signature: ____________________________
Proper Ophthalmic Drop Usage
Reference: Safemedication.com, How to Use
Eye Drops Properly
Time: 5 minutes
Possible
1.
Wash hands with soap and water.
2
2.
Check dropper tip to ensure dropper integrity.
1
3.
Avoid touching tip of dropper.
2
4.
Tilt head back, pull down lower eye lid with finger to form a pocket.
2
5.
Hold dropper with tip down with other hand as close to eye without touching
it.
1
6.
Brace remaining fingers of that hand against your face
1
7.
While looking up, gently squeeze dropper to have a single drop fall into the
pocket made by the lower eyelid. Remove finger form the lower eyelid.
2
8.
Close eye for 2 to 3 minutes and tip head down towards the floor.
2
9.
Do not blink or squeeze eyelid.
2
10.
Place a finger on the tear duct and gently apply pressure.
2
11.
Wipe excess liquid off of face with a tissue or cloth.
1
12.
Verbally acknowledge to the judge that a wait of at least 5 minutes is
necessary between drops into the same eye.
2
13.
Replace and tighten cap on dropper bottle. Do not wipe or rinse the dropper
tip.
2
14.
Wash hands with soap and water.
2
TOTAL POINTS - PROCEDURE VIII
Allocated
24
**If a student jeopardizes the patient's or his/her own safety or fails to perform a critical technique and does not take
immediate action to correct the error, the total points for the procedure or specific subpart(s) will be deducted.
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