General Dispensing Procedure

What is dispensing?

Dispensing is the whole process that begins when a prescription is received and ends when the medicine is in the patient's hands, with the advice they need to use it safely. It includes interpreting the prescription, selecting or preparing the medicine, labelling it, checking it, recording it and advising the patient.

It is much more than counting tablets. Every step exists to make sure the right medicine reaches the right patient, in the right dose, in the right form, with the right advice.

A pharmacy technician works under the supervision of a pharmacist. The pharmacist is responsible for the final check and for any clinical judgement.

Steps taken while dispensing

Step 4 in detail: selecting the medicine

• Read the label of the container when you take it from the shelf.
• Check the expiry date. Never dispense a medicine that is expired or close to expiry unless the pharmacist agrees.
• Use FEFO (first expiry, first out). This means stock that expires soonest is dispensed first, so less stock is wasted.
• Look at the medicine itself. Tablets that are cracked, discoloured or sticky, or liquids that look cloudy when they should be clear, should be shown to the pharmacist.

Step 5 in detail: preparing the medicine

• Wash your hands and keep the work area clean and tidy.
• Use a counting tray and spatula. Do not touch tablets or capsules with your hands.
• Clean the tray between different medicines so no tablets are left behind.
• Measure liquids at eye level, using a clean measure.

Worked example: how much to supply?

The rule is: amount per dose × doses per day × number of days.

Example 1. Paracetamol 500 mg tablets: 2 tablets four times a day for 3 days.

2 tablets × 4 times × 3 days = 24 tablets

Example 2. Amoxicillin suspension 250 mg/5 mL: 5 mL three times a day for 5 days.

5 mL × 3 times × 5 days = 75 mL

Always check which pack sizes are available, and ask the pharmacist what to do when the amount needed does not match a pack size.

Addressing patients

How you speak to patients affects whether they trust you and follow your advice.

• Greet the patient politely and use a respectful title, such as Sir, Ma, Mr or Mrs.
• Speak the patient's language when you can, or use simple words. Avoid medical terms.
• Give the patient your full attention: look at them, listen, and do not rush.
• Be patient and kind with elderly patients, children and those who are anxious or in pain.
• Protect privacy. Keep your voice low and, where possible, counsel in a quiet corner. Never discuss one patient's medicine in front of others.
• Be honest. If you do not know an answer, say so and ask the pharmacist.
• Be culturally respectful and never judge a patient for their condition or their questions.

Counselling points

When you hand over a medicine, make sure the patient knows:

1. What it is for.
2. How much to take and how often.
3. How long to keep taking it, and to finish a full course of antibiotics.
4. Whether to take it with food or on an empty stomach.
5. The common side effects and what to do if they happen.
6. How to store it, and to keep it out of the reach of children.
7. What to do about a missed dose.
8. When to return or seek help.

Then check understanding: ask the patient to tell you how they will take the medicine. This is called the teach-back method.

Preventing dispensing errors

Most errors can be prevented by good habits:

• Read the label three times: at the shelf, when labelling, and before handing over.
• Never guess. Unclear writing, doses or names go to the pharmacist.
• Be careful with look-alike, sound-alike medicines. For example, hydralazine and hydroxyzine, or metformin and metronidazole. Shelve them apart and read the full name every time.
• Work in a tidy, quiet area. Avoid interruptions during the final count and check.
• Have every prescription checked by a second person.
• Use the patient's full name when handing over, so medicines do not go to the wrong person.
• Record every error or near miss, so the pharmacy can learn from it.