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pediatric-pharmacy/SOPs/SOP-003-Training.md

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# Standard Operating Procedure: Training and Competency
| Document ID | SOP-003 |
|-------------|---------|
| Title | Training and Competency |
| Revision | 1.0 |
| Effective Date | [DATE] |
| Author | [AUTHOR] |
| Approved By | [APPROVER] |
| Department | Pediatric Pharmacy |
---
## 1. Purpose
To ensure all pediatric pharmacy personnel are properly trained, competent, and maintain current knowledge in pediatric pharmaceutical care, medication safety, and specialized pediatric pharmacy practices.
## 2. Scope
This procedure applies to all personnel involved in pediatric pharmacy operations, including:
- Pediatric pharmacists
- Pharmacy technicians working with pediatric medications
- Pharmacy students and residents in pediatric rotations
- Compounding personnel preparing pediatric formulations
- Quality and administrative staff
## 3. Responsibilities
### 3.1 Pharmacy Director
- Ensures adequate training resources
- Approves training program
- Reviews competency trends
- Ensures regulatory compliance
### 3.2 Training Coordinator
- Maintains training records
- Schedules training sessions
- Tracks competency assessments
- Coordinates continuing education
### 3.3 Department Managers/Preceptors
- Identifies training needs
- Provides on-the-job training
- Conducts competency assessments
- Documents training completion
### 3.4 All Personnel
- Complete required training
- Demonstrate competency
- Maintain continuing education
- Report training needs
## 4. Definitions
| Term | Definition |
|------|------------|
| Competency | Demonstrated ability to perform job functions safely and accurately |
| Initial Training | Training provided before independent practice |
| Ongoing Training | Periodic training to maintain and update skills |
| Competency Assessment | Evaluation of ability to perform specific tasks |
| Preceptor | Licensed pharmacist qualified to train and assess others |
## 5. Procedure
### 5.1 Training Needs Assessment
1. **New Hire Assessment**
- Review job description and required competencies
- Assess prior experience with pediatric pharmacy
- Identify knowledge gaps
- Develop individualized training plan
2. **Ongoing Needs**
- Annual competency reviews
- New procedures or equipment
- Quality events or errors
- Regulatory changes
- Expansion of services
### 5.2 Initial Training Program
#### 5.2.1 General Orientation (All Staff)
- Facility tour and emergency procedures
- Introduction to pediatric patient population
- Quality Management System overview
- Documentation requirements
- HIPAA and patient privacy for minors
- Medication error reporting
#### 5.2.2 Pediatric Pharmacy Fundamentals (All Clinical Staff)
- Pediatric developmental stages (neonate, infant, child, adolescent)
- Weight-based and BSA-based dosing principles
- Pediatric dosing references and resources
- Common pediatric medications and indications
- Off-label medication use in pediatrics
- Pediatric high-alert medications
- Age-appropriate counseling techniques
- Parent/guardian communication
#### 5.2.3 Dosing and Calculations (Pharmacists and Technicians)
- Dosing calculation methods (mg/kg, mg/m²)
- Maximum dose verification
- Dilution calculations for neonates
- BSA calculation methods (Mosteller, DuBois)
- Use of dosing calculators and verification tools
- Independent double-check procedures
- Common calculation errors and prevention
#### 5.2.4 Pediatric Compounding (Compounding Staff)
- USP <795> pediatric applications
- USP <797> for neonatal/pediatric sterile preparations
- Suspension preparation from solids
- Flavoring systems and palatability
- Low-concentration formulations
- Unit-dose preparation
- Stability and beyond-use dating for pediatric formulations
- Aseptic technique for small volumes
#### 5.2.5 Specialized Areas (As Applicable)
**Neonatal Pharmacy**
- Prematurity and gestational age considerations
- Neonatal dosing adjustments
- TPN compounding for neonates
- Medication administration in NICU
- Drug concentrations for neonatal use
**Pediatric Oncology**
- Chemotherapy dosing (BSA-based)
- USP <800> compliance
- Pediatric chemotherapy protocols
- Supportive care medications
- Safe handling and disposal
**Controlled Substances**
- DEA requirements for minors
- Opioid dosing in children
- Controlled substance documentation
- Prescription monitoring programs
### 5.3 Competency Assessment
#### 5.3.1 Initial Competency
Must demonstrate competency before independent practice:
**Written Assessment**
- Pediatric pharmacy knowledge test (minimum 80%)
- Dosing calculation test (100% accuracy required)
- Medication safety scenarios
**Practical Assessment**
- Dosing calculation with verification
- Prescription order processing
- Compounding technique (if applicable)
- Patient counseling simulation
- Computer system use
**Direct Observation**
- Preceptor observes minimum 20 orders/preparations
- Uses standardized competency checklist
- Documents satisfactory performance
#### 5.3.2 Ongoing Competency
Assessed annually for all staff:
**Annual Competencies**
- Dosing calculations (5-10 scenarios, 100% required)
- High-alert medication protocols
- Medication error prevention
- One specialty area relevant to role
**Triggered Competencies**
- After medication error (within 30 days)
- New equipment or technology
- New procedures or protocols
- Return from extended leave (>6 months)
### 5.4 Continuing Education
#### 5.4.1 Requirements
- Pharmacists: State board requirements + 5 hours pediatric-specific annually
- Technicians: State board requirements + 3 hours pediatric-specific annually
#### 5.4.2 Approved Activities
- Pediatric pharmacy conferences (PPAG, ASHP)
- Online CE with pediatric focus
- Journal clubs on pediatric topics
- In-service training programs
- Specialty certification preparation (BCPPS)
### 5.5 Documentation
1. **Training Records**
- Training date and topic
- Trainer name
- Training method (classroom, online, OJT)
- Completion status
2. **Competency Records**
- Date of assessment
- Assessor name
- Competency demonstrated
- Score/result
- Remediation if needed
3. **File Maintenance**
- Individual training files for each employee
- Accessible for inspections
- Updated within 30 days of training
- Retained per regulatory requirements
### 5.6 Remediation
If competency not demonstrated:
1. Identify specific deficiency
2. Provide additional training/practice
3. Re-assess within 30 days
4. Document remediation and outcome
5. Escalate to Pharmacy Director if unsuccessful after second attempt
### 5.7 Preceptor Qualification
To serve as preceptor/trainer:
- Licensed pharmacist with minimum 2 years pediatric pharmacy experience
- Demonstrated competency in area of training
- Completed preceptor training program
- Annual review of preceptor performance
## 6. Pediatric-Specific Competencies
All pediatric pharmacy staff must demonstrate:
- Accurate weight-based dosing calculations
- Recognition of age-inappropriate doses
- Identification of pediatric high-alert medications
- Appropriate use of pediatric dosing references
- Understanding of developmental considerations
- Effective parent/guardian communication
## 7. Records
| Record | Location | Retention |
|--------|----------|-----------|
| Individual training files | HR/Pharmacy | Duration of employment + 3 years |
| Competency assessments | Training files | 3 years |
| Training attendance logs | Training coordinator | 3 years |
| CE certificates | Individual files | Per state board requirements |
## 8. Related Documents
- FRM-004 Training Record
- FRM-XXX Competency Assessment Checklists
- Job Descriptions
- Annual Competency Calendar
## 9. References
- State Board of Pharmacy CE requirements
- USP <795>, <797>, <800> training requirements
- ASHP Guidelines on Pharmacy Technician Training
- PPAG Pediatric Pharmacy Practice Standards
- Joint Commission HR standards
---
## Revision History
| Rev | Date | Description | Author |
|-----|------|-------------|--------|
| 1.0 | [DATE] | Initial release | [AUTHOR] |