Do You Use Nurses in Your Specialty Pharmacy? You May Want To

FOR THE 15TH CONSECUTIVE YEAR, nursing has remained the most trusted profession in the United States, according to the Gallup organization. This trust has afforded nurses the ability to practice in various settings, including specialty pharmacy. Meanwhile, pharmacists have maintained their title as the second most trusted profession for the past few years. It is only natural that these most trusted professions collaborate and care for patients in a setting such as a specialty pharmacy.

Nurses have had roles in pharmacy for years—specifically in the infusion pharmacy setting—before the advent of specialty pharmacy. Their versatility enables specialty pharmacies to be nimble while providing exceptional care and education. Nurses are natural educators in traditional nursing roles. They have an innate ability to educate patients and caregivers regarding disease states and the specialty medications prescribed for them. Nurses hired to work in a specialty pharmacy frequently hold certifications in areas of focus for a specialty pharmacy, such as Oncology Certified Nurse and Certified Registered Nurse of Infusion. The certifications allow pharmacies to use their certified nurses to provide care for specific populations.

Nurses have the capacity to fulfill a great variety of duties in the specialty pharmacy arena, including:

• prior authorization (PA)
• disease state training
• patient management programs
• delegated utilization management
• accreditation
• maintaining quality
• telephone triage
• answering simple clinical questions
• side effect management
• call center
• sales and marketing efforts
• manufacturer programs
• injection training
• account management
• case management
• business development
• appeals
• patient assistance
• intake
• home infusion coordination

Specialty pharmacies across the country hire nurse practitioners, registered nurses (RNs), and licensed practical nurses (LPNs) for many of these specialty pharmacy roles. The use of nurses varies based on the Nurse Practice Act and the regulations of each board on nursing in their respective state.

You may have an interest in introducing the practice of nursing into your specialty pharmacy. The patient management program is a great area to start. Because nurses are familiar with working in prescriber offices, it is a natural evolution for nurses to step in and help coordinate the patient management program at your pharmacy.

Nurses have roles in the quality of patient care and providing a standard of care. By integrating a nursing role in the quality management program of your pharmacy, you may provide further pharmacist and nurse collaboration and an alternate perspective on quality.

In traditional nursing roles within the prescriber’s office, nurses are already performing a form of patient management through triaging calls, developing care plans, providing patient education and side effect management, obtaining PA, coordinating home infusion, and managing appeals.

The patient management program lends itself to allow the nurses to establish relationships with specialty pharmacy patients while providing empathy, continuing to educate patients regarding their disease states, and maintaining patient compliance and adherence to prescribed medication regimens. Additionally, patients find comfort and solace in speaking with a nurse, which allows the nurses to obtain and provide necessary patient clinical information while sharing the essential education required for the patients and their disease state medication regimens.

Nurses working in a specialty pharmacy may also play a vital role in the PA process. Nurses are able to obtain the PA, provide payer delegated utilization management, and manage appeals with the prescribers’ office when necessary. A nurse working in these roles on behalf of the pharmacy may facilitate and ease the process for the patient, caregiver, and health care provider.

Accreditation and quality program efforts may benefit from having a nurse on staff as well. Nurses in traditional roles are frequently responsible for the preparation of accreditation in hospitals, clinics, and home health. This preparation includes developing policy and procedures, accreditation training, and performing mock surveys. These requirements are similar to accreditation requirements for the specialty pharmacy. Having a nurse on staff may help your pharmacy obtain said accreditation.

With all of the roles available in a specialty pharmacy, the next time you are hiring, consider hiring a nurse. Not only will it bring the practice of nursing into your pharmacy, it will allow for pharmacy and nursing to collaborate in patient care. Multidisciplinary collaboration allows for better patient care and improved outcomes.

Before hiring, however, check and understand the Nurse Practice Act and the rules and regulations set forth by the board of nursing in your state to ensure the use of RNs or LPNs in your pharmacy. Some state boards have specific requirements and regulations on telephonic nursing, for example.

It is also important to know the reporting structure for the RNs and LPNs in your state. Many states may require that an RN oversee the practice of the LPNs. Still, once those considerations are handled, hiring a nurse can help your specialty pharmacy in more ways than one.