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of state boards interpret this requirement quite literally: they will allow a nuclear pharmacy to operate provided it stocks a full line of regular pharmaceuticals and possesses the required number of graduates, spatulas, and other equipment and personnel. In partial defense of the state boards, nuclear pharmacy has emerged and grown so rapidly that the boards are not prepared to deal with an application to open a nuclear pharmacy. The National Association of Boards of Pharmacy has prepared a model nuclear pharmacy act for this express purpose. If the rules, regulations, and laws administered by these organizations are not sufficient, some nuclear pharmacies, known as centralized nuclear pharmacies, service two or more facilities, not physically connected with the pharmacy. In most cases it is necessary to transfer the finished radiopharmaceuticals some distance from the building that houses the pharmacy. The state department of transportation has jurisdiction in this case. Most DOTs, in actual practice, allow radiopharmaceuticals to be transported in an ordinary automobile, provided the drugs are packed in special DOTapproved outer containers.

Not a Complete Mystery Now that we have followed a typical nuclear pharmacist's work day, seen the precautionary measures used to guard against radioactivity, and identified the various agencies that look over the nuclear pharmacist's shoulder, it should be apparent that nuclear pharmacy has more similarities to than differences from traditional pharmacy. The same skills and training are there, along with the requirement for a special body of knowledge-radiation health physics. The field may be relatively new, but it's not a complete mystery. Practitioners who enter this area of pharmacy will find it highly rewarding, both professionally and economically. -Arthur P. Herrmann APhA Director of Clinical Practices

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,

Emergence Of the Specialty

By STANLEY M. SHAW As the practice of nuclear pharmacy emerged in the early 1970s, pharmacy practitioners realized their need for improved communication on various aspects of the practice as well as in rna tters of legislation and education. As a result the Academy of Pharmacy Practice (Academy of General Practice at that time) sponsored a symposium entitled "Nuclear Pharmacy '74" at the APhA an-

Stanley M. Shaw, PhD, is chairman of the APhA Academy of Pharmacy Practice Section on Nuclear Pharmacy and secretary of the Board of Pharmaceutical Specialties. At present, he is visiting professor at the University of Alberta, Edmonton, Canada T6 G 2H7. Shaw will return to his position in August as professor of bionucleonics at the School of Pharmacy and Pharmacal Sciences, Purdue University, Lafayette, IN 4 7 90 7. Staff support was provided by APhA Associate Executive Director for Professional Affairs Richard P. Penna.

Results of a scan are displayed in color on the screen. nual meeting in Chicago. The following year the Academy sponsored a workshop on the practice of nuclear pharmacy at the annual meeting in San Francisco. At that meeting the Section on Nuclear Pharmacy was officially formed.

Section Objectives Set At the outset the section identified certain objectives: • To provide a mechanism whereby section members (nuclear pharmacists) could make their training and expertise available to other Academy members; • To provide a forum ·w here the special problems and interests of section members could be discussed; • To serve as a means for planning and executing institutes and workshops of interest to section members and other pharmacists; • To provide a mechanism for expressing section member needs and

American Pharmacy Vol. NS 19, No. 6, June 1979/304 1

views on APhA policy. Only days after its birth the section represented nuclear pharmacists at a public hearing of the Radioactive Pharmaceutical Advisory Committee to FDA on regulations being considered for the definition of operations connected with the preparation of radioactive drugs. In the past five years the section has offered assistance to state boards of pharmacy in rna tters related to the regulation of nuclear pharmacies, has assisted nuclear pharmacists with regulatory problems, and has continued to interact with state and federal regulatory agencies. A standing committee on regulatory affairs maintains continued surveillance in this important area. A two-day program for nuclear pharmacists is sponsored by the section at each APhA annual meeting. These sessions provide an opportunity to learn and help chart future actions. In addition to a host of invited speakers, contributed papers on scientific and practice aspects are solicited each year. Communication has also increased via the Academy of Pharmacy Practice newsletter, which contains a section devoted to nuclear pharmacy in each monthly issue. The section has also been very active in the development of guidelines for practitioners. Members of the educational affairs committee completed a task analysis of nuclear pharmacy practice which was followed by development of Nuclear Pharmacy Practice Standards. The committee is in the process of developing a self-assessment document which will allow nuclear pharmacists to measure their performance against the Standards. Thus the section is in the forefront-in the goal of the pharmacy profession-to improve the quality of pharmacy services through voluntary selfassessment and improvement.

pharmacy. Through the efforts of numerous members a petition was prepared for the Board of Pharmaceutical Specialties in which the section requested recognition of nuclear pharmacy as a specialty practice. On June 19, 1978, after nine months of investigation and deliberation, the Board of Pharmaceutical Specialties recognized nuclear pharmacy as the first specialty in pharmacy practice. The petition provided evidence that a demand and a need exist for a nuclear pharmacy specialty; that substantial numbers of pharmacists are currently practicing in this specialty; that a specialized knowledge base exists; that functions performed are clearly beyond the range of functions performed by general practitioner pharmacists; that there exist education and training programs that have as their purpose the preparation of pharmacists practicing in this specialty; and that a\ substantial opportunity exists for

the transmission of knowledge and scientific information in the specialty. The bylaws of the Board of Pharmaceutical Specialties provide that when a specialty is recognized, the board will create a specialty council on nuclear pharmacy which shall: • Recommend to the board standards and other requirements for certification and recertification of pharmacists in the specialty; • Develop and administer examinations as .required for certification and recertification; • Evaluate the qualifications of individual pharmacists; • Submit to the board the names of pharmacists recommended for certification or recertification in the specialty. The certification process is designed to provide a system for identifying pharmacists who practice nuRadiopharmaceuticals are transferred in lead-shielded cases.

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Certification Procedures Nuclear pharmacy leads the pharmacy profession in the development of a board certification procedure for specialists in the practice of American Pharmacy Vol. NS 19, No.6, June 1979/305 .............__

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clear pharmacy according to the standards. The nine-member Specialty Council on Nuclear Pharmacy consists of six nuclear pharmacists appointed by the Section on Nuclear Pharmacy and three pharmacists not in the specialty of nuclear pharmacy appointed by the Board of Pharmaceutical Specialties. The council has met on two occasions-in December 1978 and April 1979. It has chosen as its guide in developing a certification process the Nuclear Pharmacy Practice Standards adopted by the Section on Nuclear Pharmacy. In addition, it has determined that certification

frequency of this requirement has yet to be determined .

will be based on a demonstration of experience in performing specific functions identified in the Standards, and that successful candidates must pass an oral and written certification examination based on elements of nuclear pharmacy practice. A subcommittee of the council has been appointed to identify specific functions to be included in the experience requirement and to identify elements of nuclear pharmacy practice on which examination items will be developed. The council also has determined that there will be a recertification requirement for nuclear pharmacists, but the precise

Success Depends on You The section exists to serve nuclear pharmacists, be they employed in a hospital, centralized nuclear pharmacy, industry, or education. Much progress has been made and many goals realized, but much remains to be done . Past and future success is directly related to the dedication and participation of nuclear pharmacists in their organization. Membership in the section is open to all full members of the APhA at no added cost. o

Assessing Nuclear Competency All professionals are concerned about maintaining their competency to practice. Nuclear pharmacists, the first members of an identified specialty in pharmacy, have been busy for the past several years delineating the responsibilities which are unique to the practice of nuclear pharmacy. The task analysis of nuclear pharmacy practice performed in 1976-1977 served as the basis for subsequently developing Nuclear Pharmacy Practice Standards which were accepted by the Section on Nuclear Pharmacy at the 1978 APhA annual meeting in Montreal. The approach was similar to that used in the joint APhA/AACP competency project. With the adoption of these Standards, the profession has a clear statement of what the practice of nuclear pharmacy is. Now it is important that nuclear pharmacists perform in a manner congruent

Ronald ]. Callahan, MS, is a radiopharmacist in the nuclear medicine division, Massachusetts General Hospital, Boston, MA 02114, and chairman-elect of the APP Section on Nuclear Practice. Staff support was provided by APhA Professional Affairs Division Director of Continuing Education Samuel H. Kalman.

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By RONALD J. CALLAHAN

fairs committee of the Section of Nuclear Pharmacy (APhA Academy of Pharmacy Practice) has now undertaken the task of establishing such a program for its members. Its task has been simplified, since the educational affairs committee has been responsible for the accomplishments to date in both conducting the task analysis and developing and validating the practice standards. The committee members (chairman Ronald J. Callahan, Joshua Prestidge, Susan Rowles, Arthur Solomon, and Mitchell Barke) are in the process of identifying specific practice situations to which the pertinent standards will be applied. Once a sufficient number of specific situations is identified, they will be used to construct self-assessment items which will require that the nuclear pharmacist be able to use appropriate knowledge and skills to perform the tasks called for under the described conditions. Developing enough self-assessment items will require the input of various faculty members (for content), practitioners, and "test" design specialists. Nuclear pharmacists interested in participating in this work are asked to contact Ronald J. Callahan through the Academy of Pharmacy Practice. o

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with the standards. In other words, practitioners must have some realistic way to determine for themselves whether or not they are living up to these self-imposed standards of professional service. One way to provide such an opportunity is through a competency assurance program whereby professionals can obtain the information feedback needed to maintain competency. Each profession has a responsibility to design and conduct such a program for its members, so as to assure the public that it is served by competent practitioners. Recognizing this need and this responsibility, the educational af-

Photos on pages 21 , 23, 24, 26 taken at the University of Maryland Medical Center.

American Pharmacy Vol. NS 19, No.6, June 1979/306

Emergence of a specialty.

~ of state boards interpret this requirement quite literally: they will allow a nuclear pharmacy to operate provided it stocks a full line of regular...
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