Final Exam Flashcards
Describe the role of an inpatient health system (hospital) pharmacist.
- Verify physician orders
- Screen orders for therapeutic duplication, interactions, allergies, etc.
- Check ADC fills and IV’s
- Provide drug information to medical staff and nursing
- Oversee technicians
- Process Hospice prescriptions
- Perform Medication Reconciliation on high readmit risk patients (CHF, COPD)
- Dispense controlled substances for ADC’s.
Distinguish how a health system pharmacist is different from other pharmacist.
- Inpatient-central
- Inpatient-unit based
- Critical Care
- Infectious Disease
- Emergency Care
- Pediatric
- Oncology
- Cardiology
- Ambulatory Care/Clinic based
- Drug Information
- Administration
Identify three unique characteristics of nursing as a healthcare profession.
Highest nursing degree
Licensure/state requirement
National certification
What is an LPN?
1 year
Technical Degree
National Licensure Exam
Bound by State Nursing Practice Act
Task Oriented
Stable Client
What is an ADN, RN?
2 year Technical Degree
National Licensure Exam
Bound by State Nursing Practice Act
Unstable Clients
Bedside care
What is a BSN, RN?
4 year degree
National Licensure Exam
Bound by State Nursing Practice Act
Unstable Clients
What is a MSN, RN?
6 Year degree
Various specialty areas
Education
Informatics
Administration
What is a DNP, RN?
6-7 Year degree
Various specialty areas
Education
What is a PhD, RN?
8-10 year Terminal degree
Research Focused
Educators
Administrators
Describe three commonalities of the profession of nursing with the profession of pharmacy.
- Pre-Req’s Science/Math
- Accreditation for Educational Programs
- Licensure Exam
What is the relationship between inpatient pharmacy and nursing?
- Pharmacy and Nursing- receive Healthcare Provider Orders/ Prescriptions
- Pharmacy- prepares medication orders
- Nursing- administers medications
When does pharmacy and nursing serve on a variety of committees together?
- Quality and safety
- Practice
- Informatics
- Leadership
What is a pharmacy working in outpatient?
- Fills prescriptions written by providers directly to the patient.
- May “call provider” for order clarification
What is a nurse working in outpatient?
- Sort through all of the prescribed and OTC medications a patient reports taking during a healthcare visit
- May “call in” orders from providers
What are the unique characteristics of nurses?
- Largest percentage of healthcare workforce world wide.
- Broadly defined term. In the United States, range from 1 year technical degree to 10 year terminal degree
- Nurse Practitioners and Doctorate of Nursing Practice Registered Nurses may have prescriptive privileges depending on their area of study and the licensure and additional certifications.
What are the 3 routine interdisciplinary collaborations between pharmacy and nursing?
- Inpatient: Fill- administer medications; shared legal and ethical responsibilities
- Outpatient: Fill medications; communicate; document
- Beyond: Public health and safety, research, education
What are the roles of a physician in the healthcare team?
- Investigator
- Prescriber
- Educator
How can a physician be an investigator?
- Make the diagnosis based on history and physical.
- Order diagnostic tests
- Obtain referrals
How can a physician be a prescriber?
Prescribe the treatment using pharmacologic therapy and non-pharmacologic therapy
How can a physician be an educator?
- Educate the patient
- Diagnosis specific
- Routine health maintenence
What are the common reasons pharmacists interact with physicians?
- Prescription medications
- Vaccinations
How do pharmacists interact with physicians through prescription medications?
- Identification of medication errors
- Recognition of potential drug interactions
- Documentation of adverse reactions
- Initiation of insurance prior authorization
- Communication of prescription nonadherance
How do pharmacists interact with physicians through vaccinations?
- Screening
- Counseling
- Administration
How do nursing and pharmacists improve care access and patient outcomes?
- Statewide protocols
- Standing orders
- Laws expanding scope of pharmacist practice
- Collaborative practice agreements
What are the collaborative practice agreements?
- Patient specific
- Population specific
What is patient specific collaborative practice agreements?
- Applies only to the patient(s) listed in the agreement
- Limited to post diagnostic care
- Frequently used for chronic disease management
What is population specific collaborative practice agreements?
- Applies to a patient population
- Requires consistency through a written treatment protocol
- Used for acute and chronic disease management
- Used for preventive care
What are examples of collaborations to improve patient outcomes?
- Medication management
- Patient counseling
- Health professional education
What is medication management?
- Monitoring therapy as needed
- Modifying therapy when appropriate
What is patient counseling?
- Supply information to fill gaps in knowledge
- Provide instruction for proper use of medications and devices
What is health professional education?
- Raise physician awareness of drug specific problems such as side effects and drug interactions
- Promote disease specific therapeutic recommendations
What is public health?
What we as a society do to assure the conditions in which people can be healthy
What are the 2 levels of public health?
- Planning (macro)
- Implementation (micro)
What is macro public health?
Focus on the well-being of the population as a whole
What is micro public health?
Provider to patients or program to population
What does a public health pharmacist do in the CDC?
Epidemiology and biostatistics
Field worker
Education
What does a public health pharmacist do in the FDA?
Drug regulation
Analysis of reports
Epidemiology and biostatistics
Education
What does a public health pharmacist do in legislation?
Public health policy at the federal and state levels
What does a public health pharmacist do in HRSA?
Ryan White/HIV clinics
What does a public health pharmacist do in CMS?
Work on formulary committees at the federal and state levels
What fields that don’t require a MPH to practice as a pharmacist?
- US Public Health Service Corps
- Provide population-based care (especially in health systems)
- Health education
- Public health policy at the local level
- Disaster preparedness
- Research and training
- Medical missions
What are the duties of a clinical pharmacist?
- Therapeutic drug monitoring
- Renal monitoring
- Anticoagulation monitoring
- Antibiotic stewardship
- Interdisciplinary rounds in critical care
- Dedicated critical care pharmacist
- Dedicated REACH/Transition of care pharmacist
What is the ASHP Practice advancement initiative 2030?
- Patient-centered care
- Leadership in medication use and safety
- Technology and data science
- Pharmacist role in education and training
- Pharmacy tech role, education and training
What are the steps to achieve ASHP Practice advancement initiative 2030?
- Transition of care of the patient (REACH)
- Increase presence in patient care areas and multidisciplinary setting
- Maximum utilization of automation
- Expand tech roles
- Encourage advanced education
Which nurses have prescription authority?
- MSN, NP, RN
- DNP, RN
- APRN
What is “what?”
Describe for explain
What is “So what?”
Identify areas that brought strengths and weaknesses
What is “Now what?”
Action plan or goals to improve
