Module 1 Flashcards
The provision of distributional and clinical pharmacy services at a broad range of institutional settings: hospitals, long-term care, hospice, correctional facilities, etc.
These institutions that pharmacists serve are formally or informally linked together into integrated health systems.
At one time, _____ referred almost exclusively to service in hospital pharmacies.
Institutional Pharmacy Practice
Integrate all care under the umbrella of a central organization.
Often includes inpatient/acute care, primary/outpatient care, long term care, and home care
Integrated Health Systems
Are a collection of organizations and institutions whose mission is to positively impact health outcomes.
Although they are made up of independent entities, they are systems because the entities are interdependent and unified.
Health Systems
Pharmacy’s Roles in the Medication Use Process:
Prescribing
Transcribing
Dispensing
Administration
Monitoring
Often viewed as something that only physicians are authorized to do.
A more common role for pharmacists actually beyond ______ is their duty to influence the prescribing of other health professionals. Pharmacists indirectly influence ______ by acting as information resources about medications, providing feedback about the quality of prescribing, and developing prescribing protocols through the formulary.
Prescribing
a formalized process in hospitals by which an oversight body of a health care organization or other appropriate provider body, having reviewed an individual health care provider’s credentials and performance and found them satisfactory, authorizes that individual to perform a specific scope of patient care services within that setting.
Privileging
It is the process by which a prescriber’s written order is copied and either manually or electronically entered into pharmacy records.
• Pharmacists must understand potential breakdowns in the transcribing process and help find ways to minimize errors.
Transcribing
Act of physically transferring the drug product following review and approval of the prescription to the area responsible for administering the medication to the patient.
• Also an area where medication errors can occur, including but not limited to wrong drug, wrong dose, or wrong dosage form errors.
Dispensing
Medication ________ to the patient in hospitals is typically managed by nurses.
• Last step before patients are given their medications, and errors at this point cannot be corrected.
• Nurses usually serve as the final check in the medication-use process. • Pharmacists help improve safety of medication administration by clearly
labeling medications, using bar-coding systems and unit dose packaging, reducing the time and effort involved in accessing drugs, and using technology that reduces administrations errors (eg, smart pumps)
Administration
_____the patient’s response is a critical phase where pharmacists play a vital role.
• This includes reviewing laboratory values that are correlated with the expected medication-therapy outcomes, as well as other objective and subjective factors that indicate whether the therapy is effective, or may be having a toxic effect.
Monitoring
The operational structure that defines how and where pharmacists practice, including the type of drug distribution system used, the layout and design of the departments, how pharmacists spend their time, practice functions, and practice priorities.
It is probably the most important factor determining the role and effectiveness of the pharmacy department. It sets the stage and defines the roles
Practice Models
Three Major Types of Pharmacy Practice Models:
Drug-Distribution-Centered Model
Clinical-Pharmacist-Centered Model
Patient-Centered Integrated Model
Pharmacists primarily distribute drugs and process new medication orders.
•They have a reactive role where they respond to requests of physicians and nurses but rarely initiates major changes in therapy.
• The pharmacist is not actively involved with the health care team or in the development of therapeutic plans for the patient. Therefore, they are not accountable for the health outcomes of patients and exert little leadership in influencing the medication-use process.
Drug-Distribution-Centered Model
• Clinical Pharmacists are chiefly involved in clinical activities associated with medical teams. In this model, they accept little or no responsibility for the medication-use or delivery systems. Their primary responsibility is to assist physicians and other health professionals in avoiding and solving clinical problems.
• Distributive Pharmacists spend most of their time in drug distribution, reviewing orders and verifying the accuracy of medication preparation by technician.
• Since little or no collaboration occurs between the two, the latter are selectively accountable for the medication-use process.
Clinical-Pharmacist-Centered Model
•All pharmacists in the department accept responsibility for all elements of the medication-use process and therefore spend their time on both clinical and distributive functions.
• Many distribution tasks are delegated to well-trained pharmacy technicians, so the pharmacists’ roles in drug distribution are often limited.
• Pharmacists are able to expand their clinical roles to more active engagement as part of an interdisciplinary team.
•Pharmacists exhibit a high degree of ownership of and accountability for the entire medication-use process.
Patient-Centered Integrated Model
