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
Key individuals:
Pharmacist
1. Dispensing Pharmacists
2. Clinical Pharmacist
A. Generalists
B. specialists
3. Integrated practice
4. Pharmacy Technicians
responsible for the preparation of medications, either directly or through supervising the preparatory work of pharmacy technicians.
Pharmacists
most traditional role; Play an important role in verifying that medications are prepared correctly and are dispensed accurately.
Dispensing Pharmacists
Are likely to serve on interdisciplinary patient-care teams, and interact directly with patients. They usually have clinical pharmacy training and often have completed a pharmacy residency.
• Generalists - provide clinical pharmacy services to a wide range of patients
• Specialists - have a defined expertise in one or more areas (critical care, oncology, etc.)
Clinical Pharmacists
The pharmacist has both dispensing and clinical roles. This is the most prevalent role in institutional practice.
• Pharmacists in management usually serve as the supervisor for pharmacy activities or as the director for the pharmacy department.
• Other pharmacist roles are evolving. This include those who are responsible for informatics, investigational drug services, research, sterile compounding, and emergency care
Integrated practice
integral in the purchasing, stocking, preparation, and compounding of medication which are all under the direct supervision of the pharmacist.
Pharmacy Technicians
Hospital pharmacy services are about providing high-quality patient care by bringing expertise on medicines to the healthcare team. It is about ensuring safe and effective use of medicines, and ensuring that resources are widely used-cost-effective use of medicines.
On top of a pharmacist’s basic responsibility, it includes talking to patients about their drug regimen, checking their understanding of how to use their medicines and involving them in the decision-making process regarding their medicine.
It is vital that services are patient-focused, not pharmacocentric.
Hospital Pharmacy Practice
Intended to serve as a basic guide for the provision of pharmacy services in hospitals by outlining a minimum level of services that most hospital pharmacy departments should consistently provide.
Purpose….Minimum Standards of Practice ASHP Guidelines: Minimum Standard for Pharmacies in Hospitals, 2012
It is the pharmacists’ mission to help people make the best use of medications and so they are also concerned with the outcomes of pharmacy services.
These elements are critical to safe, effective, and cost-conscious medication use in a hospital. Although the scope of pharmacy services may vary, these elements are linked to successful outcomes that failure to provide any of these services may compromise the quality of patient care.
Elements of Care
Elements of Care:
- Practice Management
- Medication-Use Policy Development
- Optimizing Medication Therapy 4. Drug Product Procurement and Inventory Management
- Preparing, Packaging, and Labeling Medications
- Medication Delivery
- Monitoring Medication Use
- Evaluating the Effectiveness of the Medication-Use System
- Research
Minimum Standards of Practice DOH Hospital Pharmacy Management Manual
N/A
General Principle
The pharmacy is an essential service of a hospital, responsible for the provision of pharmaceutical care to patients.
UHC: “provide every Filipino the highest quality of healthcare, efficient, equitably distributed, fairly financed and appropriately used by an informed and empowered public”.
→client-friendly pharmacy in accordance with its ethical and professional practice
N/A
General Principle
Hospital Pharmacists + other Healthcare Providers. = Better Health Outcome of all Patients
Ensure that quality pharmaceutical care is provided through application standards and methods of which the patients are the prime beneficiary.
N/A
Goals:
• Optimal therapeutic outcome and medication safety for all patients
• Application of new methods and techniques on pharmaceutical care in relation to patient safety
• Elevate pharmacy stature by enhancing its services through the use of automation technology and capacity building of the management and the workforce.
Practice
• Vital Role
- Provision of safe, effective and quality pharmaceutical products
- Pharmaceutical care
- Drug information
- Patient medication counseling
- Health promotion.
•Sec. 4 of R.A. 10918
The traditional role of pharmacist in drug product preparation and dispensing broadened to patient care approach.
N/A
Practice
Ideally, the hospital pharmacy shall have the following services:
• Dispensing
• Clinical Pharmacy
• Drug Information Service
• Compounding
• Training
• Research
• Administrative
N/A
