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asthma therapeutics > PHA 221 > Flashcards

PHA 221 Flashcards

pharmacy law and ethics

1
Q

what is a remote consultation?

A

= a type of consultation between a patient and healthcare professional that involves a complete episode of care which does not need face-face contact.

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2
Q

examples of remote consulting

A
  • telephony
  • video consultation
  • online ‘written’ consultations - online questionnaire
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3
Q

Cons of remote prescribing

A
  • delayed or missed diagnoses
  • over or under investigation of patients
  • increased burden for clinicians to make judgement remotely
  • reduction in therapeutic relationships between patients and clinicians
  • missed opportunity to identify subtle cues during face to face consultations.
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4
Q

benefits of remote prescribing

A
  • save patient time, reducing the need to travel
  • patients who are digitally literate and happy to consult remotely
  • patient groups who experience difficulty with social interactions
  • may find it easier to explain their symptoms using online consultations tools or explain embarrassing problems in a remote prescribing setting
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5
Q

The CONSULT Guide

A

Consider - whether the consultation is remote or not
Organise - and check if technology is in place
Necessary - ensure all necessary info is to hand
Start - initiate the consultation effectively
Undertake - work through the consultation
Listen - consider patient needs and agree next steps
Terminate - close the consultation appropriately

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6
Q

CONSIDER

A
  • is video call clinically required? - dermatological issue
  • is a phone call sufficient? - new meds phone call is appropriate
  • does the patient have capacity to participate?
  • is a remote consultation of any benefit?
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7
Q

ORGANISE

A
  • What software or hardware is required? - lighting / confidentiality
  • is the connection stable and appropriate?
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8
Q

NECESSARY

A
  • Have you got all necessary info to hand?
  • Do you need any additional paperwork or info?
  • Do you have a consultation open? - record info in the moment
  • note which method of consultation you used
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9
Q

START

A
  • identity check - age, name, date of birth
  • Location - safe space to talk, private space to talk, check location
  • Call back methods - check how to contact the patient if tech fail, advise call back
  • Check - hear clearly, visual assessment
  • Acknowledge- help build rapport
  • Inform - share you are taking notes, let them know of any other screens
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10
Q

UNDERTAKE

A
  • usual structured process - idea , history taking, expectations, concerns
  • Consider if appropriate ‘in the moment’ - face to face appointment
  • Regular check in - if patient needs any support
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11
Q

LISTEN

A
  • Consider patient preference
  • shared decision
  • document any preferences and next steps
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12
Q

TERMINATE

A
  • summarise and check
  • check patient understanding
  • ask if they need me to clarify anything
  • any questions
  • make patient aware you are ending the call and wait for them to disconnect first
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13
Q

PACE mnemonic - managing emotions

A

Probe - discover what the issue is
Alert - try to progress if the patient is shouting
Challenge - state the terms of the consultation
Escalate - following through on your statement

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14
Q

Principle 1

A
  • patient safety = first priority
  • consider if remote prescribing is appropriate
  • raise concerns if the device or system your are working in does not have adequate patient safety safeguards
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15
Q

Principle 2

A
  • understand how to identify vulnerable patients and how to protect them
  • any safeguarding or capacity concerns - makes remote consultations less appropriate
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16
Q

Principle 3

A
  • tell patient your name, role and professional registration details
  • establish a dialogue and make sure patient understands how the remote consultation is going to work
  • patient history and potentially face - to face appointment
17
Q

Principle 4

A
  • explain you can only prescribe if safe to do so
  • can’t prescribe without sufficient info about patient
  • if you can’t prescribe because its unsafe - signpost to other services or offer face to face appointment
18
Q

Principle 5

A
  • obtain informed consent and follow relevant mental capacity
  • test of materiality when obtaining informed consent
19
Q

Principle 6

A
  • undertake an adequate clinical assessment access medical records or test results
  • physical exam based on presenting symptoms
20
Q

Principle 7

A
  • give patient info about all options available - patient friendly language
  • also include options that aren’t appropriate via remote methods
21
Q

Principle 8

A
  • appropriate arrangements for aftercare
  • unless patient objects - share all relevant info with other healthcare professionals involved in the patients care
22
Q

Principle 9

A
  • keep notes that fully explain and justify the decisions you make
  • may include refusing to prescribe if further assessment required for the patient
23
Q

Principle 10

A
  • stay up to date with relevant training, support and guidance when consulting in remote context

asthma therapeutics (5 decks)

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