Professional skills Flashcards
Professionalism
What are the 9 standards of pharmacy professionalism
- Provide person-centred care
+
- Work in partnership with others
+
- Communicate effectively
+
- Maintain, develop + use their professional knowledge + skills
+
- Use professional judgement
+
- Behave in a professional manner
+
- Respect + maintain the person’s confidentiality + privacy
+
- Speak up when they have concerns or when things go wrong
+
- Demonstrate leadership
How do we exercise
professional judgement?
- Identify the ethical dilemna or professional issue
- Gather relevant information
- Identify the possible options
- Weigh up the benefits + risks of each option
- Chose an option
- Record
Medicines, society + pharmacy
What are the uses of Medicine?
- Treat disease
- Prolong life
- Save life
- Improve quality of life
- Prevent disease
- Alleviate symptoms
- Diagnose disease
What processes are involved in the
use of medicine?
- Collecting
- Transporting
- Storing
- Prescribing
- Dispensing
- Preparation
- Administrating
- Monitoring
- Disposing
- Procurement
Sectors where medicines are managed
- General public
- Hospitals
- Industry
- Community Pharmacy
➢ Primary Care
➢ GP practices
➢ District nursing services
➢ Clinical Commissioning Groups
➢ Care Homes
Stakeholders involved in management
of medicines
➢Doctors
➢Nurses
➢Pharmacists
➢Pharmacy technicians
➢Patients
➢Carers
Roles involved in management
➢Prescribe
➢Monitor
➢Administer
➢Supply
➢Store
➢ Prepare
➢ Advise
➢ Educate
➢ Counsel
How do we manage medicines?
- Following the law
- Using them appropriately
- Avoiding making errors
- Following the law
- Legislation for authorisation, sale + supply: Human
Medicines Regulations 2012 set by the GPhC - Legal category: POM, P & GSL
- People who can legally Prescribe, Supply, Administer
- Greater levels of control:
➢ Abusable drugs
➢Narcotics
➢Cocaine
➢ Benzodiazepines
➢ Anabolic steroids
➢Controlled drugs – Misuse of drugs Act 1971
- Using them appropriately
➢ Right medicine for patient
➢ Avoid errors when dispensing and supplying
➢ Best value for money
➢ Ensure patient takes properly – via counselling
➢ Appropriate polypharmacy = Prescribing multiple medicines appropriately for individual for complex conditions / for multiple conditions
➢ medicines prescribed for long-term are taken as reccomended = adherence = no medicine waste
*would come as a 10 marker [coming in exam potentialy]
What are the potential causes of
medication errors?
- Miscommunication between healthcare
professionals - Look alike and sound alike drugs
- Newly qualified healthcare professionals OR
professionals working for large number of years - Environmental stress and workload
- Lack of accuracy checking
- Poor time management and pressure
What are the potential causes of poor
patient adherence to medications?
- Fear of side effects
- Lack of patient education
- Cost of medication
- Forgetfulness
- Cultural or religious beliefs (animal/ gelatine)
- Polypharmacy
- Mistrust of professionals
- Misinformation via the internet
Possible solutions
[ patient adherence]
Patient adherence:
- dossett boxes for eldery patients who have multiple medication a day
- check in with patients + involve family/caregiver to check in
- setting phone reminders, or linking medication intake to daily routines (eg brushing teeth) can help patients remember their doses
- explain the risks of non-adherence to patients = better educated [Counseling on Side Effects & Risk-Benefit Balance]
- Provide clear, simple + personalized explanations about medication use [counseling, leaflets, digital resources]
- offer alternatives if it contains gelatine eg (capsules often have gelatine bu can offer pill formulation instead)
- Financial Support Programs / provide generic alternatives
- recommend reliable sources, + encourage patients to ask questions
Possible solutions
[medication errors]
Medication Errors:
- Regular Training
- Double-Checking System – Encouraging second professional to verify high-risk medications (insulin, anticoagulants)
- Reducing Workload & Stress Management – Ensuring adequate staffing + breaks to minimize fatigue-related errors
- Clear Standardized Communication between healthcare professionals
- Barcoding & Electronic Prescribing – Reduces manual errors in dispensing and administration
- Emphasising the difference between look-alike/sound-alike drug names to prevent mix-ups.
(hydrOXYzine vs. hydrALAzine)
Misuse of medication
STEROIDS
[the goods v bads]
+ +
- Widely used in treating disease
- Asthma, COPD (chronic obstructive pulmonary
disease) - Shock, sepsis syndrome
- Eczema
- IBD (Inflammatory Bowel Disease)
- Conn’s disease
- SIADH (Inappropriate secretion of anti-diuretic
hormone)
¬
- Anabolic Steroids
- Abused in a number of power sports
➢ rugby, baseball, athletics, American football, weightlifting, bodybuilding, wrestling
[Improve strength by lean body mass, Decrease body fat, Prolong training by enhancing recovery time, Increasing aggressiveness]
Misuse of medication
ANTIBIOTICS
[the goods v bads]
+
- Treats ➢Pneumonia, Sepsis, Surgical Prophylaxis, TB, many more infections…
¬
- Antibiotic Resistance rising due to
- not finishing whole dose
- being used for non-bacteria infection
Handling Medicines
Legal Classification of medicines?
Pharmaceutical products fall into three main legal
categories:
- General Sales List (GSL) = sold without supervision in general retail stores like supermarkets
- Paracetamol
- Cough Syrups
- Ibuprofen
- Pharmacy (P) = sold under a pharmacist’s supervision without a prescription
- Eyedrops
- Ibuprofen 400mg
- Emergency Contraception
- Hydrocortisone cream (up to 1%)
- Low-dose Codeine
- Prescription Only Medicines (POM) = Requires a prescription from a qualified healthcare professional
- Antibiotics [amoxicillin]
- Antidepressants
- Insulin
- Strong painkillers (Codeine phosphate)
Terminology
- Active Ingredient?
- Brand name?
- Pharmaceutical form?
- Strength?
- Active Ingredient - The main ingredient which causes the required pharmaecutical effect
- Brand name -The trade mark of the product [name given by the drig company selling it]
- Pharmaceutical form - The type of formulated product, for example a tablet, capsule or liquid [its physical form]
- Strength - The amount of drug in the pharmaceutical form pr weight eg mg, g, mg/ml [Concentration]
- Total amount per pack?
- Route?
- Use(s) (indications)?
- Expiry and batch no?
- Total amount per pack - The quantity of medications in the pack.
- as a number of units (2 tablets)
- as a volume or weight (100ml or 5g)
- as a single / multiple pack(s) (1 tube)
- Route - The route of administration - how the product should be used in/on the body (orally, topically, rectally) [location at whic drug is administered]
-
Use(s) (indications) - The purpose for which the product has been licensed
(eg to treat infection, to lower blood pressure) - Expiry and batch no - shelf-life of the product under acceptable storage conditions = cannot use after
batch no- an identifier assigned by the manufacturer to reflect the production batch
EXPIRY - expires at the END of that month USE BY - expired at the START of that month
DISPENSING MEDICINES
Common latin abbreviaton for prescriprions
- od
- b.d or b.i.d
- tid or tds
- qid or qds
- op
- od - once a day
- b.d or b.i.d - twice a day
- tid or tds - three times a day
- qid or qds - four times a day
- op - original package
- om / am
- on
- q.h
- qqh
- qd
- om or am - om = every morning. am = morning [before noon]
- on - every night
- q.h - every hour
- qqh / q4h - every 4 hours
- qd - every day
- ac
- pc
- mdu / ud
- prn
- stat
- ac - before meals
- pc - after food / with food
- mdu / ud - used as directed
- prn - when required
- stat - immediately
legal requirments of a label
- name of patient
- name + address of supplying pharmacy (+telephone number)
- date of dispensing
- name of medicine
- precautions relating to medicine EG “for external use only” [auxiliary]
- keep out of reach + sight of children = recommended to add
What order to write these on a prescription:
TOP
1 - Keep out of reach + sight of children
2 - [Quantity - Drug Name - Strength - Form]
3 - Directions for use
4 - BNF cautionary labels [+auxilary labels]
5 - [Patient name - pharmacy details - date of dispensing]
BOTTOM
examples of auxiliary labels
How long are prescriptions valid for?
- shake well before use
- keep refrigerated
- Take with food/drink
Prescription is valid for 6 months after the date signed
What are the steps to dispensing a POM
in the pharmacy?
- Pharmacist receives a valid prescription from an appropriate prescriber
- Prescription is screened legally + clinically, using resources such as the BNF
- Label is generated either on the computer or manually
- The correct medicine is selected off the shelf
- Label is applied onto the product
- An accuracy check carried out = label against prescription, product against prescription, label against product
- Medicine stored until ready to be handed out to patient
Extra stuff to remember
- antibiotics - include duration
- concentration - always include units eg 1% w/w
Looking at professional + scientific literature
Dealing with information + information
retrieval in a community pharmacy
- Using NHS smartcard
- Pharmacy Manager to dispense
- BNF to check clinical doses
- MEP to check legal validity of a prescription
- Accessing PIL when handing OTC meds
- Preparing leaflets for own pharmacy business
- Completing CPD – keeping up to date with
- knowledge
Dealing with information + information retrieval in a hospital pharmacy
- Accessing patient past medical and social history
- Drug charts – new meds started, needs monitoring, allergy
- Local hospital policies
- Referring to NICE/SIGN/BTS guidelines etc
- Medicines Information Pharmacists
- CPD cycle
Dealing with information and information retrieval in an industrial pharmacy
- Accessing research articles
- Accessing BP – follow QC testing
- Lab data gathering
- Post-data analysis
- Data presentation via conferences
- Preparing new publications/book chapters
- CPD cycle
Communication skills
Why is using the correct
communication skill important?
➢Poor communication between the pharmacist and patient can result in:
- A lack of understanding about patient history
- Wrong therapeutic decisions
- Patient being confused
- Patient non-compliance
*coming in exam
What constitutes effective communication/ counselling/ consultation skills?
- Introducing yourself
- Speaking clearly & appropriate tone
- Maintaining eye contact
- Open questions and body language
- Showing empathy
- Building rapport
- Non-judgemental
- Patient-centred approach – involving the patient
- Patient-friendly language
- Showing active listening
- Offering practical demonstration where relevant
- Giving lifestyle advice where relevant
- Checking patient understanding
Interviewing and counselling patients
[ often required when conducting a Medical History Review]
➢A pharmacist may ask the following questions:
- Recently prescribed medication?
- Over the counter medicines purchased?
- Vaccinations?
- Allergies?
- Herbal medications?
Healthy living
What is health?
Health is a state of complete physical, mental + social well-being and not merely the absence of disease or infirmity.
hat does a healthy lifestyle consist of?
- Looking after your
hygiene - Balanced
diet - Exercise, rest and sleep balance
-
Dentalandeyecheck-ups - Understanding mood and
mental health - Coping with
stressand pressure – including peer pressure - Avoiding
risk factorssuch as smoking -
Drinkingreasonably - Avoiding
drugsunless those prescribed by the doctor -
Recognising symptomsof being unwell asap and acting on it - Ensuring
immunisationare up to date
Healthy eating
- 5 fruit / vegetables
- Carbohydrates [chose wholegrain / higher fibre versions = help you to get rid of solid waste +
keeps your bowels healthy] (gives energy) - Proteins (helps body make new cells)
- Dairy + alternatives [chose lower fat + sugar options]
- very little oils/spreads
- Vitamins & Minerals - Keep you healthy + protect you against disease
- Water [ 6-8 cups a day - 2 litres]
Female: 2000kcal Male: 2500kcal
*coming in exam
Activity levels needed for each age group
- Under 5’s [not yet walking]
- Under 5’s [walking]
- 5-18
- 19-64
- 65+
- Under 5’s [not yet walking]
- atleast 30 minutes tummy time spread through day
- Under 5’s [walking]
- 180 minutes a day [3 hrs]
- skipping, running, jumping, riding bike, swim, throw + catch
- 5-18
- 60 min moderate or vigorous intensity physical
activity daily – across the week
- 19-64
- 150 min moderate intensity activity a week
- Or 75 min vigorous activity a week
Spread over 4 to 5 days or everyday
- 65+
- 150 min moderate intensity activity a week
[walking, pushing lawn mower, bike] - Or 75min of vigorous activity if already active
Or combination of both
[running, aerobics swimming, riding a bike fast / on hills, football]
*coming in exam
What are the barriers to meeting these
activity guidelines?
- Lack of times
- Social influence – friends and family do not share your interest in physical activity
- Lack of energy
- Fear of injury
- Lack of skill – feeling uncertain or uncomfortable
- Lack of resources – exercise equipment
- Finances – cannot afford gym/swim sessions and other sports
- Accessibility – location, transport and distance
