Phar 5 Lec Chapter 5



HOSPIPHAR LEC ACCP and ASHPCLINICAL PHARMACY  Described competencies and training necessary to provide clinical pharmacy services  Vision 1950s  Pharmacists will increasingly become board certified if they  Health-system pharmacy pioneers were provide direct patient care in advocating that pharmacists go to patient specialty areas care areas and create a clinical role (e.g. rounds) American Society of Health-System Pharmacists (ASHP) 1970s-1980s  Vision  Pharmacists in health-system settings were  ”Medication use in hospitals and creating many new clinical roles health-systems is a prominent  Pharmacy organizations therapy for virtually all patients,  creating policies and activities to and it is inherently complex and enhance the clinical skills of their dangerous.” members  encouraged the colleges and Joint Commission of Pharmacy Practitioners (JCCP) schools of pharmacy to train their students to become clinicians  Vision for pharmacy practice in 2015  “Pharmacists will be the health 1985 care professionals responsible for providing patient care that ensures  “Directions for Clinical Practice in optimal medication therapy Pharmacy” outcomes. This will occur because  Hilton Head Island, South Carolina pharmacists will have the authority  American Society of Health-System and autonomy to manage Pharmacists (ASHP) medication therapy and will be American College of Clinical Pharmacy (ACCP) accountable for patients’ therapeutic outcomes.”  Clinical Pharmacy  “The area of pharmacy concerned Ultimate goal of Clinical Pharmacy with the sciences and practice of  “Every patient who needs the clinical drug rational medication use.” knowledge and skill of the pharmacist does  “The concept of a PATIENT- in fact receive the services.” ORIENTED RATHER THAN A PRODUCT-ORIENTED PHARMACY Hepler and Strand PARACTITIONER.”  Clinical Pharmacists  Pharmaceutical Care  “Provide patient care that  ”Responsible provision of drug optimizes medication therapy and therapy for the purpose of promotes health, wellness, and achieving definite outcomes that disease prevention.” improve a patient’s quality of life.”  Focus 1. The discipline of clinical pharmacy 2. The clinical pharmacist 3. The roles of the clinical pharmacist Lacorte, Aries S. 3D-PH | PHAR 5 FOCUS 1: DISCIPLINE OF CLINICAL PHARMACY identification and management of drug- related problems Evidence-Based Process  Evidence-based  Health care decisions that FOCUS 2: THE CLINICAL PHARMACIST incorporate the best evidence currently available in the scientific Clinical Pharmacist literature and systematic study of what works best in patient  A highly educated and well-trained population individual, with specialized knowledge and experience, who contributes to the American Pharmacists Association (APhA) outcomes of patients by using this knowledge to enhance drug therapy  Pharmacists should be directly involved in  Must be dedicated to life-long learning to developing, evaluating, and implementing ensure their value to the interprofessional clinical guidelines for diseases health care team  Clinical guidelines should be developed using interprofessional approaches and be Clinical Pharmacist Competencies (ACCP) built on the best scientific data that is evaluated regularly to ensure the guidelines reflect current practice standards ASHP’s 2015 Initiative  By 2015, pharmacists in 90% of hospitals “will be actively involved in providing care to individual patients that is based on evidence, such as the use of quality drug information resources, published clinical studies or guidelines, and expert consensus advice.” Therapeutic Problem Solving Processes  SOAP  Subjective findings  Objective findings  Assessment  Plan  FARM  Findings  Assessment  Recommendations  Monitoring  Clinical Pharmacist Recommendation (CPR)  Developed for use by clinical Education, Training, and Credentials pharmacists and be able to compare clinical pharmacy  Doctor of Pharmacy intervention trials  Degree that provides more clinical  Pharmacists’ Management of Drug-Related education Problems (PMDRP)  Residency  Designed to reduce variation in monitoring  Serves as a bridge between forms and to focus more specifically on the education and practice. Lacorte, Aries S. 3D-PH | PHAR 5 Postgraduate Year 1 Postgraduate Year 2  Board Certification (PGY 1) Residency (PGY 2) Residency  Process by which a clinician  General in nature  More specialized in specialist may be recognized as  Designed to expose nature possessing a high level of the resident to  Completion lead to knowledge about the specialty variety of practice preparation for  Certified by Board of Pharmacy areas board certification Specialties (BPS)  Instructional  Current specialties emphasis is on the PGY 2 resident: o Nuclear pharmacy progressive  Manage medication o Nutrition support pharmacy development of therapy of specialty o Oncology pharmacy clinical judgment patients o Pharmacotherapy under the guidance  Develop o Psychiatric pharmacy of model accountability o Ambulatory care practitioners practice patterns,  Credentials skills, habits, and  Documented evidence of PGY 1 resident: expert knowledge, professional qualifications  Grow beyond skills, attitudes, and  Include entry-level abilities in the o Academic degrees competence in respective o State licensure direct patient care advanced area of o Residency program certificate and in pharmacy pharmacy practice of completion operational service o Board certification in a  Develop leadership pharmacy specialty skills to apply in  Fellowship any position in any  1-3 years setting  Research-related experience  Acquire  May contain small portion of competencies in associated clinical practice skill “managing and development improving” medication-use process FOCUS 3: ROLES OF CLINICAL PHARMACIST  Provides evidence- based, patient- Bond and Raehl centered medication therapy  Evaluated associations of clinical pharmacy management with services and level of pharmacy staffing with interprofessional reductions in hospital mortality rates teams  Five (5) clinical pharmacy services  Exercise leadership associated with reductions in hospital and practice mortality, decreased drug and total cost of management skills care, and reductions in length of stay and  Demonstrate medication errors: project 1. Drug information management skills 2. Adverse drug reaction  Provide medication management and practice- 3. Drug protocol management related 4. Participating in medical rounds education/training 5. Admission drug histories  Utilize medical informatics Lacorte, Aries S. 3D-PH | PHAR 5 Elizabeth Flynn and colleagues  Designing systems that prevent drug- related problems at the individual and  Less than a third of patients were population level automatically counseled by pharmacists  Pharmacists as medication safety when receiving new prescriptions for officers medications  Developing programs designed to identify and prevent drug problems Other Clinical Pharmacy Services ONE OF THE MOST IMPORTANT AREAS FOR  Medication Reconciliation CLINICAL PHARMACY SERVICE PROVISION LIES IN  Provided by pharmacists in IDENTIFYING AND RESOLVING DRUG-RELATED response to the understanding that PROBLEMS IN DIRECT PATIENT CARE medication errors occur too frequently when patients are transferred from one setting to another  Education  Institutions associated with educating pharmacy students generally provide more clinical pharmacy services than institutions that do not  Collaborative Practice  Allow pharmacists to control medication therapy of specified patients and diseases in collaboration with one or more prescribers  Immunization  Administering an injection should NOT be considered a clinical pharmacy service  Determining a patient’s need for an immunization and setting up a tracking and reminder program to ensure that patients are immunized is a clinical service  Primary Care  Most often done as part of a collaborative practice where access to patient data is easiest  Electronic medical records  Identifying and resolving drug- related problems in population- based care  Development and enforcement of guidelines  Medication therapy management programs to large groups of patients Lacorte, Aries S. 3D-PH | PHAR 5
Copyright © 2021 DOKUMEN.SITE Inc.