Know your Speaker......Who is Remi ADESEUN?According to the According to me...Organisers... 1. A Pharmacist 1. Seasoned Pharmacist 2. Young (at heart at least!) 2. Industrialist 3. Inclined to 3. Communicator Innovation par excellence 4. Interested in 4. Pioneer networking President of NIROPHARM
Young Pharmacists Forum.. Add to the organisers’ 4 reasons for inviting me as guest speaker tonight, the event itself has 4 main elements:1. Guest Lecture2. Quiz3. Inauguration of Young Pharmacists Group4. Dinner Remi ADESEUN
Why are we here? “address various issues that militate against Young Pharmacists’ delivery of safe medicines to Nigerians”, to wit:1. Indiscipline2. Unethical Practices3. Impatience4. “Register and Go” Remi ADESEUN
4 Key Issues1. Safe Medicines for Nigerians2. Role of the Pharmacist3. Role of the Young4. Values, Virtues, Ethics & Professionalism in Pharmacy Practice
In the final analysis,... Adopting the following 4 Cs’ as Young Pharmacists, will help us “move the Pharmacy profession from the growing pessimism and gloom to sustainable professional fulfilment” (OAKPCO 2012).1. Conviction (based on regularly updated knowledge and built on strong values, virtues, ethics and professional foundation.2. Communication (with patients as the centrepiece)3. Collaboration (Intra and Inter-Profession)4. Common Good
Safe Medicines For Nigerians... Who Cares? Individuals Patients Society Healthcare Professionals Government International Bodies/NGOs/Advocacy Groups Young Pharmacists Care!
Safe Medicines...Patient Safety Concept: Patient safety is Health defined as the Preservation prevention of Prevention harm to Treatment patients, Use of Medicines including Diagnosis through errors Prescription Procurement of commission Dispensing and omission Storage Goes beyond “safe Usage medicines”
Safe Medicines...Challenges Major Challenges: protection of consumers against counterfeit or contraband medicines Securing the medicines supply chain Physician/Pharmacist Error Patient Error Self-Medication Prescription Medicine Control
Medication Error...Definition "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer”. *The definition of "harm" includes both "temporary or permanent impairment of body function/structure requiring intervention and an error resulting in death"
Medication Error...Context May be related to: professional practice health care products procedures, and systems including: Prescribing Order communication Dispensing Product labelling; packaging; and nomenclature; compounding; distribution Use administration; education; monitoring
Medication Error...IndexType of Error Category ResultNO ERROR A Circumstances or events that have the capacity to cause errorERROR, NOHARM B An error occurred but the medicine did not reach the patient An error occurred that reached the patient but did not cause patient C harm* An error occurred that resulted in the need for increased patient D monitoring but no patient harm* An error occurred that resulted in the need for treatment orERROR, HARM E intervention and caused temporary patient harm* An error occurred that resulted in initial or prolonged hospitalisation F and caused temporary patient harm* G An error occurred that resulted in permanent patient harm* An error occurred that resulted in a near-death event H (e.g.anaphylaxis, cardiac arrest)ERROR,DEATH I An error occurred that resulted in patient death
Medication safety...1 a) improvement of packaging d) safer prescribing of and labelling of medicines as medicines, helped by the well as the proprietary and availability of complete patient non- proprietary naming, in records, electronic prescribing, cooperation regulators and the decision support and clinical industry; pharmacy services ; b) safer selection and e) safer medicines preparation, procurement of medicines, by minimizing the preparation including a medication errors in clinical areas and supplying risk assessment of medicines ready-to-use medicines; during formulary and f) safer dispensing of purchasing decisions ; medicines, enhancing the c) safer storage of medicines in ability to intercept medication clinical areas in hospitals and errors, and reducing dispensing community where high risks errors by the use of automated medicines stock should be dispensing systems; restricted ;
Medicine Safety...2 g) safer administration of i) independent, updated and medicines, helped by the clear accessible information on and legible label of medicines medicines must be available to up to the point of care, health care providers and barcoding, patients, and considered with minimising the storage of high patient information when risk medicines and the use of prescribing, dispensing, and standardised procedures; administering medication; h) safer monitoring of j) and patient education for a medicines supported by regular safer medicines’ use, medication reviews and the considering patients as active proactive detection of adverse partners in their care; drug events ; k) safer communication about medicines for individual patients between health care providers. Remi ADESEUN
Role of the Pharmacist...1 the guardians/safeguards against "poisons" Preventing Medication Error. responsibility to ensure that when a patient receives a medicine, it will not cause harm. the involvement of pharmacists in patient safety can be as early at the prescribing phase and up to the administration of the medicines.
Role of the Pharmacist...2 Individual making appropriate intervention at each stage of the medication-use process National working with other healthcare professionals, governments and regulatory agencies Global working with pharmacy organisations on a global basis, e.g. FIP
Role of the Pharmacist...3 Individual Commit to & Promote a “Safety Culture” acknowledgment of the high-risk, error-prone nature of an organisation’s activities a blame-free environment where individuals are able to report errors or close calls without fear of reprimand or punishment an expectation of collaboration across ranks to seek solutions to vulnerabilities a willingness on the part of the organisation to direct resources for addressing safety concerns Innovation and Collaboration
Role of the Pharmacist...4 National PSN commitment to “Access to Safe Medicines as a Human Right” Collaboration with the National Human Rights Commission Collaboration with Regulatory Authorities PCN, NAFDAC, NDLEA Collaboration with Patient Groups, Consumer Protection Organisations
Role of the Pharmacist...5 Global FIP STATEMENT OF PROFESSIONAL STANDARDS MEDICATION ERRORS ASSOCIATED WITH PRESCRIBED MEDICATION complementary to the FIP Statement of Professional Standards in Pharmaceutical Care and should be used in conjunction with that Statement
The Role of the Young PharmacistDefinition Character Traits ≤ 5 years post-grad? Innovation ≤ 35 years age? Collaboration Malleable Change Agent Remi ADESEUN
The Role of the Young Pharmacist Concerns: Solution:1. Indiscipline 1. Values2. Unethical 2. Virtues, Practices 3. Ethics &3. Impatience 4. Professionalism4. “Register and Go” Remi ADESEUN
Ethics & Integrity in Nigeria….A Call to Action To Paraphrase Emeritus Prof. O.O.Akinkugbe: “The topic we engage today reflects the cumulus in our present sky:values upturned, integrity short-changed, discipline outraged and merit marginalised. A dawn is upon us and each Nigerian must make some contribution to the total national effort”. Of Monks & Monkeys-The Wages of Integrity in Nigeria’s Polity. 1999. Government College Ibadan 70th Anniversary Lecture
The Importance of Ethics &Integrity in the Nigerian Context “National Ethics” is item 23 in Chapter II of the Constitution of the Federal Republic of Nigeria 1999. Code of Conduct is item 209 under section C Part “ (State Executive) ..states inter alia: “A Person in the Public Service of a State shall observe and conform to the “Code of Conduct”
Ethics & Integrity….Many Questions What is “Ethics”? “Integrity”? How does Ethics contrast with Law? Why the Focus on Ethics & Integrity? What is the nexus between Ethics, Integrity, Leadership & Good Governance? What is the goal of Good Governance?
What does ETHICS mean to you? “Ethics has to do with what my Feelings tell me is right or wrong” “Ethics has to do with my Religious beliefs” “Ethics is doing what the Law requires” “Ethics is the standard of behaviour Society accepts”We are what we repeatedly do. Excellence, then, is not an act, but a habit.Aristotle
What is ETHICS? Ethics refers to: well founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues. the study and development of ones ethical standards.
How does Ethics contrast with the Law?Ethics Ethics is the study of Law right or wrong Is the collection of conduct in situations rules of conduct where there is a imposed by an choice of behavior authority involving human values
Relationship between Ethics and the Law • With ethics, human values are the primary binding social mediator • With law, rules of conduct are the primary binding social mediatorPurpose • Societies, communities and peopleTarget • People to live well together Goal • Ethics governs society’s moral standards, a realm that the law can’t always reach • The law imposes a specific conduct on society, a realm that ethics can’t alwaysNeed reach
Integrity in Relation to Value Systems & Ethics What is Integrity? A concept of consistency of actions, values, methods, measures, principles, expectations, and outcomes. A value system may evolve over time while retaining integrity provided those who espouse the values account for and resolve inconsistencies. A Person can be described as having ethical integrity to the extent that everything that person does or believes (actions, methods, measures & principles) all derive from a single core group of values.
Integrity in Modern Ethics 3 key requirements: Discerning what is right and what is wrong Acting on what you have discerned, even at personal cost Saying openly that you are acting on well founded standards of what is right and what is wrong Benefits: Leads to increased performance for individuals, groups, organisations and societies. Results in improved quality of life and value- creation for all
What is an Ethical Culture? An ethical culture is an intangible structure of organizing and characterizing a group of people to constitute a framework influencing the behavior of each individual in the group
How to Evaluate an EthicalCulture Collect feedback from: Front-line employees Established confidential or anonymous reporting mechanisms Human Resources Department Evaluate whether: Ethical values are properly interpreted, clear and working as desired A swift and consistent way to deal with ethical concerns exists Ethical values provide a sense of trust and confidence in the public Ethical values are enforceable and revisable, or not
Remi ADESEUNHow to Evaluate anEthical Culture• Benchmark with data you collect from peer institutions• Perform ethics audits
Influences of Ethical Behavior Personal values Credible enforcement of ethics violations Attitude and behavior of supervisors Attitude and behavior of senior managers Friends and co-workers Internal drive to succeed Ethics related legislation
Pressures that Compromise Following boss’s directive Meeting aggressive financial objectives Helping the organization survive Meeting scheduled pressures Wanting to be a team player Saving jobs
Pressures continued Advancing boss’s career interest Rationalizing that others do it Feeling peer pressure Resisting competitive threats Advancing own career interests
Why Ethical Lapses Occur The “Bad Apple” Corrupt Individual; Eliminate The “Bad Barrel” Organisational/Societal Culture; Overhaul, Commit to adequate personal integrity Competitive Pressures Short-term focus, unsustainable Opportunity Pressures Temptation; the greater the reward or the smaller the penalty, the greater the probability of unethical conduct Globalisation of Business Negative cultural “cross-pollination”
What is a Conflict ofInterest? A conflict of interest is a situation where a public office holder exploits relationships with theinstitution for personal financial or other gain, which may compromise or have the appearance of compromising professional judgment when makingdecisions or influencing the decisions of other public office holders.
Types of Conflicts ofInterest TANGIBLE INTANGIBLE The personal gain is The personal gain is professional or non- financial/material material
Potential Conflicts ofInterest Conflict of effort or conflict of obligation is when work time is spent on a secondary personal activity Conflict of conscience is when personal, political, or religious views influence objectivity Political conflict of interest is when one responds positively to an idea/proposal/person because it represents or is presented by a person/group with whom one is politically affiliated, or where one may act to delay/prevent access or opportunity of an alternative idea/proposal in order to strengthen the interested individual or group’s chances
Potential Conflicts ofInterest Using institutional facilities, resources or time for personal gain and/or activities for which one is paid by anyone other than the employer, except when such activities have been approved in compliance with institutional policies and procedures Accepting or soliciting any gift, hospitality, favor, service, benefit, or monetary award that one should reasonably know is offered to influence decisions or actions (bribes, kickbacks, etc) Doing personal business with the institution, employees or trustees, or their immediate family members or business partners
Potential Conflicts ofInterest Participating in the hiring of or having supervisory authority over a family member or a relative Accepting additional employment which competes or conflicts with one’s primary duties Excessively browsing the web, participating in social media, or participating in entertainment or leisure activities during official time and for reasons not related to official duties
Code of Conduct An outline of responsibilities of or best practice for an individual or the organization Set of principles of good organisational behavior adopted by the Organisation
Training and Communication Ethics and Integrity 1. New employee orientation 2. Policy and/or employee handbook 3. Periodic discussions in meetings 4. Formal annual communication 5. Performance reviews 6. Employee hotline
Encourage Whistle-blower A whistleblower is an employee, former employee, or member of an organization, especially a business or government agency, who reports misconduct to people or entities that have the power and presumed willingness to take corrective action. Generally the misconduct is a violation of law, rule, regulation and/or a direct threat to public interest -- fraud, health, safety violations, and corruption are just a few examples
Discipline The punishment should fit the crime Unintentional Write-up Impact on performance review Deliberate Termination
Imperatives Establishing & Maintaining High Ethical and Socially Responsible Standards must be a Priority Organisations must be aware of and committed to enthroning conditions and structures that are favourable to the development of integrity and ethical behaviour Leaders must recognise the key role they play in influencing the people’s ethical behaviour. The Leaders’ actions speak louder than words.
Characteristics of a Professional 1 Has a good image: Image is the way a person presents his physical self to the others. A good image helps the professional to portray confidence and positive attitude. The key aspects of image are: o Clothing: An employee must wear clean, well-ironed formal or semi-formal clothes. o Footwear: Shoes should be coordinated with clothing. o Accessories: Should be minimal. o Hair and Nail: Should be clean and trimmed. o Makeup and Perfume: Should be light. o Everything else from head to toe: Should be appropriate for corporate
Characteristics of a Professional 2 Has a good attitude: • Respect supervisor and seniors • Be friendly with all colleagues • Have a ‘win-win’ approach • Work hard, work smart
Characteristics of a Professional 3 Takes ownership and responsibility: • Meet Deadlines • Complete work effectively and efficiently • Accept your faults and be open to learning • Be open to taking more responsibilities
Characteristics of a Professional 4 Is prompt and orderly: • Keep office space clean and hygienic • Respond to meeting requests, emails, calls promptly • Respect other’s as well as your time • Organize tasks , events and manage work in a calm and orderly way
Characteristics of a Professional 5 Uses proper speech: • Avoid abusive, defamatory, offensive or obscene language • Avoid informal abbreviations, language • Avoid sensitive and racist comments • Respect others and be courteous
Characteristics of a Professional 6 Follows office etiquette, rules and policies: • Smile and greet others • Follow queue system • Do not fight in work floor • Do not speak loudly • Rise up when a senior comes to your desk • Understand company policies and procedures and follow them at all times • Be respectful to women
Characteristics of a Professional 7 Has Integrity and honesty: • Do not steal or misuse office resources. • Do not participate in any dealings which compromise your honesty and integrity • Report any issues that are questionable to HR or Supervisor • Do not indulge in any malicious actions that can risk company’s or your credibility
Characteristics of a Professional 8 Is a good Communicator: • Follow etiquette for verbal communication(email, telephone, meeting) • Be aware of Non-Verbal communication and Body language • Be an active listener
Conclusion: 4Cs 4 Safe Meds! Adopting the following 4 Cs’ as Young Pharmacists, will help us “move the Pharmacy profession from the growing pessimism and gloom to sustainable professional fulfilment” (OAKPCO 2012).1. Conviction (based on regularly updated knowledge and built on strong values, virtues, ethics and professional foundation.2. Communication (with patients as the centrepiece)3. Collaboration (Intra and Inter-Profession)4. Common Good