2. NURSING HOME
• A residential facility for people with chronic
illness or disability.
• Also known as a convalescent home and long
term care facility includes adults who suffer
from chronic (long-lasting) or such illnesses as
stroke or Alzheimer’s disease .
• Both medical and residential care is provided.
3. Methods of handling drugs in hospitals
without pharmacist:
• Most extended care facilities and small
hospitals do not employ full time pharmacist,
many of them contract for such services.
• Medical staff rely upon community pharmacist
to dispense medication from local pharmacy
and deliver the facility .
• Pharmacy service in small hospital is provided
by department of pharmacy of a nearby large
hospital
4. Extended care facility and pharmacy
department
• If extended care facility has pharmacy
department a licensed pharmacist is
employed to administrate pharmacy
department.
• If no pharmacy depart. Then prompt
&convenient obtaining required drugs &
biologicals from community pharmacist
5. • If facility has only drug room where bulk drugs
are stored consultant pharmacist is
responsible for control of bulk drugs
• Consultant pharmacist dispenses drug from
drug room properly labels and make them
available for nursing personnel.
6. Small-large hospital relationship:
• Sharing of departments like Pharmacy
Radiology Pathology Services are provided by
the pharmacist on call in large hospitals.
7. Roles of pharmacist in Extended care
facility
• Drug regimen review : encompasses the
clinical activities of consultant pharmacist
Drug regimen must be reviewed at least
monthly by pharmacist Any irregularity found
during review must be reported to physician
and director of nursing.
• Examples of irregularities include Use of three
or more analgesics at a same time
8. • Use of iron therapy without red blood cells
assessment, Concurrent use of two or more
hypnotics
• Pharmacist should check the medication order.
appropriate medication order includes
Drug
Dose
route of administration
frequency
reason of use.
9. • The regulation require that patients drug
regimen should be free from unnecessary
drugs.
10. Medication error and ADRs:
• The consultant pharmacist should report and
document any drug irregularities, drug
interaction and clinical recommendations
promptly to the attending physician or nurse-
in-charge and the nursing home administrator
11. • Drug interactions, including interactions
between prescription drugs and over-the-
counter drugs, drugs and disease, and
interactions between drugs and nutrients.
Contraindications and precautions.
12. Medication pass observation:
• To observe the preparation and administration
of medication.
• Compare medication label with med.
administration sheet Ensure drug dose ,time 5
RIGHTS(resident,drug,dose,time and route)
14. • The consultant pharmacist should ensure the
automatic stop order in case where duration
and number of dose is not specified.
• The consultant pharmacist ensures that all
known allergies are documented in plain view
in the patient's medical record.
15. • Periodic inspection of nursing station
medication cabinet to ensure
external & internal med are separately placed,
No outdated med.
proper record of narcotics being administered
to the patient .
