Clinical pharmacists can participate in ward rounds to optimize patient care. They monitor treatment, identify drug interactions, suggest alternate therapies, and assist with discharge planning. The goals are to improve understanding of patients, provide drug therapy information, and optimize management. Pharmacists prepare by reviewing medication charts and histories. During rounds, they address queries and make recommendations diplomatically. Effective communication and follow-up are important for pharmacist contributions to patient care decisions.

1. WARD ROUND
PARTICIPATION
SMITHA SARAH
THAMBI
ASSISTANT
PROFESSOR
THE ERODE COLLEGE
OF PHARMACY

2. DEFINITION
A ward round is a visit made by a medical practitioner,
alone or with a team of health professionals and medical
students, to hospital inpatients at their bedside to review
and follow up the progress in their health

3. ROLE OF CLINICAL
PHARMACIST
Clinical pharmacist may participate in ward
rounds along with medical staff and monitor
the treatment of patients.
Pharmacist can identify drug effect
modifications due to interactions with several
foods, alcohol, smoking, environment
chemicals as well as due to pregnancy.
Pharmacist may suggest an alternate therapy if
applicable and can compile and process data
using computers and make it available to the
medical staff.
Pharmacist can also participate in drug
utilization review and patient care audit which
assures the quality of drug use in ambulatory
patient and to control drug costs.

4. GOALS AND OBJECTIVES OF
CLINICAL PHARMACISTS ON
WARD ROUNDS
Gain improved understanding of the
patient’s clinical status and progress,
current planned investigations and
therapeutic goals.
Provide relevant information on various
aspects of the patient’s drug therapy.
Optimize therapeutic management by
influencing drug therapy selection,
implementation, monitoring and follow-
up
Investigate unusual drug orders or

5. GOALS AND OBJECTIVES OF
CLINICAL PHARMACISTS ON
WARD ROUNDS
Assimilate additional information about
the patient such as co-morbidities,
medication compliance or
complementary and alternative medicine
use that might be relevant to their
management.
Detect adverse drug reactions and drug
interactions.
Participate in patient discharge
planning.

6. CLASSIFICATION
Ward rounds may be classified according
to the purpose of the round and
composition of the participating
healthcare team. The common types of
ward rounds are
Pre-rounds
Registrar/Resident rounds
Professor/Unit chief rounds
Teaching rounds

7. PRE-ROUNDS
During these rounds, the interns or medical
PG students in teaching hospitals perform a
daily review of patients in their unit and ward.
This is largely a learning opportunity and very
few management decisions are made during
these rounds.
Trainee clinical pharmacist also join these
rounds.
The clinical pharmacist can complete the
patient medication and clinical review at this
time.

8. REGISTRAR/RESIDENT
ROUNDS
In teaching hospitals, the registrar/
residents/ individually or as a team
conduct ward rounds, at least once a day
at fixed time, usually in the morning.
These rounds are extensive and may
also involve clinical teaching to medical
postgraduate students and interns.
These are useful rounds for clinical
pharmacists of all levels of experience to
join.

9. PROFESSOR/ UNIT
CHIEF ROUNDS
The chief of a unit or ward, or the
professor in a speciality conducts
rounds together with their
registrars/residents, post graduate and
interns for all patients under their care,
on a daily basis or on a few days of each
week.
These rounds may be more challenging
for clinical pharmacists in terms of
their clinical knowledge.

10. TEACHING ROUNDS
In teaching hospitals, academic medical
staff conduct bedside clinical teaching
rounds for residents, medical
postgraduate students, interns and
medical undergraduate students.
Though these rounds provide an
opportunity for pharmacists to improve
their clinical knowledge, they are not the
best rounds for making interventions or
recommendations.

11. PRE-WARD ROUND
PREPARATION
Accurate and up to date information on
the patient’s health status, disease
management and medical and
medication history is essential for active
participation in clinical decision making.
A review of the medication chart and
case record should be completed prior
to the ward round.
Issues that arise during pre-ward round
participation need to be clarified by
referring appropriate information

12. PRE-WARD ROUND
PREPARATION
In case of newly admitted patients, a
detailed medication history need to be
collected from the patients or their care
givers.
Any new information gained during
medication history interview should be
brought to the attention of the
appropriate healthcare professionals and
used to update existing patient profiles.

13. PRACTICAL TIPS FOR
WARD ROUND
PARTICIPATION
Pharmacists should complete their pre-
ward round preparation well ahead of
commencement of the round.
In hospitals with a formulary or drug
list, the pharmacist should ensure that
all prescriptions are in accordance with
the hospital formulary.
While identifying potential problems
such as drug interactions, adverse
reactions and medication errors;
pharmacist should be prepared to

14. INTERVENTIONS
DURING WARD ROUNDS
A pharmacist intervention is defined as any
action by a pharmacist that directly results
in a change in patient management or
therapy.
Opportunities for intervention arise during
various activities like:
Medication history interview
Medication chart review
Therapeutic drug monitoring
Drug information
Ward round participation.

15. INTERVENTIONS
DURING WARD ROUNDS
Intervention by pharmacist to assist
prescribing can be
Active
Passive
Reactive

16. INTERVENTIONS
DURING WARD ROUNDS
The main drug – related queries that may arise during
ward rounds relate to:
 Dose and frequency
 Choice of medication
 Adverse effects
 Drug interactions
 Formulation
 Duration of therapy
 Actions and uses/pharmacology
 Drug availability/supply
 Identification of patient’s medications on admission
 Legal and administrative issues
 Miscellaneous, such as storage conditions

17. INTERVENTIONS
DURING WARD ROUNDS
•Recommendations or interventions made
during ward rounds need to be prioritized
according to their clinical significance and
likely patient benefits.
•Interventions are more likely to be
successful when pharmacist recommend
solutions / alternatives for the drug therapy
problems identified.

18. COMMUNICATION DURING
WARD ROUNDS
Effective communication skills and clinical knowledge are
prerequisites for effective participation.
Pharmacists need to take an active role in patient care by
conveying their views on patient management to other healthcare
professionals.
Good inter-professional relationships are key for success.
English is the official language of communication among
healthcare professionals during ward rounds.
Knowledge of regional language is an added quality as most of
the time the clinician talk to the patients in their regional
language.
Pharmacists should be cautious while discussing drug-related
issues on the ward round in the presence of patients or their care
givers.
Interventions should be made in a diplomatic way, which shows
respect for the physician’s clinical experience and should not

19. WARD ROUND FOLLOW-
UP
Clinical pharmacists often encounter
issues during a ward round that require
follow-up
Pharmacist should prioritize these issues
according to their urgency and
relevance.

20. ISSUES THAT REQUIRE
FOLLOW-UP
Responding to enquiries
Communicating information
Completing documentation
Altering the patient’s care plan
Discussion with patients

21. THANK YOU