Introduction to Clinical Pharmacy Practice.pptxSHIVANEE VYAS
Clinical pharmacy is a branch of hospital pharmacy that deals with various aspects of patient care, including the dispensing of drugs and advising the patient on the safe and rational use of those drugs.
A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
Pharmacist’s participating in medical ward
rounds promotes health care
Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.
REVIEWING THE CLINICIANS PRESCRIPTION AND TREATMENT PROGRESSION IS THE FUNDAMENTAL RESPONSIBILITY OF PHARMACIST. THIS PRESENTATION WILL DEAL WITH VARIOUS ASPECTS OF REVIEWING PATIENT DRUGTHERAPY PLAN
Introduction to Clinical Pharmacy Practice.pptxSHIVANEE VYAS
Clinical pharmacy is a branch of hospital pharmacy that deals with various aspects of patient care, including the dispensing of drugs and advising the patient on the safe and rational use of those drugs.
A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
Pharmacist’s participating in medical ward
rounds promotes health care
Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.
REVIEWING THE CLINICIANS PRESCRIPTION AND TREATMENT PROGRESSION IS THE FUNDAMENTAL RESPONSIBILITY OF PHARMACIST. THIS PRESENTATION WILL DEAL WITH VARIOUS ASPECTS OF REVIEWING PATIENT DRUGTHERAPY PLAN
Patient Counselling is needed for
Better patient understanding to their illness and role of medication.
Improve medication adherence.
Improve dosage regimen adherence.
More effective Drug treatment.
Reduce incidence of adverse drug effect and unnecessary healthcare cost.
ADR reporting.
Improve quality of life for patient.
Raising image of Pharmacist & its profession.
Introduction to daily activities of clinical pharmacist.
Drug therapy monitoring,
Medication chart review
Clinical Progress
Pharmacist intervention
Detection and management of ADRs
Drug Information Services, Drug information Sources, Illegal DIC, Drug Information Bulletin, Classification of scientific literature, services offered bu drug information services
Patient Counselling is needed for
Better patient understanding to their illness and role of medication.
Improve medication adherence.
Improve dosage regimen adherence.
More effective Drug treatment.
Reduce incidence of adverse drug effect and unnecessary healthcare cost.
ADR reporting.
Improve quality of life for patient.
Raising image of Pharmacist & its profession.
Introduction to daily activities of clinical pharmacist.
Drug therapy monitoring,
Medication chart review
Clinical Progress
Pharmacist intervention
Detection and management of ADRs
Drug Information Services, Drug information Sources, Illegal DIC, Drug Information Bulletin, Classification of scientific literature, services offered bu drug information services
A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted everyday to review the progress of each patient outcome. Pharmacist’s participating in medical ward rounds promotes health care , Participation of the Pharmacists in ward rounds in various practice settings helps to provide rational drug use. Decreases adverse drug events, improve patient care, and reduce length of hospital stay and health care cost
These slides are prepared to give the basic knowledge of ward rounds; how these ward rounds helps to enhance the practical skills of the medical practitioner, medical student as well as pharmacists
ward round participation for Medical students, Pharmacy, nursing medical and paramedical staff, understanding of do's and don't, types of the ward rounds, preparation of ward round for medical students, goals, and objectives of the ward round, classification of ward rounds, Interventions during ward rounds, teamwork during ward rounds, ethics inward roun, teaching rounds, emergency calls,
brief review on clinical pharmacy, drug information centre & patient safety program
The lecture was presented at Al-Mahmoudiya General Hospital as part of the training course for fresh appointed pharmacist at 16/5/2023 at 11 & 15/5/2023
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities.
It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
A cornerstone of the discipline is continuous improvement based on learning from errors and adverse events.
Let us see what Pharmacists, Doctors and Patients can do about it.
In this slides included clinical pharmacy introduction and pharmaceutical care, also explanation about the goals and objectives of the clinical pharmacy requirements
Clinical Pharmacy Introduction to Clinical Pharmacy, Concept of clinical pptxraviapr7
b) Clinical Pharmacy
Introduction to Clinical Pharmacy, Concept of clinical pharmacy
Functions and responsibilities of clinical pharmacist, Drug therapy monitoring
Medication chart review, clinical review., pharmacist intervention
Ward round participation, Medication history and Pharmaceutical care.
Dosing pattern and drug therapy based on Pharmacokinetic & disease pattern
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CANSA has compiled a list of tips and guidelines of support:
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3. MEDICAL WARD ROUNDS
Ward rounds are the routine clinical rounds where the
healthcare professionals (a doctor with or without a nurse,
pharmacist, or any paramedical staff like technician or
physiotherapist) visit the patients in the ward to assess the
progress of the health condition of the inpatients.
At least one ward round is conducted every day to review the
progress of each inpatient, although more than one is not
uncommon.
It is also utilized as bedside teaching skills in a teaching hospital.
4. Goals and Objectives of Clinical Pharmacists on Ward
Rounds
• Gain an 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, such as pharmacology, pharmacokinetics, drug
availability, cost, drug interactions and adverse reactions
• Optimize therapeutic management by influencing drug therapy
selection, implementation, monitoring and follow-up
• Investigate unusual drug orders or doses
5. • Assimilate additional information about the patient such as
comorbidities, medication compliance or complementary and
alternative medicine (for example herbal remedies) use that might be
relevant to their management
• Detect adverse drug reactions and drug interactions
• Participate in patient discharge planning.
7. PRE-ROUNDS
During these rounds, the interns or medical post-graduate
students in teaching hospitals perform a daily review of patients
in their unit or ward.
This is largely a learning opportunity to familiarize themselves
with the cases, especially new admissions or transfers, and very
few management decisions are made during these rounds.
Trainee clinical pharmacists may join the interns or
postgraduates in their pre-rounds and complete the patient
medication and clinical review at this time.
8. REGISTRAR/RESIDENT ROUNDS
In teaching hospitals, the registrars and residents, individually or
as a team conduct ward rounds, at least once a day at a fixed
time, usually in the morning.
In the intensive care unit (ICU), rounds may be conducted several
times a day.
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 too.
9. PROFESSOR/UNIT CHIEF ROUNDS
A ward round participation involving PG students, registrars,
residents, and experienced doctors together is known as
professor/chief rounds. It may be conducted daily, weekly, or
monthly.
These types of ward rounds become extensive and specialized
for discussing complex and complicated problems.
It may be difficult for clinical pharmacists to join these
consultant rounds due to timing.
10. TEACHING ROUNDS
In teaching hospitals, academic medical staff conducts bedside
clinical teaching rounds for residents, medical PG students,
interns, medical UG students, and Pharm D students.
It is usually extensive rounds and is conducted only a few times
a week.
A clinical pharmacist can join during such rounds but will have
limited exposure since this kind of ward rounds do not involve
any kind of decision making and interventions.
11. PRE-WARD ROUND PREPARATION
• Pharmacists need to prepare adequately before participating in
ward rounds.
• Accurate and up to date information on the patient’s health
status, disease management and past medical history is essential
for effective participation in clinical decision making.
• To achieve this a review of the medication chart and case record
should be completed prior to the ward round.
• Pre-ward round participation gives an overview of the drug and
disease related issues that may arise during a ward round.
12. Many clinical pharmacists maintain individual patient profiles
which summarize information relevant to the patient’s drug
therapy. This includes:
Allergies or hypersensitivities
The reason for admission
Provisional or final diagnosis
Past medical history
Medications on admission
Relevant social history
laboratory data
Other relevant investigations and reports
Medication compliance
14. For all newly admitted patients, it is appropriate to collect a
detailed medication history from the patient or their carers,
which needs to be cross-checked with information collected by
other healthcare professionals.
Any relevant new information obtained during the medication
history interview which may change patient management (for
example, history of allergy to a medicine) should be brought to
the attention of the appropriate healthcare professionals and
used to update existing patient profiles.
Pre-ward round preparation allows the pharmacist to be well
informed and organized about the patient.
15. Practical tips for ward round participation
Pharmacists should complete their pre-ward round preparation
well ahead of commencement of the round.
Pharmacist should ensure that all prescriptions are in
accordance with the hospital formulary.
Clinical pharmacists may wish to carry appropriate references
while working in wards, Eg. BNF, up-to-date clinical
guidelines, Drug Information Books., etc.
When identifying potential problems such as drug interactions,
adverse reactions and medication errors, pharmacists should be
prepared to suggest alternatives to resolve the problem.
16. Pharmacists should avoid the temptation to enter discussions
concerning diagnosis. The one exception to this is where a
patient’s symptoms or signs are possibly drug-related.
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.
Types:
i. Active - Personal visits to influence prescribing
ii. Passive - Drug information services
iii. Reactive - Monitoring prescriptions
17. The errors identified by the pharmacist included:
o Incomplete orders
o Wrong dose
o Wrong frequency
o Inappropriate choice
o Duplicate therapy.
The main drug-related queries that may arise during ward rounds
relate to:
Dose and frequency
choice of medication
Adverse effects
18. 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
19. Communication during ward rounds
Effective communication skills and clinical knowledge are pre-
requisites for effective participation ward rounds.
Good interpersonal relationships are a key of success.
Learning of regional language helps the pharmacist to follow
the conversation between the clinicians and the patients.
It also helps you to interact effectively with the patients.
Interventions or recommendations made by the pharmacist
should be made in a diplomatic way, which shows respect for the
physician’s clinical acumen and experience, and should not
challenge a medical practitioner’s integrity.
20. WARD ROUND FOLLOW-UP
Clinical pharmacists often encounter issues during a ward round
that require some follow-up.
Some of the outstanding issues that may arise during a ward
round include:
1. Responding to enquiries
2. Communicating information - changes in drug therapy
3. Completing documentation-ADRs identified during the
round may need to be documented on an alert sheet.
4. Altering the patient’s care plan
5. Discussions with patients - the reasons for alteration in
therapy, drug administration or self monitoring techniques
and caution regarding likely adverse effects
21. REFERENCES
1. A Textbook of Clinical Pharmacy, Essential concepts and
Skills by G Parthasarathy, Karin Nyfort-Hansen, Milap C
Nahata. 2nd Edition. Pg No:211- 221.
2. https://www.14impressions.in/2020/12/goals-
classification-interventions-and.html#point0