Associate Chief Pharmacist-Clinical Services, Guy' and St Thomas' NHS Foundation Trust, London. Reader in 19 acute hospital trusts in North-west England bestthing.info:/bestthing.infodia/pdf/ bestthing.info wellness and disease prevention.8 The practice of clinical pharmacy Wide variations in the extent and nature of hospital clinical pharmacy services 1–4: available online at: bestthing.info pdf. PDF | Objective: To describe how clinical pharmacy is helping to improve medication use at a South Indian teaching hospital by addressing.
|Language:||English, French, Hindi|
|Genre:||Business & Career|
|ePub File Size:||29.88 MB|
|PDF File Size:||13.29 MB|
|Distribution:||Free* [*Sign up for free]|
PDF | Clinical Pharmacy is a unique service provided by the leading pharmacy At the King Khalid University Hospital (KKUH) the first Clinical Pharmacy. HOSPITAL AND CLINICAL bestthing.info - Download as PDF File .pdf), Text File .txt) or view presentation slides online. current scenario of pharmacy practices in four hospitals of Bangladesh and to identify the Hospital pharmacy, Clinical pharmacist. .. pdf/bestthing.info
Prescription errors are a major cause of preventable adverse drug events, therefore interventions aimed at preventing these errors are likely to result in cost reduction.
HOSPITAL AND CLINICAL PHARMACIST.pdf
Possibilities for the reduction of prescription errors are the use of electronic prescribing systems and clinical pharmacy services 18, Our institution has an electronic prescription system and the beginning of a pharmacy residence program enabled the implementation of clinical activities for inpatients and outpatients with significant improvements in the hospital pharmacy unit. One important breakthrough conquered in our institution during the study period was that the participation of pharmacists in daily clinical activities in inpatient units, which was essential to complement the activities of clinical pharmacists.
This insertion allows the identification of DTPs that were not yet perceived in the pharmacy unit, such as the presence of interactions and incompatibilities between the solutions administered by Y catheter; inadequate protection or medication storage and infusions; problems in the interpretation of medications in the hospital's computerized information system.
The importance of the clinical pharmacist in the prevention, early detection and resolution of DTPs has become clear. Approximately one in every seven prescriptions had some type of DTP, requiring a pharmacist intervention. This result is similar to that found by Franklin et al. Other studies also detected the need of dose adjustment as the most frequent medication error 20, LaPointe 22 , in his review, showed as the most frequent medication errors: wrong medication Moreover, the absolute prevalence of polypharmacy and the number of medications per prescription was high average of 11 medications per order also predisposing to a higher prevalence of inappropriate or unnecessary medications.
The medications predominantly involved in DPT were ranitidine, enoxaparin and meropenem. These medications are commonly prescribed to critically ill patients, for being part of clinical protocols for example: ranitidine for prophylaxis of stress ulcer, enoxaparin for prophylaxis of deep venous thrombosis and enoxaparin for treatment of acute coronary syndrome or for being used to treat pathologies frequent in this population for example: meropenem for infections by Gram-negative bacteria.
The acceptability of the interventions made in the period was It is important to consider that, in our study, pharmacist recommendations to physicians regarding pharmacotherapy monitoring, which correspond to 6.
This aspect may have led to a reduction in the acceptability rate of the study.
In other hand, in a study performed by Leape et al. During the classification of DTPs, several questions emerged, and they were discussed in weekly meetings between the team of clinical pharmacists and preceptorship. Through these discussions, it was possible to identify needs for adjustments in several steps, including: review of the standardization of pharmacist interventions and monitoring registration methods; periodic review of the clinical pharmacy manual; training and capacity building of first-year pharmacist residents, pharmacy technicians, members of the nursing staff, and medical staff; in addition to updating the dispensing routine.
Regarding the disclosure of the data collected, continuous reports of the clinical pharmacy performance were sent to the responsible units, assistance direction, teaching direction, and clinical direction of the hospital. This structure provided a wide dissemination of the activities performed, and permitted the assistance teams to discuss results.
It allowed the identification of the most prevalent interventions, and the definition of potential improvement actions with the unit's responsible and the residence team to reduce these numbers. Our study has some limitations. Otherwise, we could evaluate more than 6, prescriptions in the area of cardiovascular and critical care.
In our experience, these units correspond to the most important areas regarding the occurrence of medication errors. Another limitation corresponds to the fact that the assessment of prescriptions was performed in the hospital pharmacy unit, often hampering the communication with the healthcare team and the perception of errors associated with the preparation and medication administration routine.
Despite the fact that pharmacist participation in clinical rounds could minimize this limitation, we cannot rule out the possibility that DTP prevalence may have been underestimated. Like any new process, the effective action of the clinical pharmacist in Brazil still has a long way to go. However, everyday the need for the inclusion of clinical pharmacists in healthcare teams becomes more evident, since the incidence of medication errors is still alarming, and pharmacist interventions can generate direct benefits for patient safety, as well as provide improvement in the quality of care.
Furthermore, the process of medication use is a dynamic process and the interventions made by the clinical pharmacist can bring enhanced outcomes, thus ensuring better safety, efficacy and cost-effectiveness of pharmacotherapy. The data confirms that up to Moreover, these activities demonstrated that they improve communication inside the healthcare team and between pharmacists and patients.
HOSPITAL AND CLINICAL PHARMACIST.pdf
We also thank the pharmaceutical residents that helped in data collection. Intervention research in rational use of drugs: a review. Health Policy Plan. To err is human: building a safer health system. The role of education in the rational use of medication.
WHO: Genebra; Medication errors: causes, prevention and reduction. Br J Haematol. Causes of prescription errors in hospital inpatients: a prospective study.
Prevalence, incidence and nature of prescription errors in hospital inpatients: a systematic review.
Drug Saf. Comment on 'prevalence, incidence and nature of prescription errors in hospital inpatients: a systematic review'. ASHP guidelines: minimum standard for pharmacies in hospitals. American Society of Health-System Pharmacists. Am J Health Syst Pharm.
Clinical pharmacists and inpatient medical care: a systematic review.
Arch Intern Med. Ars Pharm.
American College of Clinical Pharmacy. The definition of clinical pharmacy. Clinical pharmacist competencies. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit.
PHARMACIST PRESENT AND
Erratum in: JAMA ; 10 Benefits of patient counseling include patient satisfaction, prevention of medication errors, better clinical outcomes and psychological support to the patient. Patient education especially plays an important role in chronic diseases. Ward round participation As a member of healthcare team, the pharmacists can attend ward rounds.
The goals are improved understanding of patient's history, progress, clinical details, to provide the information on clinical aspects of patient's therapy and to improve discharge planning. The pharmacists can also help in decision-making to select the quality low-cost medicine; optimize the quality of patient care and clinical outcomes; ensure medicine selection as per formulary and local guidelines.
CPs can participate in various community service programs such as smoking cessation, alcohol consumption cessation, health promotion, health nutrition, etc. There is lot of scope for research in community pharmacy in India. As per Basak and Sathyanarayana, there are 30 articles available on community pharmacy based research in different journals from to from India. Role of clinical pharmacists in research Despite of being a highly populated country ranking 2nd on the globe with numerous hospitals, contribution of clinical and epidemiological research by India is not remarkable in the world.
For the current contribution, Indian physicians, nurses and other healthcare providers are playing more or less roles. As the concept of clinical pharmacy is still in the initial stages of development, contribution of CPs toward the research is negligible at this point of time.
As a result of this scenario, less data from the hospitals are getting published; the country lags behind other developed countries in producing quality data and research; and tremendous data from the hospitals remain unpublished in journals, e.A community pharmacist may perform clinical activities as well as a hospital practitioner. Ayyoehan Tiara Annisa. The acceptability of interventions was classified as follows: accepted; not accepted with justification, when the intervention was not accepted but there was a plausible explanation to justify the medical decision; not accepted without justification; accepted with alterations, in these cases an intervention was proposed, however during the discussion with the healthcare professional some change was made; does not apply to interventions consisting of educational actions.
Regarding the acceptability of CPIs, How does clinical pharmacy differ from pharmacy?