The role of a pharmacy residency program in global health: Establishing pediatric clinical pharmacy services in a Malawian hospital

2021 ◽  
Author(s):  
Thomas W Laudone ◽  
Cameron J McKinzie ◽  
Hanna S Kumwenda ◽  
Lauren A Blum ◽  
Sarah A Dascanio ◽  
...  
Keyword(s):  
Global Health ◽  
Patient Care ◽  
Clinical Pharmacy ◽  
Residency Program ◽  
Pharmacy Practice ◽  
Successful Implementation ◽  
Pharmacy Services ◽  
Great Opportunity ◽  
Clinical Pharmacy Services ◽  
International Experiences

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To describe the establishment of pediatric clinical pharmacy services in a hospital in Malawi as part of a pharmacy residency program in global health. Summary While pharmacy is expanding its role in global health through the introduction of international advanced pharmacy practice experience (APPE) rotations at US schools of pharmacy, international experiences for pharmacy residents are currently very limited. Such programs are advantageous for pharmacists planning for a career in public or global health, and there is also great opportunity for clinical pharmacists to work with international partners for professional development and to help advance pharmacy practice. The University of North Carolina at Chapel Hill Eshelman School of Pharmacy recently expanded its international APPE rotation in Malawi into the postgraduate training space through creation of a pediatric pharmacy residency training program, with the specific aim of working with partners in Malawi to introduce pediatric pharmacy services at Kamuzu Central Hospital. As this was the first time there was a pharmacist involved in patient care on the pediatric wards, the focus for the participating pharmacy resident was on establishing a positive relationship with the medical team through providing high-quality collaborative patient care for the pediatric population. In addition to working to establish pediatric clinical pharmacy services, the resident further contributed to sustainable improvements in pediatric patient care by identifying areas for quality improvement. We discuss several considerations for the successful implementation of international experiences and their impact on participating residents. Conclusion Pharmacy has an opportunity to build on the success of international APPE rotations and expand postgraduate offerings. Through collaboration with other institutions already involved in global health and identifying international rotation sites, residency programs across the country can create similarly beneficial global health experiences for their pharmacy residents.

Clinical Pharmacy Practice Patterns Among North Carolina Rural Hospitals

2019 ◽  
pp. 089719001986632 ◽  
Author(s):  
Cameron Lanier ◽  
Jason Moss ◽  
Robert Tunney ◽  
Ruthanne Baird ◽  
Kim Kelly
Keyword(s):  
North Carolina ◽  
Patient Care ◽  
Clinical Pharmacy ◽  
Pharmacy Practice ◽  
Rural Hospitals ◽  
Pharmacy Services ◽  
Clinical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Pharmacy Services

Introduction: Rural hospitals are isolated without adequate funding needed to provide for clinical services offered at larger health systems. The purpose of this study is to determine the clinical pharmacy services available and desired by rural hospitals in North Carolina. Methods: This prospective, cross-sectional, survey was distributed to a cohort of rural pharmacy directors and managers at rural hospitals across North Carolina. Data collected pertained to characteristics of the hospital and pharmacy, pharmacy director, clinical services, and responder impressions on their ability to maintain or enhance clinical services. Responses were summarized utilizing descriptive statistics and free-responses were coded for similar themes. Results: Seventeen respondents (32.6%) completed the survey. Clinical activities varied, as did characteristics of the hospitals and staff. Improved patient care is the primary reason why hospital pharmacies expand their clinical participation (46.7%). Pharmacy directors believed growth of clinical activities was a long-term goal while reporting regulations, staff, and finances as barriers to growth. Conclusion: Clinical pharmacy services vary in NC rural hospitals. Directors exhibit a willingness to expand clinical responsibilities. Rural hospital pharmacy directors desire pharmacists to be active clinically in patient care, but face barriers in reaching that goal.

A Model for Inpatient Clinical Pharmacy Practice and Reimbursement

1986 ◽  
Vol 20 (12) ◽  
pp. 989-992 ◽  
Author(s):  
Richard A. Hutchinson ◽  
David P. Vogel ◽  
Kenneth W. Witte
Keyword(s):  
Health Care ◽  
Clinical Pharmacy ◽  
Pharmacy Practice ◽  
Pharmacy Services ◽  
Clinical Role ◽  
Clinical Pharmacy Services ◽  
The Past ◽  
Health Care Reimbursement

The development and expansion of clinical pharmacy over the past 15 years have resulted in several debates. One debate that was very lively in the late 1970s concerned proper reimbursement for clinical pharmacy services. Although this debate is less heated now, its importance is even more significant with today's major changes in health care reimbursement. This article reviews the key reasons for the original debate and discusses how recent changes have increased and added direction to the debate. A model is presented that the authors believe represents the key to the increasing acceptance of the pharmacist's clinical role.

scholarly journals Analysis on Clinical pharmacy services provided by pharmacists for promoting elderly patients care

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 745-750
Author(s):  
Bushan Kumar GG ◽  
Jyothi Singamsetty ◽  
Rajasekhar K V ◽  
Sahitya Meda
Keyword(s):  
Patient Care ◽  
Adverse Drug Reactions ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Pharmacy Services ◽  
Care Hospital ◽  
Drug Reactions ◽  
Clinical Pharmacy Services ◽  
Medication Therapy ◽  
Prescription Errors

Clinical pharmacy services are the services provided by the pharmacists to promote patient care, optimizes medication therapy, promote health and disease prevention. This prospective cross sectional study was conducted in tertiary care hospital over a period of 6 months. This collected data is checked for their appropriateness of any prescription related errors and DRPs were identified. Results obtained were assessed to determine the influence of Clinical pharmacist services. Majority of the prescriptions were with 5-9(62.5%) drugs. The majority of co-morbidities among 125 enrolled patients in age group of 60-70, 55 patients were with 3-4 co-morbidities. Among 125 prescriptions around 12 prescriptions were identified with 622 drug interactions. Among 125 patients 2 (0.277) adverse drug reactions were observed and according to Naranjo's probability assessment scale these adverse drug reactions were mild and 15(2.08%) dispensing errors, 10(1.386%) prescription errors where majority of prescription errors are due to missed written frequencies in the prescriptions. 5(0.693%) administration errors, 5 (0.693%)untreated indications were observed. Presence of clinical pharmacist in hospital settings can reduce drug related problems and they can assist other staff in improving patient care.

scholarly journals Health-related stakeholders’ perceptions of clinical pharmacy services in Qatar

2020 ◽  
Author(s):  
Tesnime Jebara ◽  
Scott Cunningham ◽  
Katie MacLure ◽  
Ahmed Awaisu ◽  
Abdulrouf Pallivalapila ◽  
...  
Keyword(s):  
Clinical Pharmacy ◽  
Public Awareness ◽  
Healthcare Delivery ◽  
Pharmacy Practice ◽  
Service Development ◽  
Pharmacy Services ◽  
Clinical Pharmacy Services ◽  
Health Related ◽  
Innovation Characteristics ◽  
Inner Setting

Abstract Background In Qatar, the National Vision 2030 and the National Health Strategy 2018–2022 articulate the need to improve healthcare delivery by better utilisation of the skilled workforce. In this regard, pharmacy practice is rapidly advancing and several extended pharmacy services are now available in institutionalised settings. Objective This study aimed to determine health-related stakeholders’ perceptions of current clinical pharmacy services in Qatar, and the potential development and implementation of further patient-centred roles. Setting All major organisations and institutions relating to the practice, education, regulation, and governance of pharmacy in Qatar. Method Qualitative, face-to-face semi-structured interviews were conducted with individuals in key strategic positions of policy development and influence (i.e. health-related academic leaders, healthcare policy developers, directors of medicine/pharmacy/nursing, and patient safety leaders). Participants were recruited via a combination of purposeful and snowball sampling, until the point of data saturation was reached. The interview guide was grounded in the Consolidated Framework for Implementation Research domains of innovation characteristics, outer and inner setting, characteristics of individuals, and implementation process. The interviews were digitally recorded, transcribed and independently analysed by two researchers using the Framework approach. Main outcome measure Perceptions of stakeholders regarding current and potential for future clinical pharmacy services in Qatar. Results Thirty-seven interviews were conducted with stakeholders of policy influence in healthcare. The interviewees reported a variety of clinical pharmacy services available in Qatar, which they perceived as positively impacting patient care outcomes, pharmacists’ professional autonomy, and the healthcare system in general (innovation characteristics). However, they perceived that these services were mainly performed in hospitals and less in community pharmacy setting (inner setting) and were undervalued by patients and the public (outer setting). Expansion of pharmacists’ clinical activities was supported, with recognition of facilitators such as the skillset and training of pharmacists, potential time release due to automation and well-considered implementation processes (characteristics of individuals, inner setting, process). Conclusion Health-related stakeholders in Qatar have positive perceptions of current clinical pharmacy services and support the expansion of pharmacist’s roles. However, service development needs to consider the issues of patient and public awareness and initially target institutionalised healthcare settings.

scholarly journals Establishing a New Ambulatory Care Practice Site as a Pharmacy Practice Faculty

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 111 ◽  
Author(s):  
Vasudha Gupta ◽  
Evan Williams
Keyword(s):  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Clinical Skills ◽  
Pharmacy Practice ◽  
Care Practice ◽  
Pharmacy Services ◽  
Clinical Faculty ◽  
Clinical Pharmacy Services ◽  
Clear Vision ◽  
Pharmacist Services

There is an imminent need to identify and develop new ambulatory care practice sites with the increase in the number of colleges of pharmacy across the nation. This manuscript provides recommendations to help clinical faculty determine whether a potential pharmacy practice site will be able to provide adequate resources and support to establish a successful practice. This may be challenging to pharmacy practice faculty in settings where clinical pharmacy services have never been utilized. Topics include the pre-work needed prior to approaching a new practice site, assessing the need for physical requirements, meeting key personnel, marketing clinical skills and services, implementing, and evaluating practice site. Preparation includes having a clear vision of the pharmacist services, ensuring that stakeholders have an understanding of the pharmacy services inquiring the site support and resources for the pharmacist, and regularly communicating.

scholarly journals Incorporation and Impact of a Clinical Pharmacist in a Hospital-Based Neurology Clinic Treating Multiple Sclerosis Patients

2020 ◽  
pp. 0000-0000
Author(s):  
Alexandria May ◽  
Olivia Morgan ◽  
Kristi Quairoli
Keyword(s):  
Patient Care ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Medication Management ◽  
Pharmacy Services ◽  
Patient Counseling ◽  
Clinical Pharmacy Services ◽  
Clinical Pharmacists ◽  
Medication Access ◽  
Neurology Clinic

Abstract Background: Clinical pharmacists are uniquely positioned to assist with the complexities of medication management for patients with multiple sclerosis (MS). The objective of this study is to describe clinical pharmacy services provided as well as provider satisfaction and perceived impact of incorporating a clinical pharmacist in MS patient care. Methods: This study was conducted in two parts: a retrospective chart review and provider survey conducted in an outpatient neurology clinic at an academic medical center. Between April 2017 and June 2018, electronic medical records (EMRs) of patients with documented interventions by a pharmacist were reviewed to describe clinical pharmacy services provided to MS patients. A voluntary, anonymous survey was distributed to neurology providers to evaluate provider satisfaction and perceived impact of clinical pharmacist involvement in MS patient care. Results: There were 64 patients identified during the study period with 378 documented interventions made by clinical pharmacists. Pharmacist interventions were most commonly related to facilitating medication access (N=208), pre-treatment screening (N=57), patient counseling (N=51), and providing drug information (N=43). All providers surveyed (n=9) indicated that facilitating medication access, patient counseling, and drug interaction management were moderately or very important clinical pharmacy services. Furthermore, all providers surveyed strongly agreed that pharmacist involvement decreased time to therapy initiation for patients and decreased provider time spent on medication management. Conclusions: Clinical pharmacists play an integral role in MS patient care, particularly with facilitating medication access. Prospective studies are needed to further evaluate the contribution of clinical pharmacists in the care of MS patients.

A Systematic Review of ICU and Non-ICU Clinical Pharmacy Services Using Telepharmacy

2018 ◽  
Vol 52 (12) ◽  
pp. 1250-1258 ◽  
Author(s):  
Kyle Strnad ◽  
Bethany R. Shoulders ◽  
Pamela L. Smithburger ◽  
Sandra L. Kane-Gill
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Acute Care ◽  
Patient Outcomes ◽  
Clinical Pharmacy ◽  
Care Setting ◽  
Pharmacy Services ◽  
Acute Care Setting ◽  
Nursing Satisfaction ◽  
Clinical Pharmacy Services

Objective: To assess the impact of telepharmacy services in the acute care setting. Data Sources: EMBase, MEDLINE, and SCOPUS database searches were performed through April 2018. Study Selection and Data Extraction: PRISMA guidelines were applied for this systematic review. All English-language studies meeting the criteria of the following population, intervention, comparison, and outcome question were included: What impact does the provision of inpatient clinical pharmacy services delivered via telemedicine have on patient outcomes compared with standard of care? Data Synthesis: A total of 11 studies were identified for the acute care setting, including 3 for critically ill patients. All studies demonstrated a positive impact on patient outcomes, nursing satisfaction, and disease management. Varying modes of telepharmacy technology were used, such as remote access to electronic medical records, faxing or scanning documents, pictures or webcams. For communication purposes, telepharmacists used email or electronic communication, facsimile, video review, or telephone to speak directly with hospital personnel and patients. Relevance to Patient Care and Clinical Practice: Inpatient telepharmacy is feasible and should be leveraged to further enhance patient care by complementing existing service models. Conclusions: Telepharmacy services enhanced patient outcomes, improved nursing satisfaction, and expanded services within inpatient settings. Similar technologies were leveraged in non–intensive care units (ICUs) and ICUs, but the goals of telepharmacy appeared to differ. ICUs focused on an expansion of services in the ICU and non-ICUs addressed improved patient outreach in rural areas.

Redesigning the clinical pharmacy practice model at a psychiatric hospital

2015 ◽  
Vol 5 (1) ◽  
pp. 50-56
Author(s):  
Monica Zolezzi ◽  
Ingo Gottstein ◽  
Benjamin Nilsson
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Clinical Pharmacy ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Pharmacy Services ◽  
Practice Model ◽  
Clinical Notes ◽  
Clinical Pharmacy Services ◽  
The Impact

Introduction: Integrated, patient-centered clinical pharmacy services have been shown to improve patient outcomes in a variety of settings, including mental health. In this article, we describe and report the impact of a restructured clinical practice model that incorporated direct patient care by pharmacists implemented at a psychiatric facility in Edmonton, Canada. The purpose of redesigning the clinical pharmacy program was to deliver proactive pharmacist care through integrated clinical pharmacy services and to better align pharmacists' activities with those that have been reported to have a positive impact on patient outcomes. Methods: Pharmacists' documentation notes in medical records for patients admitted and discharged from the hospital at four different time periods were reviewed. For each time period, the number, type, and documentation rate were measured and compared using a Student t test with correction for unequal variances. Significant change was defined as P < .05. Documentation rates were also compared for short-stay versus long-stay patients. Results: A consistent and statistically significant increase was found in pharmacists' clinical notes per chart from 0.15 to 1.5 (P < .001) after implementation of the redesigned clinical practice model. The proportion of clinical notes also increased from 22% in the preimplementation period to up to 68% in the current period. This indicates that pharmacists were spending proportionally more time on proactive versus reactive care. Documentation rates also increased regardless of the patients' length of stay. Discussion: The redesigned clinical practice model enabled a successful transition of the pharmacists' role, from being predominantly reactive to becoming more proactive and integrated.

scholarly journals Outpatient clinical pharmacy practice in the face of COVID-19 at a cancer center in New York City

2021 ◽  
Vol 27 (2) ◽  
pp. 389-394
Author(s):  
Prakirthi Yerram ◽  
Jennifer Thackray ◽  
Lisa R Modelevsky ◽  
Josiah D Land ◽  
Samantha N Reiss ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Clinical Pharmacy ◽  
York City ◽  
Clinical Care ◽  
Pharmacy Practice ◽  
Outpatient Clinics ◽  
Pharmacy Services ◽  
Clinical Pharmacy Services ◽  
The Impact

Purpose With the rapid spread of COVID-19 in New York City since early March 2020, innovative measures were needed for clinical pharmacy specialists to provide direct clinical care safely to cancer patients. Allocating the workforce was necessary to meet the surging needs of the inpatient services due to the COVID-19 outbreak, which had the potential to compromise outpatient services. We present here our approach of restructuring clinical pharmacy services and providing direct patient care in outpatient clinics during the pandemic. Data sources We conducted a retrospective review of electronic clinical documentation involving clinical pharmacy specialist patient encounters in 9 outpatient clinics from March 1, 2020 to May 31, 2020. The analysis of the clinical pharmacy specialist interventions and the impact of the interventions was descriptive. Data summary As hospital services were modified to handle the surge due to COVID-19, select clinical pharmacy specialists were redeployed from the outpatient clinics or research blocks to COVID-19 inpatient teams. During these 3 months, clinical pharmacy specialists were involved in 2535 patient visits from 9 outpatient clinics and contributed a total of 4022 interventions, the majority of which utilized telemedicine. The interventions provided critical clinical pharmacy care during the pandemic and omitted 199 in-person visits for medical care. Conclusion The swift transition to telemedicine allowed the provision of direct clinical pharmacy services to patients with cancer during the COVID-19 pandemic.

Sign in / Sign up

Export Citation Format

Share Document