scholarly journals Contribution of Pharmacy Practice Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study

2019 ◽  
Vol 72 (5) ◽  
Author(s):  
Richard S Slavik ◽  
Manish Khullar ◽  
Sean K Gorman ◽  
Nicole Bruchet ◽  
Sarah Murray ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Patient Care ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Process Of Care ◽  
Étude Prospective ◽  
State Education ◽  
Literature Evidence ◽  
Drug Therapy Problems ◽  
De Qi

ABSTRACTBackground: Canadian pharmacy practice residency programs promote development of key competencies for direct patient care resulting in resolution of drug therapy problems (DTPs), which is 1 of 8 national clinical pharmacy key performance indicators. There are no Canadian data on the contribution of residents to resolution of DTPs, including DTPs for priority diseases covered in disease-state education modules (PD-DTPs) or quality indicator DTPs (QI-DPTs), as assessed through application of evidence-based interventions proven to reduce morbidity, mortality, or health resource utilization. Objective: To describe the contribution of pharmacy practice residents to direct patient care using 3 process-of-care measures: resident-resolved DTPs, PD-DTPs, and QI-DTPs. Methods: This prospective, observational single-group study was conducted across 5 rotation sites within the authors’ health authority from September 2, 2013, to June 13, 2014. The primary outcome was number of DTPs resolved. The secondary outcomes were number of PD-DTPs resolved; number of QI-DTPs resolved; numbers of DTPs, PD-DTPs, and QI-DTPs resolved over time; and residents’ satisfaction with electronic tracking of resolved DTPs (in terms of training, usability, efficiency, and time requirements). Results: Four residents completed a total of twenty-one 4-week rotations and resolved a total of 1201 DTPs. Of these, 620 (52%) were PD-DTPs and 479 (40%) were QI-DTPs. Overall, the number of interventions increased for rotations 1–3, decreased for rotations 4 and 5, and increased again for rotation 6. The median score for all questions in all domains of the satisfaction survey was 4 out of 5 (“agree”). Conclusions: Pharmacy practice residents were resolving DTPs, PD-DTPs, and QI-DTPs for patients and were contributing significantly to direct patient care. On the basis of literature evidence, the number and type of interventions observed in this study would be expected to improve clinical and health economic outcomes for patients.RÉSUMÉContexte : Les programmes de résidence canadiens en pratique pharma-ceutique encouragent le développement de compétences clés relatives aux soins directs offerts aux patients. Ces compétences entraîneront la résolu-tion des problèmes de pharmacothérapie (DTP), l’un des huit indicateurs clés nationaux de rendement relatifs à la pharmacie clinique. Il n’existe pas de données canadiennes portant sur la contribution des résidents à la résolution des problèmes de pharmacothérapie, notamment ceux relatifs aux maladies prioritaires (PD-DTP) couverts dans les modules d’éducation sur les problèmes de santé, ou les indicateurs de qualité des DTP (QI-DPT), évalués au moyen d’interventions fondées sur des données scientifiques dont il a été prouvé qu’elles réduisaient la morbidité, la mortalité ou l’utilisation des ressources sanitaires. Dans une étude, les intervenants avaient des opinions divergentes concernant la contribution des résidents à la résolution des DTP, des PD-DTP et des QI-DTP.Objectif : Décrire la contribution des résidents dans le cadre de la pratique pharmaceutique des soins directs offerts aux patients à l’aide de trois mesures spécifiques du processus des soins : DTP, PD-DTP et QI-DTP résolus par les résidents. Méthodes : Cette étude prospective par observation portant sur un seul groupe a été menée dans cinq sites de rotation compris dans la sphère d’autorité sanitaire des auteurs, du 2 septembre 2013 au 13 juin 2014. Le résultat principal était le nombre de DTP résolus. Les résultats sec-ondaires étaient les suivants : nombre de PD-DTP résolus; nombre de QI-DTP résolus; nombre de DTP, de PD-DTP et de QI-DTP résolus avec le temps; et la satisfaction des résidents à l’égard du suivi électronique de leurs DTP résolus (en termes de formation, de facilité d’utilisation, d’efficacité et d’exigences en matière de temps). Résultats : Quatre résidents ont effectué un total de 21 rotations de quatre semaines et ont résolu 1201 DTP. De ceux-ci, 620 (52 %) étaient des PD-DTP et 479 (40 %), des QI-DTP. Les interventions générales ont augmenté de la 1re à la 3e rotation; elles ont diminué à la 4e et à la 5e rotation; elles ont à nouveau augmenté à la 6e rotation. Le score moyen de toutes les questions posées dans l’enquête de satisfaction, tous domaines confondus, était de 4 sur 5 (ou « d’accord »).Conclusions : Les résidents en pratique pharmaceutique résolvaient les DTP, les PD-DTP et les QI-DTP des patients et contribuaient de manière significative aux soins directs aux patients. Sur base de la documentation, on pourrait s’attendre à ce que le nombre et le type d’interventions observées dans cette étude améliorent les résultats cliniques et sanitaires des patients.  

Clinical Pharmacy Practice in the Operating Room

1993 ◽  
Vol 6 (4) ◽  
pp. 165-170 ◽  
Author(s):  
Amy L. Shafer
Keyword(s):  
Drug Therapy ◽  
Patient Care ◽  
Operating Room ◽  
Clinical Pharmacy ◽  
Research Collaboration ◽  
Adverse Drug Reaction Reporting ◽  
Pharmacy Practice ◽  
Drug Distribution ◽  
Direct Patient Care ◽  
Clinical Expertise

An operating room pharmacy has traditionally been focused on the provision of controlled substance accounting and drug distribution services. Clinical pharmacy can be practiced in this setting as well, to the benefit of patients and operating room staff. The operating room pharmacist can provide such services as drug information, drug use evaluation, participation in patient care rounds, adverse drug reaction reporting, assistance in emergency drug therapy, formulary management, research collaboration, pharmacokinetic and pain management consultation, and education regarding drug therapy. The clinical expertise of the operating room pharmacist can be gained through literature review, surgical case observation, attendance and participation in anesthesia conferences, and direct patient care. By providing clinical services appropriate to a given institution's needs in the operating room setting, and delegating direct distributive functions to pharmacy technicians whenever possible, the pharmacist can move into a rewarding role as a clinician member of the operating room health care team.

Creation of a certification requirement for pharmacists in direct patient care roles

2017 ◽  
Vol 74 (19) ◽  
pp. 1584-1589 ◽  
Author(s):  
David R. Hager ◽  
Katherine J. Hartkopf ◽  
Sara M. Koth ◽  
Steven S. Rough
Keyword(s):  
Health System ◽  
Patient Care ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Organizational Goals ◽  
University Of Wisconsin ◽  
Definition Of ◽  
The University ◽  
Ongoing Support ◽  
Certification Requirement

Abstract Purpose Steps taken by a large health system to require certification for all pharmacists in direct patient care roles are detailed. Summary Major supply chain changes and rising payer expectations are reshaping pharmacy practice, resulting in expanded responsibilities for pharmacists and a heightened need for certification in specialized practice areas. In response, the pharmacy leadership team at UW Health, the integrated health system of the University of Wisconsin–Madison, used an iterative process and a “rolling” FAQ format to develop and implement a certification requirement. Key decisions during the process included decisions to accept only rigorous certifications (mainly those offered by the Board of Pharmacy Specialties), to provide institutional support for continuing education–based recertification, and to use an accepted definition of direct patient care in determining which pharmacists need to be certified. The team obtained the support of the UW Health human relations department by drafting a policy and rewriting all pharmacist position descriptions to incorporate the certification requirement. An all-pharmacist forum was held to build staff commitment. As a result of the requirement, 73 pharmacists were required to obtain certification by 2018 at a total cost to UW Health of $44,000; ongoing support of certification maintenance will cost an estimated $40,000 per year. Conclusion Health systems can be successful in establishing uniform certification expectations for pharmacists in direct patient care roles, even across diverse practice settings, by aligning expectations with organizational goals.

scholarly journals Tech-Check-Tech in Community Pharmacy Practice Settings

2016 ◽  
Vol 33 (2) ◽  
pp. 47-52 ◽  
Author(s):  
Timothy P. Frost ◽  
Alex J. Adams
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Relevant Literature ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Community Settings ◽  
Practice Model ◽  
Term Care ◽  
Institutional Settings ◽  
Community Pharmacy Practice

Objective: The benefit of a tech-check-tech (TCT) practice model in institutional settings has been well documented. To date, few studies have explored TCT beyond institutional settings. This article summarizes the existing evidence in community pharmacy–based TCT research with respect to dispensing accuracy and pharmacist time devoted to direct patient care. Data Sources: A literature review was conducted using MEDLINE (January 1990 to August 2016), Google Scholar (January 1990 to August 2016), and EMBASE (January 1990 to August 2016) using the terms “tech* and check,” “tech-check-tech,” “checking technician,” and “accuracy checking tech*”. Bibliographies were reviewed to identify additional relevant literature. Study Selection and Data Extraction: Studies were included if they analyzed TCT and were conducted in a community pharmacy practice site, inclusive of chain, independent, mass merchant, supermarket, and mail order pharmacies. Studies were excluded if the TCT practice model was conducted in an institutional or long-term care setting. Survey data on theoretical models of TCT in community pharmacy practice settings were also excluded. Data Synthesis: Over the past 14 years, 4 studies were identified indicating TCT has been performed safely and effectively in community settings. The studies demonstrate that trained community technicians perform as accurately as pharmacists and that TCT increased the amount of pharmacist time devoted to clinical activities. In the 2 studies that reported accuracy rates, pharmacy technicians performed at least as accurately as pharmacists (99.445 vs 99.73%, P = .484; 99.95 vs 99.74, P < .05). Furthermore, 3 of the studies reported gains in pharmacist time, with increases between 9.1% and 19.18% of pharmacist time for consultative services. Conclusions: The present studies demonstrate that TCT can be safe and effective in community pharmacy practice settings, with results similar to those found in institutional settings. It is anticipated more states will explore TCT in community settings in the years ahead as a strategy to improve patient care.

scholarly journals Evaluation of a Longitudinal Institutional Advanced Pharmacy Practice Model

2018 ◽  
Vol 9 (3) ◽  
pp. 2
Author(s):  
Erin Christensen ◽  
Kara Webber ◽  
Janet L Kelly ◽  
Stanley S Weber ◽  
Teresa A O'Sullivan
Keyword(s):  
Patient Care ◽  
Clinical Pharmacist ◽  
Graduate Training ◽  
Medical Center ◽  
Pharmacy Practice ◽  
Training Model ◽  
Direct Patient Care ◽  
Healthcare Team ◽  
Care Experience ◽  
Service Project

  Objective: To evaluate a longitudinal experiential training model for advanced pharmacy practice experiences (APPEs). Innovation: A six-month longitudinal pilot program named the Focused Institutional Longitudinal Experience (FILE) program was developed at two academic medical centers to maximize active participation of the student and minimize the time spent orienting and onboarding students to each APPE experience.  A unique component of the FILE program is the longitudinal service project, which involved a medication use evaluation, including a review of published literature and drug policy recommendations to medical center quality committees. Analysis: Student ratings regarding the quality and value of the FILE student experience was compared to the traditional APPE model.  Nine quality measures were compared (e.g. amount of opportunity for direct patient care experience, learning, integration into healthcare team, and accountability for patient outcomes) between students from the FILE program to peers completing similar APPEs outside the FILE program. FILE students and APPE preceptors also completed surveys regarding the value of several program aspects. Key Findings: There was no difference between FILE and non-FILE student self-rated measures of APPE quality, and thus the decision to participate in a longitudinal APPE program should be based on the personal preference of the student.  Students in the FILE program agreed or strongly agreed (mean score 4.3) that they felt prepared for post-graduate training at the completion of the program. The potential value that students in a longitudinal program might bring to the site is reinforced by the general agreement by preceptors in the end of year survey  that FILE students take less of their time to orient to their service and the trend toward perception that FILE students are more likely to independently participate in patient care activities.  Next Steps: To address feedback on preceptor-mentor role and the desire for more interaction with pharmacy residents, students are now paired with a pharmacy resident, and the student and resident work together on the service project with a clinical pharmacist as an advisor.  Updated standards of practice clearly delineate the roles and responsibilities of students, residents, and the clinical pharmacist preceptor.  Annual surveys of FILE students and preceptors provide necessary feedback to continuously improve the quality of the program.     Article Type:  Note

Forensic Psychiatric Pharmacy Practice at Atascadero State Hospital

1996 ◽  
Vol 9 (4) ◽  
pp. 222-228 ◽  
Author(s):  
Brian Gibler ◽  
Grace Hayes ◽  
Fred Raleigh ◽  
Barbara Levenson ◽  
Sheryl Heber ◽  
...  
Keyword(s):  
Patient Care ◽  
State Hospital ◽  
Discharge Planning ◽  
Pharmacy Practice ◽  
Data Entry ◽  
Prescribing Patterns ◽  
Interdisciplinary Treatment ◽  
Direct Patient Care ◽  
Drug Induced ◽  
Forensic Psychiatric

Atascadero State Hospital (ASH) is the nation's largest maximum security forensic psychiatric hospital. Most patients are committed under penal codes as psychiatrically unstable prisoners, mentally disordered parolees, individuals found not guilty by reason of insanity, or individuals deemed incompetent to stand trial. Pharmacists' involvement in patient care and supportive activities at ASH are varied. Direct patient care activities include attendance at interdisciplinary treatment teams, medication consultation upon request of physicians or other staff, and follow-up on adverse drug reactions. Pharmacists may also be involved in discharge planning, especially for patients on clozapine treatment. Patient medication education is provided by pharmacists through medication management classes and discharge counseling. Indirect patient care activities include verification of data entry for automation of physician orders and drug regimen review (DRR) audits. Drug Use Evaluations (DUEs) and the Annual Survey allow tracking and improvement of prescribing patterns. Committees and Continuous Quality Improvement (CQI) activities throughout the hospital often include pharmacist members. Teaching is another important function of the pharmacist. Pharmacology classes are given to psychiatric technician students. Drug-induced movement disorder classes are provided to new employees. Additionally, pharmacy students on clinical clerkship rotations are trained and assist in providing clinical services. Capable technicians play a key role in allowing greater emphasis of time on clinical and administrative pharmacist functions. ASH provides the somewhat unique combination of clinically-oriented pharmacist positions in a rural community.

Exploring practice site contributions and professionalization impact of engaging student pharmacists on hematology-oncology advanced pharmacy practice experience rotations

2021 ◽  
pp. 107815522098557
Author(s):  
Matthew J Yacobucci ◽  
Christina L Lombardi ◽  
Laurie L Briceland
Keyword(s):  
Patient Care ◽  
Pharmacy Practice ◽  
Healthcare Personnel ◽  
Direct Patient Care ◽  
Self Awareness ◽  
Patient Counseling ◽  
Student Activities ◽  
Self Reflection ◽  
Oncology Practice ◽  
The Impact

Introduction Student pharmacists contribute meaningfully to patient care during Advanced Practice Pharmacy Experiences (APPEs) in varied settings. We aimed to characterize and evaluate the impact of student participation in hematology-oncology (hem-onc) APPEs on the practice site, and on student professionalization. Methods For students completing hem-onc APPEs during 2016–2019, rotation activities and post-APPE self-reflections describing meaningful impact were reviewed; activities were categorized into direct and indirect patient care, and up to three reflection themes of professionalization impact were extracted from each self-reflection. Hem-onc preceptor cohort was surveyed to assess impact of student contributions on the practice site. Results 171 students completed hem-onc APPEs in ambulatory care (133) and/or inpatient (38) settings. Of 932 student-reported activities, the most common were: evaluating patient pharmacotherapy (209), providing education to medical staff (132), patient counseling [non-chemotherapy (99); chemotherapy (82)], and providing drug information (96); 89% involved direct patient care/education. Survey results from 16 of 33 preceptors identified the most impactful student activities as evaluating pharmacotherapy, medication education/adherence resources, and in-service presentations. Of 392 student self-reflections, themes of impact focused on professionalization/self-awareness (39.3%), counseling/communication skills (27.8%), practice skills development (20.4%) and collaborative teamwork (12.5%). Conclusion Pharmacy students make significant direct patient care contributions to hem-onc practice settings by evaluating pharmacotherapy and providing education to patients and healthcare personnel. Participation in hem-onc APPEs is highly influential to the professionalization of students, particularly in developing skills in oncology practice, patient interactions/communications, and developing self-awareness.

scholarly journals Advancing Community Pharmacy Practice – A Technician Product Verification Pilot to Optimize Care

2020 ◽  
Vol 11 (2) ◽  
pp. 14
Author(s):  
Michael Andreski ◽  
Erica Martin ◽  
Victoria Valentine Brouner ◽  
Sarah Sorum
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Error Rate ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Utilization Review ◽  
Original Research ◽  
Pharmacy Technician ◽  
Pharmacy Technicians ◽  
Product Verification

Elevating the technical role of pharmacy technicians to perform Technician Product Verification (TPV) is one strategy that has shown promise to optimize pharmacy practice models. This is done by better positioning pharmacists to provide clinical care, in line with their education and expertise. TPV permits a Validated Pharmacy Technician, as defined by the Wisconsin Pharmacy Examining Board, to verify the accuracy of a product filled by another technician. The pharmacist maintains responsibility for assessing the clinical appropriateness of the prescription, including drug utilization review, data entry, and patient counseling.  During the study period, 12,891 pharmacist-verified prescriptions (baseline) and 27,447 Validated Pharmacy Technician-verified prescriptions were audited for accuracy. The aggregate verification error rate for pharmacist-verified prescriptions was 0.16% and 0.01% for Validated Pharmacy Technician-verified prescriptions. The mean error rate was significantly less for Validated Pharmacy Technician-verified prescriptions than for pharmacist-verified prescriptions (0.19 ± 0.174 % vs 0.03 ± 0.089 %, p=0.020) (Figure 3). This suggests TPV in the community pharmacy setting maintained patient safety. In this study, Validated Pharmacy Technicians were shown to be more accurate than pharmacists at performing product verification. The ability to delegate the product verification task holds the potential to free up pharmacist time for increased direct patient care. Increasing direct patient care by pharmacists in community pharmacies may have significant implications for improving patient outcomes and pharmacy quality.   Article Type: Original Research

Expanding the role of pharmacy technicians to facilitate a proactive pharmacist practice

2019 ◽  
Vol 76 (6) ◽  
pp. 398-402 ◽  
Author(s):  
Brandi Newby
Keyword(s):  
Patient Care ◽  
Pharmacy Practice ◽  
Medication Therapy Management ◽  
Direct Patient Care ◽  
Order Entry ◽  
Practice Model ◽  
Therapy Management ◽  
Pharmacy Technician ◽  
Medication Therapy ◽  
Pharmacist Role

Abstract Purpose This study describes a change in pharmacy practice to expand pharmacy technician roles to allow dispensing without a pharmacist check, thereby enhancing the pharmacist role in direct patient care. Summary In an effort to optimize patient care with limited resources, we set out to change our pharmacy practice model. We transferred duties that did not require clinical judgment in the dispensary from the pharmacist to the regulated technician. The transferred roles included order entry, order entry verification, and final check of medications and preparations. The changes in roles were well received by the pharmacy staff. The pharmacist practice changed from a reactive process, where the pharmacist waited for orders to be sent to the pharmacy, to a proactive process where the pharmacist collaborated directly with patients and the health care team. The pharmacists were able to provide daily medication therapy management for every inpatient in the new practice model compared with only reactive targeted care in the former practice model. Implementation of the new practice model at our site led to a reduction in time for medications to be delivered to the patient and reduced pharmacy-related medication errors. Conclusion A new pharmacy practice model was successfully implemented whereby the pharmacy technician roles were expanded to the point where they perform all the distribution roles in the dispensary. This, in turn, allowed a change in the pharmacist role, which was focused on daily proactive direct patient care and medication therapy management.

Sign in / Sign up

Export Citation Format

Share Document