scholarly journals Approach to the Pediatric Prescription in a Community Pharmacy

2011 ◽  
Vol 16 (4) ◽  
pp. 298-307
Author(s):  
Sandra Benavides ◽  
Donna Huynh ◽  
Jill Morgan ◽  
Leslie Briars

Pediatric patients are more susceptible to medication errors for a variety of reasons including physical and social differences and the necessity for patient-specific dosing. As such, community pharmacists may feel uncomfortable in verifying or dispensing a prescription for a pediatric patient. However, the use of a systematic approach to the pediatric prescription can provide confidence to pharmacists and minimize the possibility of a medication error. The objective of this article is to provide the community pharmacist with an overview of the potential areas of medication errors in a prescription for a pediatric patient. Additionally, the article guides the community pharmacist through a pediatric prescription, highlighting common areas of medication errors.

2020 ◽  
Vol 11 (4) ◽  
pp. 23
Author(s):  
Jennifer Mazan ◽  
Margaret Lett ◽  
Ana Quiñones-Boex

Background: Patient safety places emphasis on full disclosure, transparency, and a commitment to prevent future errors. Studies addressing the disclosure of medication errors in the profession of pharmacy are lacking. Objective: This study examined attitudes and behaviors of American pharmacists regarding medication errors and their disclosure to patients. Methods: A 4-page questionnaire was mailed to a nationwide random sample of 2,002 pharmacists. It included items to assess pharmacists’ knowledge of and experience with medication errors and their disclosure. The data was collected over three months and analyzed using IBM SPSS 22.0. The study received IRB exempt status. Results: The response rate was 12.6% (n = 252). The average pharmacist respondent was a 57-year old (+ 12.1 years), Caucasian (79.8%), male (59.9%), with a BS Pharmacy degree (73.8%), and licensed for 33 years (+ 12.8 years). Most respondents were employed in a hospital (26.4%) or community (31.0 %) setting and held staff (30.9%), manager (29.1%), or clinical staff (20.6%) positions.  Respondents reported having been involved in a medication error as a patient (31.0%) or a pharmacist (95.5%). The data suggest that full disclosure is not being achieved by pharmacists. Significant differences in some attitudes and behaviors were uncovered when community pharmacists were compared to their hospital counterparts.  Conclusion: There is room for improvement regarding proper medication error disclosure by pharmacists.


Author(s):  
Nazri Nordin ◽  
Mohamed Azmi Ahmad Hassali ◽  
Azmi Sarriff

Objective:  To investigate perspectives and expectations of stakeholders of community pharmacists’ (CPs) roles and the use of STARZ-DRP as a structured and systematic framework to help CPs to extend their role to make an accurate triage decision in community pharmacy settings.Methods: Individuals who were in high positions in the Ministry of Health (MOH), pharmacy, medical and consumer associations and individuals who were a private medical practitioner and retail pharmacist were invited via mail to participate in the face to face interview. The interviews were audio-taped and transcribed verbatim to identify themes as many as possible.Results: Eight stakeholders had responded to the invitation. Mean (± standard deviation) age (years) of stakeholders was 56.50 ± 11.82. Five themes were noted which were: (i) CPs are focusing more on business-oriented, (ii) CPs should perform patient-oriented services, (iii) responsibilities to triage customers, (iv) a systematic approach for triaging activities, (v) STARZ-DRP as a systematic approach to making triage decision.Conclusion: CPs are paying particular attention on business-oriented than patient-oriented services. All stakeholders point out that CPs should intensify their current practice and all of them have the same opinion that CPs should take the responsibilities to make an accurate triage decision for self-care customers. Almost all stakeholders agree that STARZ-DRP is an ideal framework to help CPs to make an accurate triage decision in community pharmacy settings. 


2010 ◽  
Vol 2 (3) ◽  
pp. 234 ◽  
Author(s):  
Linda Bryant ◽  
Gregor Coster ◽  
Ross McCormick

INTRODUCTION: Changes in delivery of health care services has led to pressure for community pharmacists to extend their traditional role and become more involved with patient-focussed services such as medication reviews, in collaboration with general practitioners (GPs). This has not been generally implemented into routine practice, and many barriers have been suggested that inhibit community pharmacists extending their role. These have often focussed on physical or functional barriers. This study explores possible attitudinal factors that prevent increased participation of community pharmacists in medication reviews undertaken in collaboration with GPs. METHODS: Twenty community pharmacist participants who participated in the General Practitioner– Pharmacist Collaboration (GPPC) study were interviewed. The GPPC study investigated the outcomes of community pharmacists undertaking a clinical medication review in collaboration with GPs, and the potential barriers. Semi-structured interviews were analysed using a general inductive thematic approach. FINDINGS: Emerging themes were that community pharmacists perceived that they were not mandated to undertake this role, it was not a legitimate role, particularly from the business perceptive, and pharmacists were concerned that they lacked the skills and confidence to provide this level of input. CONCLUSION: While there is concern that community pharmacists’ skills are underutilised, there are probable attitudinal barriers inhibiting pharmacists from increasing their role in clinical medication reviews. Perceived legitimacy of the service was a dominant theme, which appeared to be related to issues in the business model. Further investigation should consider the use of a clinical pharmacist working within a general practice independent of a community pharmacy. KEYWORDS: Community pharmacy services; drug utilization review; primary healthcare; health plan implementation


2018 ◽  
Vol 32 (5) ◽  
pp. 524-528 ◽  
Author(s):  
Mackenzie A. Dolan ◽  
Chelsea P. Renfro ◽  
Stefanie P. Ferreri ◽  
Betsy B. Shilliday ◽  
Timothy J. Ives ◽  
...  

Objective: To determine community pharmacist preferences in transition of care (TOC) communications. Methods: In this cross-sectional study, data were gathered via electronic survey of community pharmacists regarding their preferences for TOC communications. The survey was distributed via email by the North Carolina Board of Pharmacy. Results were analyzed using descriptive statistics. Results: Survey responses were received from 343 community pharmacists (response rate = 6.1%). Responders most commonly worked in an independent, single store (29.2%, n = 100) or national chain (29.2%, n = 100) pharmacy setting. Preferred method for a TOC communication was via electronic health record (63.0%, n = 184). Preferred TOC communication content are mentioned as follows: active (93.2%, n = 274) and discontinued (86.4%, n = 254) medications and reason for hospitalization (85.0%, n = 250). The top 3 self-identified barriers to utilizing a TOC communication: lack of care coordination with community pharmacy (35.0%, n = 14), lack of support from other health-care providers (22.5%, n = 9), and absence of compensation for providing the service (17.5%, n = 7). When asked if TOC communications were available, 97.5% (n = 278) indicated it would be useful. Conclusion: Community pharmacists acknowledged a need for TOC communications and shared their preferences in the content and method of communication. Future research is warranted to implement TOC communications between a health system and community pharmacy.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Khanbhai ◽  
S Manning ◽  
R Fordham ◽  
G Xydopoulos ◽  
C Grossi-Sampedro ◽  
...  

Abstract Background Atrial fibrillation (AF) is the most common sustained atrial arrhythmia. AF significantly affects patients' quality of life and increase morbidity and mortality. Patients with AF need to be appropriately anticoagulated to reduce the risk of stroke. Approximately every fifth stroke is due to AF and average costs for both health and social care is £44,000 over the first five years. Recent updated guidelines on the management of AF have recommended that all patients over the age of 65 be offered screening in the community using either short term ECG or manual pulse palpation. Purpose To determine the feasibility of an innovative community pharmacy led AF detection service incorporating referral for review and treatment to a specialist arrhythmia centre. Method Community pharmacists received intensive training on AF, how to record an ECG using a Kardia monitor and documenting the consultation on a referral form hosted on a national pharmacy database called PharmOutcomes. Targeted opportunistic detection was undertaken by the pharmacists for anyone over the age of 65 years with risk factors for AF. Patients were referred by the pharmacist to the specialist team via PharmOutcomes if they had possible new AF, previous AF and not anticoagulated, anticoagulated but experiencing side effects or adherence issues or a high AF symptom burden. Patients initated on anticoagulation by the specialist team were referred back to the community pharmacist via the New Medicines Service (NMS) for adherence monitoring. Results During a proof of concept phase (May to October 2016) and an upscale phase (May 2018-May 2019) 28 pharmacies were recruited and 1737 participants were enrolled in the study. 891 (51.3%) were male, 851 (41%) were aged over 75 years. 299 patients were referred by the pharmacists and 99 of these were seen by the specialist team in clinic. 28 patients (1.6%) were diagnosed with AF. 20 out of 28 (71.0%) were initiated on anticoagulation. 29 out of 146 patients (19.9%) had previous AF with either a high symptom burden (11) or a heart rate below 50 or above 100 beats per minutes (18). 7 patients (4.3%) with previous AF were started on anticoagulation. 48 out of 99 patients (48.4%) had their medication optimised. This included rate control titration and adjustment of anticoagulation doses. 31 out of 99 patients (31.3%) required further interventions such as holter monitors, echocardiograms or referral to other specialists. Conclusions The results demonstrate that the this service is a robust multidisciplinary process for the detection, protection and perfection of AF. The direct referral pathway ensures that patients are reviewed by a specialist team and receive optimal treatment and management. Referral back to the community pharmacist via the NMS enhances concordance with anticoagulation. Further analysis is being undertaken to assess the cost-effectiveness and health impact of this service. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): The Health Foundation; ASHN in collaboration with BMS Pfizer


2021 ◽  
Vol 11 (2) ◽  
pp. 113-122
Author(s):  
T.T. Muhammed Anwar ◽  
G.R. Rajalakshmi

Drugs are the prime member of any disease prevention plans and ailment treatment programmes. Pharmacists are the health professionals appointed by relevant authorities for safe and efficacious use of drugs, since they are the specially upskilled and trained personnel for controlling, organizing and distribution of medicines. Medicine alone does not provide desired treatment output. In order to achieve the optimal treatment goals pharmacist must provide enhanced drug related needs and ensure the services are of proper quality. This study aims to assess the Good Pharmacy Practice among community pharmacist, determine the frequency of ethical dilemma at community pharmacy settings and to assess the reasons why community pharmacists may compromise ethical values.It was a descriptive cross - sectional study carried out in different community pharmacies in Kozhikode district of Kerala. The study was executed in 6 months time period. The sample size was 115 community pharmacists working in Kozhikode district. Total of 120 subjects were enrolled and data were collected using a validated self-administered questionnaire. The result shows that most of the pharmacists were providing quality services to the patients and they are facing various ethical dilemma situations in their day today life. They were facing ethical dilemma situation at least once in three months. Community pharmacists compromise on ethical values and ethical issues mainly for protecting their job. The physicians request and employer’s invasion into their activities has a great role in ethical dilemma situations and thus violating the rules. Keywords: GPP, community pharmacy, ethical dilemma, pharmacy services.


2019 ◽  
Vol 10 (2) ◽  
pp. 18 ◽  
Author(s):  
Scott J Alexander ◽  
Natalie A DiPietro Mager

Background: Community-clinical linkages have been promoted as a means to improve population health.  The community pharmacy is an ideal location for these partnerships to occur due to the expertise of the community pharmacist. While the need for these partnerships exists, there are limited data regarding community pharmacists’ current participation in such programs. Objective: The purpose of this analysis was to assess Ohio community pharmacists’ involvement and interest in community-clinical linkages.  Methods: An electronic survey tool containing 26 questions was developed to assess Ohio community pharmacists’ participation in community-clinical linkages and interest to develop such partnerships. The tool was sent via email to a random sample of 500 pharmacists registered in Ohio and practicing in a community setting.  Chi-square or Fisher exact nonparametric statistical tests were used as appropriate to identify whether there were any significant differences in current partnership or interest to partner with a prescriber who refers patients to their community pharmacy based on education (Bachelor of Science or Doctor of Pharmacy degree) or pharmacy location (urban, suburban, or rural).  Results: Nine emails were undeliverable, leaving a sample of 491 pharmacists.  Ninety-three (19%) responded to the survey.  Sixteen respondents (17%) indicated that they currently partner with a prescriber who refers patients to their pharmacy for assistance with medications or chronic disease state management; this practice was more often reported in urban settings (p=0.022).  Of those not currently participating in such a partnership, 53 (57%) were interested in developing one.  Thirty-two respondents (34%) reported providing referrals for at least 1 type of screening or counseling service.  For some types of services, pharmacists reported that they provide the service in the pharmacy and/or were interested to develop the service in the pharmacy rather than provide a referral.  However, for any given service there were a number of pharmacists who expressed interest in providing referrals although they were not currently doing so. Conclusion: This sample of Ohio community pharmacists reported limited participation in community-clinical linkages but interest to develop them.  Further studies should explore the pharmacists’ role and impact in such programs.   Article Type: Original Research


2015 ◽  
Vol 18 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Abdur Rakib ◽  
Md Shahid Sarwar ◽  
Shaheda Zannah ◽  
Sayema Khanum ◽  
Mamunur Rashid

Community pharmacists play a vital role in improving medication safety and better healthcare facility to the community. Unfortunately, the field of community pharmacy in Bangladesh is still to be developed and there is scarcity of data regarding current role of community pharmacists in Bangladesh. The present study was conducted to find out the role of community pharmacists in Bangladesh. For the study purpose, we visited 42 retail pharmacies in Banani, Khilkhet and Uttra areas of Dhaka city and interviewed the community pharmacists working there. We found that there were total 50 community pharmacists in 42 retail pharmacy and also observed that most of the pharmacists (64%) worked alone. Interestingly, we didn’t find a single A-grade pharmacist working as community pharmacist. B-grade pharmacists who completed a 3 year diploma in pharmacy were only 4 in number and 92% of them were C-grade pharmacists with 3-4 months training. The average age of the participants was 29.6 ± 1.2 years. The average length of service for the community pharmacists was 7.6 ± 1.3 years. The top issues that patients consulted with the pharmacists were on medication use (76%), which physician they should visit (54%) and therapy (26%). There was not a significant effect of work experience of community pharmacists on their attitudes toward community-based clinical services. In this study, we observed that 95% community pharmacies provide blood pressure measurement facility, 90% provide diabetes screening, 76% provide dressing services, and only 47% provide nebulization. No community pharmacist was found to be involved with adverse drug reaction reporting. In conclusion, we recommend that the government and the pharmacy regulatory authority should take sufficient initiatives to develop the community pharmacy sector in Bangladesh for the welfare of mankind.Bangladesh Pharmaceutical Journal 18(2): 137-141, 2015


Author(s):  
Lina Mohammad Naseralallah ◽  
Tarteel Ali Hussain ◽  
Shane Pawluk ◽  
Myriam Eljaam

Background: Medication errors are avoidable events that could occur at any stage of the medication use process. They are widespread in the healthcare system and are associated with increased risk of morbidity and mortality. Implementing a clinical pharmacist is one strategy that is believed to reduce medication errors in the general population including pediatric patients who are more vulnerable to medication errors due to several contributing factors including the challenges of weight-based dosing. Aim: The aim of this study is to qualitatively and quantitatively evaluate the impact of clinical pharmacist interventions on medication error rates for hospitalized pediatric patients. Methodology: PubMed, Embase, Cochrane and Google Scholar search engines were searched from database inception to February 2019. Study selection, data extraction and quality assessment was conducted by two independent reviewers. Observational and interventional studies were included. Data extraction was done manually and the Crowe Critical Appraisal Tool (CCAT) was used to critically appraise eligible articles. Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Results: A total of 19 studies were systematically reviewed and 6 studies (29 291 patients) were included in the meta-analysis. Pharmacist interventions involved delivering educational sessions, reviewing prescriptions, attending rounds and implementing a unit-based clinical pharmacist. The systematic review showed that the most common trigger for pharmacist interventions was inappropriate dosing. Pharmacist involvement was associated with significant reductions in the overall rate of medication errors occurrence (OR, 0.27; 95% CI, 0.15 to 0.49). Conclusion: The most common cause for pharmacist interventions in pediatric patients at hospital settings was inappropriate dosing. Overall, pharmacist interventions are effective at reducing medication error rates.


2020 ◽  
Author(s):  
Bintang Marsondang Rambe

Latar Belakang Keselamatan pasien (patient safety) rumah sakit adalah suatu sistem dimana rumah sakit membuat asuhan pasien lebih aman yang meliputi assessment risiko, identifikasi dan pengelolaan hal yang berhubungan dengan risiko pasien, pelaporan dan analisis insiden, kemampuan belajar dari insiden dan tindak lanjutnya serta implementasi solusi untuk meminimalkan timbulnya risiko dan mencegah terjadinya cedera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil yang dilakukan oleh perawat (Kemenkes, 2011).Salah satu kesalahan yang dapat merugikan pasien adalah medication error. Menurut WHO (2016) medication error adalah setiap kejadian yang dapat dicegah yang menyebabkan penggunaan obat yang tidak tepat yang menyebabkan bahaya kepasien, dimana obat berada dalam kendali profesional perawatan kesehatan. proses terjadi medication error dimulai dari tahap prescribing, transcribing, dispensing,dan administration. Kesalahan peresepan (prescribing error), kesalahan penerjemahan resep (transcribing erorr), kesalahan menyiapkan dan meracik obat (dispensing erorr), dan kesalahan penyerahan obat kepada pasien (administration error). Medication error yang paling sering terjadi adalah pada fase administration / pemberian obat yang dilakukan oleh perawat.Administration error terjadi ketika pemberian obat kepada pasien tidak sesuai dengan prinsip enam benar yaitu benar obat, benar pasien, benar dosis, benar rute pemberian, benar waktu pemberian dan benar pendokumentasian. Secara global, kesalahan pemberian obat (medication errors) sampai saat ini masih menjadi isu keselamatan pasien dan kualitas pelayanan di beberapa rumah sakit (Depkes RI, 2015; AHRQ, 2015). Perawat sebagai bagian terbesar dari tenaga kesehatan di rumah sakit, mempunyai peranan dalam kejadian medication error. Perawat berkontribusi karena perawat banyak berperan dalam proses pemberian obat. Pemberian obat/ Medication Administration adalah salah satu intervensi keperawatan yang paling banyak dilakukan, dengan sekitar 5- 20% waktu perawat dialokasikan untuk kegiatan ini (Härkänen et al.,, 2019). Pemberian obat juga mencakup tugas-tugas lain, seperti menyiapkan dan memeriksa obat obatan, memantau efek obat-obatan, mengedukasi pasien tentang pengobatan, dan memperdalam pengetahuan perawat tentang obat – obatan sendiri (DrachZahavy et al., 2014 dalam Yulianti et al., 2019)Berdasarkan isu tersebut, penulis tertarik untuk melakukan literature review terkait faktor perawat dalam pelaksanakan keselamatan pasien terhadap kejadian medication administration error di Rumah Sakit.


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