Drug formulary development &. Evidence based pharmacy practice ppt School of pharmacy. Introduction ix Part I. Learning Outcomes. Pharmacy Practice Definition The applications of knowledge and skills of pharmacists, and the infrastructure of pharmacy, to meeting the health needs of the population. objectives. scott knoer, m.s., pharm.d. Clinical pharmacy: evidence-based practice information sources. S. I programme ppt. 5 1.4 The pharmacy profession 5 1.5 New dimensions of pharmacy practice 7 1.5.1 Pharmaceutical care 7 1.5.2 Evidence-based pharmacy 8 by jamie al-nasir, school of pharmacy, kingston, Academy of Pharmacy Practice and Management- Nuclear Pharmacy Practice Section APPM-NPPS - Sponsor. Good pharmacy practice. practice of pharmacy is ethically inconsistent with good business. Quality Management Hasmik Abrahamyan Ph.D. in Pharmacy - Yerevan, 04.11.2012. good. Turboprops . Related Journals of Pharmacy Practice . Scope of pharmacy ppt Deepak Sarangi. Introduction to pharmacy practice. Pharmacy Practice - . Identify reasons for establishing home care services & growth of home care industry Cite 7 goals of home care therapy Identify members & roles of home care team, Introduction to Pharmacy Practice Chapter 5: Home Care Pharmacy Practice, Learning Outcomes • Identify reasons for establishing home care services & growth of home care industry • Cite 7 goals of home care therapy • Identify members & roles of home care team • Identify conditions treated with home care services • Identify top drugs used in home infusion therapy • List 1-2 parameters for these drugs in home care, Learning Outcomes • Compare infusion systems for use in patient’s home • List labeling requirements for sterile products in home care • Outline important factors for determining expiration dates for sterile products used in home care setting, Key Terms • Case manager • Elastomeric balloon system • Extravasation • Intake coordinator • Patient controlled analgesia (PCA) • Patient service representative • Peripherally inserted central catheter (PICC) • Rate restricted IV administration set systems • Smart pumps • Universal precautions, Historical Overview • First home therapy in 1970s • less expensive & less hardship for patient • Currently estimated $9 - $11 billion dollars per year • Serviced by 700 to 1,000 infusion pharmacies • Home infusion • safe & effective • less expensive • pumps are portable, small, easily programmable • avoid nosocomial infections, Home Infusion Services • Provided by • hospitals, community pharmacies, home health nursing companies, integrated health care systems, and independent home infusion companies • Technician roles • preparation of parenteral products • inventory maintenance & control • creating & maintaining patient supply inventory • making deliveries to patients’ homes, The Home Care Process • Entering home care process • physician recommendation • patient, patient’s family advocate home therapy • patient’s insurance company may dictate • case manager will mediate location of therapy • hospital may also initiate process, Intake coordinator • Retrieves patient’s pertinent information • Nurse or technician specially trained for job • Technician involved in preparing drugs • Registered nurse makes initial patient visit, Steps in Home Care Services • Initial referral process usually takes 24 to 48 hours • Members of team must be available to patient 24/7 • Care plan • home care team monitors patient’s therapy • watch for complications of therapy • signs that therapy is effective • visit or contact patients on regular basis • supplies & drugs are prepared &delivered weekly • patient discharged from home care service as appropriate, Home Care Team • Physician • Nurses • Pharmacists • Pharmacy technicians • Registered dietitians • Respiratory therapists • Social workers • Physical & occupational therapists • Certified nursing assistants, Physician • Leader of the team • Major changes in therapy need physician’s approval • Signs “Certificate of Medical Necessity & Plan of Treatment” • Physician drug orders (prescriptions) • via phone as in community pharmacy setting. Pharmacy Practice Residency - . AMA Citation Introduction to CNS Pharmacology. what we as pharmacist believe our profession to be determines what it is wendell t.hill,jr.. Introduction to Pharmacy Practice - . Pharmacy: An Introduction to the Profession is an ideal resource for orientation or introduction to pharmacy courses on both the professional and the preprofessional level. Introduction to Pharmacy - . Learning Outcomes. prepared by nehad jaser ahmed. Introduction to pharmacy practice. Describe differences between centralized & decentralized pharmacies List at least 2 types of services provided by hospital pharmacy departments Slideshow 1278186 by niveditha describe differences, Introduction to Pharmacy Practice - . chapter, Pharmacy Practice Model Initiative (PPMI) - . chief. Practical Methods for Pharmacy Practice Research - . Presentation Summary : By passing a national examination that evaluates the technicians knowledge and skills needed to perform the work of a pharmacy technician. compare & contrast. Introduction to the Pharmacy Profession is an independent publication and has not been authorized, sponsored, ... Research, clinical practice, and government regulations often change the accepted standard in this field. 陳立佳 dr. li-chia chen drug usage and pharmacy practice research group, Phar 722 Pharmacy Practice III - . • Two primary methods • automation • manual • Automated Medication Dispensing Cabinets • Technicians play a key role • Maintain appropriate inventory-frequent adjustments, Manual Cart-Fill Process • Requires use of medication carts or cassettes • medication drawers labeled with patient names • fill-list report is generated • for specific time period–medications scheduled to be given will print • technician will fill each patient’s drawer from fill-list • pharmacist will check the carts for accuracy • tech-check-tech process in some states • technician exchanges cassettes in patient care areas, Emergency Crash Carts • Carts or trays with medications used in emergencies • defined list of medications • Carts/trays are filled by techs & checked by pharmacist • locked and sealed • delivered to designated patient care area, Clinical Services • Pharmacists provide patient-focused services • pharmacokinetic dosing • infectious disease consultations • drug information • nutritional support services • Pharmaceutical care • Pharmacist is advocate for patient • Patient is involved in decision-making process for care, Role of the Technician • Pharmaceutical care model allows for new roles for technician • use of technicians to record laboratory results • screening orders for non-formulary status • identifying orders on the hospital’s restricted list • review & collect missing information for patient • allergies • height • weight, Investigational Drug Services • Clinical trials evaluate efficacy/safety of medications • Study protocol is developed, reviewed, approved by Institutional Review Board (IRB) • Protocol is operating manual for clinical trial • Specific requirements /procedures must be followed, Clinical Trials • Following protocol accurately important • Patient randomized to receive study drug or placebo • Results & recordkeeping may be audited by FDA • Investigational medications must be • stored in a separate section of the pharmacy • limited access, Medication Management • Entire medication process involved • Selection & procurement of drugs • Storage • Prescribing • Preparation & dispensing • Administration • Monitoring effects • Evaluation of entire system, Selection & Procurement • Pharmacy & Therapeutics (P&T) Committee establishes hospital formulary basedon: • indications for use • effectiveness • drug interactions • potential for errors and abuse • adverse effects • cost, Formularies • Closed formulary means choice of drugs limited • Drugs are admitted to formulary by process • physician requests to add a drug to formulary • pharmacists anticipates need • drug monograph is written (by pharmacy) • P&T Committee uses information in monograph to decide whether to add drug to formulary • drugs removed from formulary • when better drugs become available • when purchasing trends show drug longer being used, Formulary & Non-Formulary • Pharmacy technicians key role in procurement • Specific procurement process • Pharmacist may suggest formulary medication to replace non-formulary medication • Pharmacy has procedures to allow for temporary use of non-formulary drug, Storage • Proper storage of medications is critical • temperature • light sensitivity • All medications in hospital are inspected monthly • inspections primarily performed by technicians • referred to as unit inspections, Storage of Controlled Drugs • Specific storage & documentation requirements • Requirements are stringent • based on abuse & diversion potential • Must comply with all legal & regulatory requirements • Technicians need to be trained & knowledgeable about these requirements, Prescribing • Policies & procedures for prescribing medications • Verbal orders are not recommended • Procedures for verbal orders to minimize errors • Helpful if indication is on medication order • Prescribers can enter order electronically or write out • Pharmacists must review medication orders, MAR • Medication order information appears on MAR • MAR=Medication Administration Record • Used by nursing to administer meds • Pharmacist must review all orders before medication administered unless emergency situation • Some hospitals outsource this function to remote sites, Preparation & Dispensing • Unit-ready-to-use form should be provided to nurse • Pharmacy should dispense patient specific unit dose packages to nursing units because: • reduction in incidence of medication errors • decrease in total cost of medication-related activities • more efficient use of pharmacy & nursing personnel • improvement in overall drug control and drug use • more accurate patient billing for drugs, IV Medications • Some IV medications available in unit dose form • Some meds not stable in solution • must be mixed by pharmacy just prior to administration • Technicians: main preparers of IV medications • Prep requires knowledge/skill of aseptic techniques, Extemporaneous Prep • Doses based on patient-specific characteristics • Pediatric patients • require very small doses • unique doses not commercially available • special dilutions made for IV solutions • Extemporaneous oral solutions/suspensions • compounded if patients unable to swallow tablet • crush tablets-follow recipe for solution or suspension, Final Prep Steps • Proper labeling • patient’s name • patient’s location in hospital • medication name • dose • route of administration • expiration date • special directions • bar-codes, Administration • Procedures to ensure timely administration of meds • Procedures to check 5 rights • right medication • right dose • right patient • right time • right route • Some hospitals add 6th right of documentation, Bar Code Systems • Computer systems linked so that • Nurse scans the patient’s wrist band & med bar code • Confirms 6 rights: • Right Patient • Right Drug • Right Dose • Right Time • Right Route • Right Documentation-added on to original 5 rights because without documentation, dose may be given more than once in error, Monitoring • Monitoring effects of medications mandatory • adverse effects • positive outcomes • important component in process • Monitoring uses patient information • laboratory results • patient’s clinical response • medication profile (anti-allergic or antidote orders ) • Technicians may gather info for pharmacists, Evaluating Medication Process • Tracking & identifying trends • adverse drug events • medication errors • performing medication-use evaluation (MUE) • MUE is commonly performed for • high-use drugs • high-cost drugs • high-risk drugs, MUE Process • Data is collected for evaluation of • appropriate use • indications, dose, route, clinical response • Data is tabulated & presented to • appropriate health care providers • hospital committees. 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