Clinical Pharmacy Practice PDF

INTEGRATED PRACTICE INTEGRATED PRACTICE IV-A IV-A -- CLINICAL CLINICAL PHARMACY PHARMACY PRACTICE PRACTICE...

INTEGRATED PRACTICE INTEGRATED PRACTICE IV-A IV-A -- CLINICAL CLINICAL PHARMACY PHARMACY PRACTICE PRACTICE THEME: 1 - PATIENT RECORD ANALYSIS THEME: 1 - PATIENT RECORD ANALYSIS Introduction Introduction Use of Use of Medical Medical Record: Record: e Terms Terms medical medical record, record, health health record record andand medical medical chart chart are used ¢ To are used To document document the the course course patient’s patient’s illness illness and and treatment. treatment. interchangeably to describe systematic documentation of a interchangeably to describe systematic documentation of a e Communicate between attending doctors and other Communicate between attending doctors and other health health care care single patient’s medical history and care across time within one _ professionals single patient’s medical history and care across time within one professionals providing providing care care toto patient. patient. particular particular healthcare providers jurisdiction. healthcare providers jurisdiction. e Legal Legal matters matters and and court cases ° Insurance court cases Insurance cases. cases. e AA medical medical record record (MR)(MR) is is clear clear concise concise and and accurate accurate history history ofof e Helps Helps inin collection collection of of health health statistics statistics patient’s life patient’s life and and illness illness written written from from health health and and medical point Teaching medical point Teaching for for undergraduates undergraduates and and postgraduates. postgraduates. of view. of view. Components: Components: e The The story story of of patient’s patient’s illness illness narrated narrated by by the patient, e ER the patient, papers ER papers e Physician orders Physician orders e Administration Forms Administration Forms observations observations made made by by the the nurses, nurses, and and comments comments and treatment ¢ Dietician and treatment Note Critical values Dietician Note e Critical values History/physical exam e History/physica l exam given by given the doctors by the doctors are are recorded recorded in in the the medical medical record. record. e Nurse Nurse Notes Lab Notes Lab reports reports e Physician/ Physician/ Definition: Medical Definition: Medical recordrecord -- chronological chronological writtenwritten account account of of , Consent Consent e Cardiology Cardiology reports reports Multidisciplinary Multidisciplinary patient’s patient’s examination examination and and treatment treatment that that includes patient’s. OR records includes patient’s © Radiology report progress Notes OR records Radiology report progress Notes medical history, medical history, complaints, complaints, physician’s physician’s physical physical findings, findings, results results ° ICU ICU flow flow sheet sheet e MOAR MOAR of diagnostic of diagnostic teststests & & procedure, procedure, and and details details of of medications medications and and Review by Review by Clinical Clinical Pharmacist: Pharmacist: (essential (essential therapeutic procedures. therapeutic procedures. It It includes includes aa variety variety of of types types of of notes notes 1. ER papers 2. Physician orders 3. ICU 1. ER papers 2. Physician orders 3. ICU daily daily progress sheet progress sheet entered over entered over time time by by health health care care professionals, recording professionals, recording 4. 4. History History 5.MOAR 5. MOAR 6. 6. LABS LABS observations and observations and administration administration of of drug drug and and therapies, therapies, orderorder for for * Besides these *Besides these other other parts are also parts are also important important but but do do not not require require administration of, administration of, test test results, results, radiology radiology reports, reports, etc. etc. regular review regular review by by thethe pharmacists. pharmacists. ~DOCUMENTS DOCUMENTS IN IN PATIENT PATIENT FILE FILE AT AT Shifa Shifa International: International: 21-84- 15-96 Patients Name: — ee r >) Shifa International PEDIATRICS PRIORITY/ TRIAGE DOCUMENT Cie i = Pee a. Resy [we [Date 0-10 Numeric Pain Seale ee Ar EMERGENCY DEPARTMENT we } } Daan Time Physician Location ©OOOHO® iat 2345678 910 Proc Tie 16 00 _¢: vue OF 08/2008 = a - Ao SE ee ee opi errs Ops Ops Ops Faas sae eae eee ees are ae ~a —— - Head & Neck: S a ba [SHIFA ISOLATION EMERGENCY SEVERITY _ — eens & | SCREENING TOOL (sIST) INDEX (ESD) |E carensie neces enzo tars oving [Patient >) ‘a | aes ro | Heart: ii cine = of breath ea ‘a ee H e "t wait’ A SHOE Eee S fe : 3 : = 5 If yes to any one of above then ASK. sant 5 Any history of travel, If yes then No = fRos. um 8 where 3 = A. hewn bee Any animal exposure/ contact TE TI PA z yy omer ames fyiWwe | coma am D2 =AR Deer aon Aa: ‘one of Le oe cant tanto Dect the positive please E ay for isolation decision © | Family Hinory D Isola nsider = 5 ; 5 O Don't Isolate i ® Es — Le ns Leen Sign of Senior Doctor un = D ee [___Sianature Of Ancoding Physician: sn 1D 28 07-2022 W-008, RIEV.02, Paye 1 of 4 Shite Iterations Hospital slamabed ISTORY A PIEYSICAL EXAMINATION, a RO aaa sa ic sian E>) Shifa Intemational Hospitals Ltd, >) = a , aaa HOME/ PAST MEDICATION HISTORY PROGRESS AND MULTIDISCIPLINARY RECORDING & RECONCILIATION FORM Date: _ Time Primary Physician: —————————— Dete & Time Physician and Mullldisciptinary Record Doctor (Name /Sign):_ csc caitaaac Drug Allergies| _51 NKDA — No home’past medication history © Unable to take medication history (give reason) De | Physician's Orders [== ——— Ss = — TS Dose | Frequency perday | Roote o~ ihren endl epTapia: ~ 1 - Medication Name (Brand / Generic Name) CRITICAL VALUE REPORTING FORM (Lab, Radiology, Cardiology, Neurophysiology and others) — a 2 lo [me [wee [tome | gaat= emiiety aa a | et] tm | ee | zs 2: | | — : 4 E lz eae eye gs 13 Medication Reconciliation Medication Reconciliation 7 IF The process The process of of identifying identifying most most accurate accurate listlist ofOf ——rrermcst comments 4 medicines is medicines is termed termed as as medication medication reconciliation. reconciliation. ~~ — _ 8.. “deg. SO = 3 The process The process ofof medication medication reconciliation reconciliation is is usually usually © —— |.. = sa 53 performed as performed as soon soon as as possible, possible, after after hospital hospital 3 admission. Usually admission. Usually thisthis task task can can bebe performed performed by by = ° "==" nes oon__ : any healthcare any healthcare professional professional including including Doctors, Doctors, (oo esos i Note: If duty doctor is not responding call the consultant directly. proses necot eniipana Nurses and Nurses and Pharmacists, Pharmacists, within within 24hrs 24hrs ofof admission.  ‘ a r MR: 345372 HEIGHT S Shifa International Hospitals Ld, | Patient Name: NASEER AHMED BHATTI ( Male ) 155 SICU DAILY PROGRESS NOTE Location: C2 WING-1 Room :01 Bed 01 ee Dav a = ee Sree (ik } pase aE AdmittedBy: Dr. Aayesha Qadeer 15 Icu Daya rope _ he tee i Repon'compied@: PHARMACLNCO1 AVITAL: BP, _mmiie WR: bem Temas We Jnta_ O2Sat:__%, On: nRe LABGs: PH Por Pods HCOds_ BE 3. Vent, Setting: Vts__ tts, reer Trg, == Allergies_ - 1V Plaids Nuteith Transfust Indwelling Catheters & Day From: 29/01/2023 To: 08/03/2023 NKDA ae |! ! na oad 2 2 2 3 ee _| Medicine Orders Count _ _ [iorrores Day | CXR: Se Medicine Genenc Route Dosage freq Order By Stat Date WilSiop@ Ord | Adm SIS 5. ECHO: 1 ECASL INFUSION GIOMG UNEZOUD INTRAVENOUS | 600MG 12Hourly De Zara Shera caoyenz3i2s7 | owes T| —————— CTIMRUAngia: 2 GAVSCON UQUD 120M SODAIGINATE-SODBICARB PERORAL TOML 8Hourly 1 a 7) 8 € _ ! | il Rashid i g — ve 3 SOWNO 5-MG/2ML (PRATROPUM-BROMIDE FORNEBUUZATION | 2ML 6 Hourly Or. Zara Sheraz 08/01/2023 1258 TAay2023 2 9 ‘2 ANTIBIOTICS/ MEDICINE (DAYS) DRAINS! OUTPUT ‘ MGM OF SOON ammainees ppeaemeemeall less Shout eee. pacts cas ; | ° ze fi ; $ GLENNA 2.1003 SUSPENSION FD BECLOMETHASONE-DIPROPIONATE —- FORNEBUUZATION | 800MCG 8Hourty Dr. Zara Sheraz owayens i300 | Wevezt | = 4 ~ | = [Sa 2 6 —POLYFAXSKIN O®VTMENT20-G POLYMYXIN-B+BACITRACIN LOCAL 2G 6 Hourly. 1vey2023 T | 20 5 Pp 3 APPLICATION | | 3 4 a 4 7 -MERONEM INJECTION 1G (MEROPENEM INTRAVENOUS 1000 MG BHourty Or. Sana Rasheed ovovzozs iia =| 12/03/2023 } 6 | @ am Fs -—_§—_}———— 8 DIFWUCAN CAPSULE 200-MG FWCONATOLE PER ORAL 200MG Once a Day Dy.Sana Rasheed oreveies ewes | a | 1 Intake; mi, | Outpat: ml. | SYSTEMIC EXAMINATION at shea deine FERORAL 10M Stony DeMageca Nar : | anes ik | bs | 5s Bowel Movernent CNS/ GCs: 1 PELION-V (00'S) TABLET 10-MG DOMPERIDONE MALEATE PER ORAL 10MG B Hourly Dr. Maqadus Alam: 09/03/2023, 1 | 3 Feed om ——— 7 Tr ENBCLORMW MO} BENZ SQUISH and SPIT | 10ML BHourly D.Maqadus Alam ; 2 | @ Blood Sugar 7 rr RESIAT pRSW it) (ORAL DROPS NYSTATIN ~~ PERORAL ss 2ML~ BHoury DelamabMaeenWs ——~S~*~«SMDIDOTTINSSSCN0NIOZI 1 | 3 | ‘Anal we _ RESESP: _ ee ms 13) RUUNG INJECTION 40-MG OMEPRAIOLE INTRAVENOUS 40MG Once a Day Rashid eS 7 3 4 é | 2 sedation gee ae ica = _}2 4 HvptRtonic saune (x) nee SODUM-CHLORIDE INHALE 3ML 6 Hourly (PRN) Or. Zara Shera ceovenes i238 tavaaos | ST Head End > 30° ABDOMEN: co SOLUTION 100-MiL GiPeptyins | — Availability Availability and and Cost Cost in better in better management management of of their their patients. patients. -»~What What dosage dosage forms forms of of Imitrex Imitrex are are available available in in pharmacy? pharmacy? H e Education Education of of public public in in areas areas of of poisoning poisoning preventionprevention & & first first aid. aid#- - Is Is Zoloft Zoloft available available as as liquid? liquid? What What size size & & conc.? conc.? um e Education Education of of health health care care professionals professionals in in the the areas areas of of clinical clinical -- What Whatare the prices are the prices of of Adalat Adalat CC CC andand Procardia Procardia XL? XL? toxicology, poisoning toxicology, epidemiology, poisoning poisoning epidemiology, poisoning prevention, prevention, > Storage and Stability Storage and Stability toxicological diagnosis, toxicological diagnosis, and and care. care. -- Should Should/Lovenox Lovenox be be stored stored in in the the refrigerator? refrigerator? e Develop ay Develop effective telecommunications and information effective telecommunications and information -- How longus flu shot stable after it is How long is flu shot stable after it is drawn drawn up up in in syringe? syringe? technology systems technology systems to to deliver deliver dependabledependable treatment treatment > Calculations Calculations= - How How many many milliliters milliliters are are in in an an ounce? ounce? recommendations. recommendations. > Preparation Preparation - How How. shouldshould ampicillin ampicillin be be reconstituted? reconstituted? un ROLE OF ROLE OF PHARMACIST PHARMACIST > Pharmacy Pharmacy Law Law /How - How many many times times can can aa prescription be prescription be e ToTo stimulate stimulate the the effective effective use use ofof drug drug information information resources resources by by __ transferred from one store to another? transferred from one store to another? pharmacist, physicians pharmacist, physicians and and other other healthcare healthcare professionals professionals » Miscellaneous Miscellaneous ; e ToTo educate educate pharmacy pharmacy students/residents students/residents to to serve serve as as effective effective - Where can I find the phone - Where can I find the phone number for Sanofi Aventis? number for Sanofi Aventis? providers of providers of drug drug information information -- Where Where can can II find find the the Vaccine Vaccine Information Information Sheet Sheet forfor the the © ToTo provide provide an an organized organized database database of of specialized specialized information information on influenza on ifluenza vaccine? vaccine? drug therapeutics to meet the drug information needs of drug therapeutics to meet the drug information needs of DOCUMENTATION DOCUMENTATION practitioners practitioners 1. Date 1. Date and and time time received. received. e ToTo expand expand the the role role of of the the pharmacist pharmacist in in providing providing drug drug 2. 2. Requester’s Requester’s health name, address, discipli address, name, contact, tient,contact, and category (e.g., public)and category (e.g., information services information services to to the the hospitalhospital and and community community ealth health care care discipline, discipline, patient, patient, public). public). To :. 3. Person 3. Person assessing assessing medication medication information information needs. needs. T promote te patient patient care through through rational drug rational drug th therapy through through. i. eee ee ee ee Dy NOUS" 4. 4. Method Method of of delivery delivery (e.g. (e.g. telephone, telephone, personal personal visit, mail) visit, mail) improved availability improved availability and and use use of of drug drug information information 5. Classification of t 5. Classification of requests. OTHER FUNCTIONS: OTHER FUNCTIONS: 5 6 oa ~ shed Fequesis. 6. Question asked. e Recommendation Recommendation to to Pharmacy Pharmacy & & Therapeutic Therapeutic committee committee 7 MUESTION ASCO.... 7. Patient-specific 7. Patient-specific information information obtained. obtained. e Development Development of of Drug Drug use use policiespolicies 8. Response 8. Response provided. provided e Formulary Formulary considerations considerations 9. References 9. References used. used. , e Coordination Coordination of of reporting reporting programs programs (ADR (ADR Program)Program) 10. Date and time 10. Date and time answered. answered. e Drug Drug Use Review (DUE)/Evaluation Use Review (DUE)/Evaluation 11. Person 11. Person responding responding to to request. request. e Investigational Investigational Drug Program Drug Program 12. Estimated 12. Estimated time time in in preparation preparation and and for for communication. communication. e Education Education and and Training Training (in-service (in-service programs, programs, students)students) 13. Materials 13. Materials sent sent to to requester. requester. e Publications Publications (Newsletter, (Newsletter, Bulletins, Bulletins, Journal, Journal, Column)Column) 14. Outcome 14. Outcome measures measures suggested suggested (e.g., (e.g., impact impact on on patient) patient) e Community Community Services Services (Information, (Information, Education)  THEME 4 4 -- Basic THEME Basic Life Life Support Support (BLS) (BLS) Learning Outcomes: Learning Outcomes: 3. SHOUT 3. SHOUT FOR FOR HELP HELP ◘ a Describe Describe the the concept concept of of Basic Basic Life Life Support Support Tell: “Patient Tell: “Patient jiski umar takreeban jiski umar takreeban itni, itni, wo wo gir gir paray paray hain. hain. Jaldi Jaldi ◘ o Explain Cardio-Pulmonary Resuscitation (CPR) Explain Cardio-Pulmonary Resuscitation (CPR) aain aur aty wy defibrillator ly k aain” aain aur aty wy defibrillator ly k aain” ◘ Illustrate Illustrate thethe features features of of Quality Quality CPR CPR 4. OPEN 4. OPEN AIRWAY AIRWAY BY BY NECKNECK EXTENSION EXTENSION ◘ o Categorize Categorize pts. on age pts. on age basis basis to to differentiate differentiate pattern pattern of of cycles. cycles. Head tilt, Head tilt, chin lift —– clear chin lift clear of of vomit, vomit, blood blood etc. etc. Can Can also also check check ◘ a Evaluate Evaluate the the patient patient for for the the suitability suitability of of receiving recetving BLS BLS support support mouth mouth visibly visibly in in child. child. Remove Remove anything anything that that blocks airway. blocks airway. ◘ o Execute Execute stepssteps ofof CPR CPR & & retrieve retrieve aa patient patient fromfrom cardiac cardiac arrest. 5. CHECK arrest. 5. CHECK BREATHING BREATHING Bystander Effect: Bystander Effect: “An“An unfortunate unfortunate aspect aspect of of our our society” society” ◘ a Look, Look, listenlisten andand feelfeel forfor normal breathing ◘ normal breathing a Not Not >10seconds. >10seconds. The essence of BLS is to solve bystander effect through The essence of BLS is to solve bystander effect through ◘ a Place 2 fingers to check pulse of carotid artery. Place 2 fingers to check pulse of carotid artery. instinctive responses instinctive responses to to save save a a life. life. ◘ a Do Do notnot confuse confuse agonal breathing with agonal breathing with normal normal breathing breathing in in BLS Basic BLS Basic life life support support includes includes recognition recognition of of signs signs ofof which patient which patient gasps gasps for for air, air, mostly mostly nearnear toto death death because because no no O2O2 sudden cardiac sudden cardiac arrest, arrest, heart heart attack, attack, stroke, stroke, and and foreign foreign body to brain. body to brain. airway obstruction, airway obstruction, and and performance performance of of Cardio-Pulmonary Cardio-Pulmonary 6. CALL 6. CALL 1122 1122 —– telltell detailed detailed demographics demographics Resuscitation (CPR) Resuscitation (CPR) and and defibrillation defibrillation with with an an AED AED automated automated external external defibrillator” defibrillator” 7. 30 7. 30 CHEST COMPRESSION -—– push CHEST COMPRESSION push hard hard and and push fast push fast ◘ a Place the heel of one hand in the centre of the chest Place the heel of one hand in the centre of the chest CARDIAC ARREST CARDIAC ARREST HEART ATTACK HEART ATTACK ◘ o Place Place otherother hand hand on on toptop ◘ o Interlock Interlock fingers fingers ◘o Result Result of of ELECTRICAL ELECTRICAL ◘ a Result Result of of coronary coronary artery artery ◘ a Compress Compress the the chest