PHA4769 Patient Care Process (Franklin)(EX1) PDF

PHA4769 Patient Care Process (Franklin)(EX1) Study online at https://quizlet.com/_gk7jjm 1. Patient Centered Care: 1. Collect 2. Assess 3. Plan 4. Implement 5. Follow up: Monitor and Evaluate - collaborate, communicate, document 2. A student pharmacist is currently on rotation in the communi...

PHA4769 Patient Care Process (Franklin)(EX1) Study online at https://quizlet.com/_gk7jjm 1. Patient Centered Care: 1. Collect 2. Assess 3. Plan 4. Implement 5. Follow up: Monitor and Evaluate - collaborate, communicate, document 2. A student pharmacist is currently on rotation in the community pharmacy. A patient inquires about an over-the counter product that he can take to treat his back pain. Together, the student pharmacist and pharmacist determine the patient, based on his symptoms, must be referred to his primary care provider. What step of the PPCP was completed? A. Assess B. Collect C. Plan D. Follow-up: C. Plan (Franklin said this would not be an exam question as it was confusing) 3. During which step of the Pharmacists' Patient Care Process (PPCP) would the pharmacist/student pharmacist obtain information from a patient/caregiv- er? A. Plan B. Assess C. Follow-up D. Collect: D. Collect 4. Pharmacist Patient Care Process (PPCP): - released by Joint Commission of Pharmacy Practice in 2014 - a contemporary, consistent, and comprehensive process - applicable to any practice setting, where pharmacist provide patient care and for any patient care service provided by pharmacist 5. Collect (of PPCP): - The pharmacist assures the collection of the necessary subjective and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient - Info gathered through: patient interview (subjective), medical & pharmacy records, direct observation, laboratory results (objective), physical assessment (objective) - Interview Components: CC, HPI, PMH, health maintenance and immunizations, FH, SH, ROS, PE, medical history 1/5  PHA4769 Patient Care Process (Franklin)(EX1) Study online at https://quizlet.com/_gk7jjm 6. Assess (of PPCP): - The pharmacist assesses the information collected and analyzes the clinical effects of the patient's therapy in the context of the patient's overall health goals in order to identify and prioritize problems and achieve optimal care. - assess each medication for appropriateness, effectiveness, safety, and patient adherence - health and functional status, risk factors, health data, cultural factors, health literacy, and access to medications or other aspects of care - immunization status and the need for preventative care and other health care services - assess can be categorized into three groups: medication assessment, patient history and risk assessment, and preventative care assessment 7. Medication Assessment (as part of Assess in PPCP): - comprehensive edu- cation assessment involves the analysis of each medication for appropriateness, effectiveness, safety, and adherence - unnecessary drug therapy, needs additional drug therapy, ineffective drug, dosage too low, adverse drug reaction, dosage too high and adherence - *most medications related problems in the self care aspect is the additional drug therapy, ineffective drug, and adverse drug reaction* - the pharmacist role in the medication assessment step in self care is to use the information collected to make appropriate medication or changes to the medication care plan - example: pt with musculoskeletal pain comes to her hometown pharmacy seeking relief: review meds to ensure NDSAID would be safe, non duplicative, etc 8. Patient History and Risk Assessment (as part of Assess in PPCP): - health and functional status - risk factors - cultural factors - health literacy - access to medications or other aspects of care that would influence decisions on optimal medication refines for the patient - ex: pt with CHF comes in with a cough, instead of recommending delsym and moving on, you know that cough is an exacerbation of CHF, so recommend going to doctor as her CHF may have worsened - Islamic women asking about multivitamins, you know some contain pig extracts, so you know which ones she cannot take 9. Preventative Care Assessment (as part of Assess in PPCP): - preventative care progression of certain disease and continuous revisiting of the pharmacy for self care treatment 2/5  PHA4769 Patient Care Process (Franklin)(EX1) Study online at https://quizlet.com/_gk7jjm - ex: working in community pharmacy and patients come to the pharmacy during influenzas season. What preventative assessment can be conducted? 10. Exclusion for Self Treatment: - pharmacists should collect the pertinent info for the disorder or problem that would lead to an assessment of inappropriateness for self treatment; therefore recommend going to provider - exclusion may include (but not limited to) -- symptom characteristic or other disorder factors are beyond the scope of self treatment (ex:broken arm) -- patient-specific factors preclude treatment with nonprescription medication (ex: kid is too young to treat w OTC stuff) -- patient health status or history precludes self treatment, even if a nonpresciption medication is indicated for the disorder (ex: person w kidney disease should not take NSAIDs) --previous treatment w nonprescription meds was ineffective after an adequate trial (ex: person took delsym for 2 weeks and still has cough... like at this point go to doctor) 11. Plan (of PPCP): - The pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective - recommend self-care with pharmacologic, nonpharmacologic, and or alternative products - refer the patient to another health care provider for treatment - recommend self care until another health care provider can be consulted - goals of therapy - patient engagement 12. Goals of Therapy (as part of Plan for PPCP): - establishing goals of therapy has been mainstay of the original pharmaceutical care process and remains central to the plan in PPCP - serves as endpoint to measure outcomes and include both practitioner and patient contributions - *Cipolle, Strand, and Morley* propose three questions to help establish patient centered goals -- what would you like to achieve w your medication -- what are your goals for this therapy -- how do you feel ab trying to achieve ___ with a new drug therapy ~ with time frame to meet goal 13. Care Continuity (as part of Plan for PPCP): - plan should include care of continuity, which involves follow up, referral and transitions of care - initial follow-up plan is based on the goal of therapy and advises the patient on what 3/5  PHA4769 Patient Care Process (Franklin)(EX1) Study online at https://quizlet.com/_gk7jjm to do once the goal is met, what should occur if the goal is not met, and what steps to take if the patient condition worsens or the patient experience an adverse effect - ex: pt has heartburn; what to consider? -- when should pt see results? -- what to do if therapy not met? -- how long should disorder be treated by self-care before further assessment is warranted by another provider -- what should pt do if they see ADR -- what to do if condition worsens 14. Implement (as part of Plan for PPCP): - the pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver - the pharmacist: -- address medications (health related problems, engages in preventative care strategies like vaccines) -- initiates, modifies, and discontinues, or administers medication to the patient or caregiver -- contributes to coordination of care, including the referral or transition of pt to another professional -- schedule follow ups as needed 15. Monitor and Evaluate (as part of Plan for PPCP): - the pharmacist monitors and evaluates the effectiveness of care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed - follow up should include: -- medication appropriateness, effectiveness, safety, and adherence through avail- able data (review rx pickups and day supply) -- clinical endpoints contributing to overall health -- outcomes of care, including progress toward achievement of therapy goals 16. Special Populations: - pediatric, geriatric, pregnancy - serious consequences with OTC cn occur if not properly recommended - what are the consequences that can occur in these special populations 17. Pediatric Patients: - subpopulations: neonates (0-1 month), infants (1m - 2y), and children (2-12 years), and adolescents (12-16) PPCP - Collect: verify pts age, obtain pt weight, consider caregiver factors - Assess: determine exclusions for self treatment and evaluate for adverse effects - Plan/Implement: consider nonpharmacologic therapy, consider specific patient education and counseling, determine appropriate dosing and administration of 4/5  PHA4769 Patient Care Process (Franklin)(EX1) Study online at https://quizlet.com/_gk7jjm medications - Follow Up: monitor and evaluate 18. Geriatric Patients: - defined as age 65 and older; large consumers of prescrip- tion and nonprescription meds PPCP - Collect: recognize that the collect step may take additional time due to complexity of info needed to make assessment; perform CMR, ask in-depth questions regarding symptoms that could be unrecognized or falsely attributed to age; ask ab swallowing difficulties; check for impaired senses - Assess: evaluate potential duplication therapy & polypharmacy; evaluate potential ADR, evaluate whether potential dose is too high - Plan/Implement: consider concomitant conditions and other meds during product selection; evaluate for nonadherence; determine appropriate dosing and adminis- tration; consider pt education - Follow Up: monitor and evaluate 19. Pregnant Patients: - consideration to ease the mothers discomfort and the effects of nonprescription meds on developing fetus is crucial PPCP - Collect: female pts of child-bearing age who present w common early pregnancy symptoms like NV; if pregnancy is confirmed, identify the stage, as some meds are dependent upon this - Assess: evaluate the safety of medication use in pregnancy; determine whether the pt pregnancy status is an exclusion for self treatment even if a nonprescription production considered safe for use in pregnancy (like animal vs human) - Plan/Implement: consider nonpharmacologic therapy option in pregnant pts; dis- courage use of homeopathic and herbal remedies in pregnancy bc safety and effectiveness is not established - Follow Up: monitor and evaluate 5/5