Over the last decades, pharmacy practice has evolved into a patient cantered care profession which aims to improve health outcome of the patient. Within the pharmaceutical practice model, the role of pharmacist is not restricted into just dispensing the right medication but to achieve an overall better outcome for the patient. Patient assessment is a vital part of this pharmaceutical model and is focused on gathering patient-specific information, evaluating that information, identify drug related problems and formulating a pharmaceutical care plan. (Jones and Rospond, 2009)
This essay is structured on a hypothetical scenario and is intended to highlight the way in which a pharmacist can access a patient. This patient assessment aims to identify the correct diagnosis and give further advices on the next steps that the patient must follow.
A 60 Years old men named Mr.P enters a pharmacy and ask to speak with the pharmacist about his cough which was lasting for more than three weeks. The pharmacist politely asks the patient to follow him to his consultation office in order to ask him some questions. Initially the pharmacist will take a normal history taking from the patient .More specific the pharmacist first asks the reason Mr. P seek care. Mr. P explains that he had a cough for three weeks. The pharmacist then, asks from Mr. to give further details about his cough; he asks him about the time he first experienced the cough, how it had progressed over time and what impact it had on his life .Mr. P. answers that the cough started suddenly three weeks ago but by the time it had become worse. His life had started to get more difficult as sometimes he experienced coughing while driving or doing other operations. He was ...
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... A, (2007). The new tuberculosis. The British Journal Of General Practice. 1 (57), pp.94–95.
Jones, M.R ,Rospond, M.R (2009). Patient Assessment in Pharmacy Practice. 2nd ed. Philadelphia: Lippincott Williams & Wilkins. 1
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Morice, A.H., McGarvey, L., Pavord, I., (2006). Recommendations for the management of cough in adults. Thorax. 61 (1), pp.1-24
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In order behave professionally, first of all, one needs the willingness to learn and be self-aware. Self-awareness would allow the respondent to realise her limitation on “between the flags” policy and be willing to learn and improve her clinical knowledge. If she had done so, she would realise the importance of documentation and the urgent need to arrange medical review for Patient A, preventing her condition from further deteriorating instead of making assumption that urgent medical assistant was unnecessary as long as the continuous administration of antibiotics. Additionally, with a sound professional experience and knowledge, clinical reasoning skills are also essential in professional behaviour. If the respondent had used problem solving, critical thinking and intuitive thinking skills to recognise and respond on Patient A’s deteriorating condition, she would have applied clinical judgement and decision making skill to prioritise the patient’ need to be urgently medical reviewed by the ED doctor even though she may receive some verbal abuse. Once she is confident with her clinical reasoning and judgement, she would take action on arranging urgent medical review, documenting her assessment for further examination and
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
Nurse’s should have a strong pharmaceutical knowledge background and be aware of the potential harm a medication could cause. In the process of medication administration, registered nurses are responsible to “determine that each medication order is clear, accurate, current and complete”. Medications should be withheld when a medication order is incomplete, illegible, ambiguous or inappropriate; with concerns being clarified with the prescriber (CNO, 2015)”. The critical care nurse demonstrated ineffective communication, which was shown by failing to ask the physician for clarification. Another instance of miscommunication is during medication reconciliation, which is a formal process in which healthcare providers work together to ensure that patient medication information is communicated consistently and accurately across transitions of care (Etchells, 2012).
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
Trevena L. (2009) Cancer screening Reprinted from Australian Family Physician: School of Public Health, University of Sydney, New South Wales. Vol. 38, No. 4
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
Edmunds, M. W., & Mayhew, M. S. (2009). Pharmacology for the primary care provider (3rd ed.). St. Louis, MO: Mosby Elsevier.
In 1998 the (AphA) adopted policies recognizing a pharmacist’s right to refuse dispensing medications based on personal belief. However, if the pharmacist refuses they still have duty to the patient to refer them to another pharmacist. The dilemma is now whether to refer or not. Potential ramifications of not referring are employment termination, civil liability, or disciplinary action form state pharmacy board.
First, here is some important background information about Pharmacists. A Pharmacist is someone who is trained and licensed to distribute medicinal drugs and to advise on their use. According to the Occupational Outlook Handbook Pharmacists do all of the following: "Fill prescriptions, verify proper amounts of medication to give to patients, check whether the prescription will interact negatively with other drugs that a patient is taking or conditions the patient has, instruct patients on how to and when to take a prescribed medicine, Advise patients on potential side effects they may experience from taking the medicine, Advise patients about general health topics, such as diet, exercise, managing stress, and on other issues, such as what equipment or supplies would be best for a health problem, Keep records and do other administrative tasks, Complete insurance forms and work with insurance companies to be sure that patients get the medicine they need, Teach other healthcare practitioners about proper medication therapies for patients, and lastly oversee the work of pharmacy technicians and pharmacists training."() Some pharmacists participate in compounding, where they create medications by mixing ingredients themselves. Pharmacists tha...
8.) Tuberculosis. 21 Dec 2004 Mayo Foundation for Medical Education and Research (MFMER). 16 July 2006 .
Pharmacy is an interesting and ever-changing field in our world today. An intriguing aspect of this profession is the wide spectrum of opportunities available. With such a versatile degree as a Doctor of Pharmacy, the possibilit...
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