IPPE II On-Site Assignments
Students,
This assignment should be completed and turned in via Blackboard by 5:00 PM the Thursday AFTER your assigned reflection lab.
Assignment 1: Patient Counseling
1. Describe the counseling requirements of the Omnibus Budget Reconciliation Act of 1990 (OBRA 90).
The pharmacist must offer to discuss the unique drug therapy regimen of each Medicaid recipient when filling prescriptions for them. Each patient must be made an offer to be counseled by the pharmacist. The items to be addressed include, the name of the drug, intended use of expected action, common side effects and their avoidance, techniques for self-monitoring, proper storage, potential drug-drug or drug-food contraindications, refill
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4. List 3 questions asked by the pharmacist during a patient counseling session. A. Have you used this medication before? B. What is this medication used for? C. What has your doctor mentioned about the side effects of this medication?
Assignment 2: Patient Scenarios (You may discuss these questions with the pharmacist)
1. Scenario 1: A patient comes in and is out of refills for his blood pressure medication. It is 8 PM on a Friday night. How would you handle this situation?
As a pharmacist I would ask them to determine if their doctor has an emergency after hour’s line that I can call for a prescription. I could also require the patient to bring their prescription bottle as verification for a few day supply emergency refill. Later, I would fax the doctor’s office for a new prescription. When I receive the prescription I would subtract the emergency supply from the quantity to fill.
2. Scenario 2: A patient comes in and is out of refills for his diazepam, which he takes for anxiety. It is 8 PM on a Friday night. How would you handle this situation?
As a pharmacist I could calmly and as kindly as possible explain that because the prescription is a controlled medication I would not be able to give them a few days emergency supply. I would recommend that they visit the closest urgent care facility to acquire this prescription.
3. Scenario 3: A Mom calls you on the
During the discharge process, Mr. K was instructed to follow-up with his primary care provider. The inpatient team also gave Mr. K prescriptions for a new anti-hypertensive medication. Sadly, they did not provide any instructions about his previous anti-hypertensive drugs. As a result, Mr. K continued to take the old and the new anti-hypertensive medications. Since his next appointment was within three weeks, he decided to wait instead
This writer met with the patient to address the conflicting issue with his medication. According to the patient, his PCP was prescribing him with his benzodiazepine medications; however, the patient says, " I had to seek a psychiatrist because it was only temporary." This explains the conflicting issues with the Rx Scripts on file. The patient started his treatment with his now psychatrist on 6/12/2017 and signed an ROI. Addressing picking up his medication from two different pharmacy, the patient was advise that he needs to be pick up his medication with only one pharmacy as it is required. The patient agreed to the terms and said, " I like CVS better than Walgreens. Sometimes they would my refill to Walgreens or whatever is closer to me,
All EMS personnel must take into consideration the “Six Rights” of medications: Right person, Right drug, Right dose, Right time, Right route, Right documentation.
Additionally, the facility should have a system in place that alerts the staff regarding high dosages. One way to alert the pharmacist would be via a computerized system that monitors the dispensing of all medications. The system should contain an up to date database for referencing medications. Also, the computerized system should have parameters set for alerting pharmacy and nursing staff for all high dosages. When taking cost into consideration, the facility might not have the feasibility to implement an entire computerized dispensing system that provides dosage alerts and cross check off of medications. To maintain patient safety with limited funds, the facility should have remote access to a pediatric pharmacy where all pediatric medications can be cross-checked and verified. If the facility was unable to have a pediatric pharmacist on staff, the remote access would provide a safety net for pediatric medication dispensing. In addition to the pharmacy staff having access to a computerized system, the physician should as well. Had the physician had computer access and been required to enter medication orders, the tenfold error could have been noted and not reached baby Miguel.
There are several types of medication, each has a purpose and function needed for their administration via the different routes.
Even so, physicians at Community Hospital may not yet be able to send a medication order to the pharmacy from their recommending device, because it has been recommended that their facility does not have the type of pharmacy information system that can support a CPOE. At the same time, this may cause a small issue, providers have taken it upon
When making the decision to prescribe there are a number of influence you have to consider. It is important to have an awareness of these influences and take them into consideration when issuing a prescription. It is importance to have knowledge of the DOH (2006) Medicines Matters this give guidance on the mechanisms available for prescribing and administration and supply of products. Team trends and external company’s and there representatives promoting their products have a big influence on your prescribing practice Bradley (2006) found that these influences were of concern to some nurses feeling that their colleague may ask them to prescribe for patients they haven’t seen. Thomas (2008)
Non care setting - Medications are often stored and administered in a variety of non-health care settings. These settings include: primary and secondary schools, Child day care centres, Board and care homes, Jails and prisons. In all these settings, employees frequently are responsible for handling and administering prescription and over-the-counter medications to clients or residents. Some organizations may employ licensed health professionals to directly manage the medication administration process. However, many of these settings have no licensed health professionals involved. Where medications are stored and administered to individuals, written policies and procedures should address the following: Acquisition of medications (e.g., from parents, caregivers, pharmacies), Specification of which personnel are allowed access to medications and allowed to administer medications to students, clients or residents, Labelling and packaging of medications managed for students, clients
When providing care patients should be able to rely on their current care attendant to be attentive and focused, while this isn't always the case. Some patients are learning the ins and outs of outsmart their doctors to gain access to the drugs that they are addicted too. According to Urgentcarenews.com there was recently a post on the internet by drug addicted paient that had created a step-by-step guide on how to scam Urgent Cares doctors. This six step plan created by a patient who scammed his urgent care facility is proof that patients can easily be given the drugs they crave accidently by these care centers. This six step plan includes the following; step one the patient makes an appointment or goes to a care facility most likely a doctor
The nurse must verify the physician’s medication order, including the dose and time, and then the pharmacy is responsible for their own checks and balances via the BCMA system in order to complete the dispensing phase of the medication (Gooder, 2011). The nurse enters the BCMA system with a login and password and is able then to see a list of the virtual due list for a specific patient. The computer on wheels is then taken to that patient’s room and the five rights of medication administration begin. As nurses, we are taught to use the five rights of drug administration are (1) right patient (2) right medication (3) right dose (4) right route and (5) right time. By scanning the barcode on the patient’s hospital identification band, the nurse then asks for the patient to verbally state their name and date of birth, which can be verified by the nurse on the virtual due list and then choses the medication that are due for administration at that time. The medication is dispensed and the nurse is able to scan the barcode on the medication, the scanning triggers the automatic documentation of the medication given (Kelly, 2012).
This goal could be helped through having telephonic medication reminders, delivery of prescriptions to the client’s home and reminders when refills are due. Another short term goal would be that the client would be able to state the symptoms of an acute exacerbation. These symptoms include fatigue, shortness of breath, rapid heart rate, increased edema and excessive (Baltimore County Department of Health, 2008). The client should be taught to recognize these symptoms and seek care from the primary doctor if any of this issues begin to occur. These steps will help prevent the acute exacerbation and prevent a hospital
Our health care environment is faced with the patient safety issues, shortages on health and human resources, increasingly complex health care needs. Before coming to activity I expect that Interprofesional activity is a way of bringing all the perspectives of different healthcare professionals to improve patient safety. During the activity I found the role of a mental health counselor might treat a patient who has been the victim of domestic abuse, individuals struggling with poor self-esteem, helps individuals and families deal with difficult emotions, in a variety of settings, including schools, hospitals, private offices and clinics, and substance abuse treatment facilities. On the other hand, Pharmacists can play an active role in treating
A Corrective Action Plan meeting was held on 8/3/15. Present during the meeting were Elena Briceno, Regional Director, People's Care, Dara Mikesell, Manager of Quality Assurance, Kristen Gener SG/PRC Service Coordinator, and Adriane Picazo, Manager of Client Services, RS1. Plan of Correction: A, Staff will dispense medications as prescribed by physician B, The Administrator arranged for staff to received medication training by a pharmacy on July 24, 1=2015, verification of this training was submitted on August 3, 2015. C, The Administrator will instruct the staff to continue following the present Medication Dispensing Protocol, which indicates that DSP A dispenses the medications and DSP B verifies the medications with the Medication Administration
My initial reaction to this situation is to not advise them to write a prescription for their patient to give to the woman nor would I advise them to visit the woman either. If possible, I would say to that instead the patient could try to convince the woman to visit them or another doctor to examine if she actually needs the drugs for her condition. In this circumstance I consider both the physical, resident, and the woman as the primary decision makers with the patient as the stakeholder. My primary ethical question is whether it is morally permissible to write a prescription for someone who is not your patient and is it right to pay them a visit at their home.
Specific purpose: To inform my audience about the growing problem of prescription drug abuse, some common drugs that cause abuse, and their effects and some common treatments.