Pharmacy care nurses

Drs. Mostofsky, Yehuda, and Salem have carefully chosen the very best researchers who can communicate the relevance of fatty acid biology to professionals who are not experts in this field. The authors have worked hard to make their information accessible to health professionals interested in public health, child health, nursing, pharmacy, psychology, as well as nutrition-related health professions. 

MEDLINE is a bibliographic database of life sciences and biomedical information. It contains references to articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, health care, biology and biochemistry. 

Xavier University College of Pharmacy New Orleans, Louisiana Denise Buonocore, MSN, APRN, CCRN Acute Care Nurse Practitioner Bridgeport Hospital, Bridgeport Connecticut, and Yale University School of Nursing Carmita A. Coleman, PharmD Assistant Dean for Student Affairs and Associate Professor of Pharmacy Practice Feik School of Pharmacy University of the Incarnate Word San Antonio, Texas... 

Like Medical Care, Nursing Care etcetera PC consists of core components the philosophy, the patient care process, and the practical management system to support the practice. PC was developed from Clinical Pharmacy Services (see below) with more focus on the patients need and on the practitioners (pharmacist) responsibilities towards the patient and the outcome of the drug therapy. To be able to show the improved process of care a categorisation system for drug-related problems was developed. The taxonomy has been further developed into seven categories (Cipolle et al. 1998). This can be used for practice and in studies. 

The main process (Fig. 1.1) for the care of a patient is normally the Primary care process (the patient handles their own drugs)—or the community care process (the patient gets help from community nurses at home or at a nursing home). All other processes such as hospital care (secondary/tertiary care) and the pharmacy process must support the main patient process. For improvement we must focus on patient safety and reduce drug-related problems. This means correct prescription and correct use (follow-up, documentation and communication) from the supportive process to the main process. 

In the case of the proposed consultant pharmacy service (scenario), Ted should consider as competitors any other organizations that provide the same service (consultant pharmacy service). In the nursing home environment, local retail pharmacies or large regional or national long-term care pharmacies that provide medications to nursing homes may also provide consultant pharmacy services. In some cases, individual pharmacists provide these services to one or two homes on an independent consultant basis. 

Opportunities to decide which products and services to offer are available to both community and institutional pharmacies. The environments are slightly different, and the decisions are important in both settings. For example, hospital pharmacies frequently are within larger infrastructures of the hospitals they serve. Many, however, still function to add value to various inputs. They serve patients and internal customers—the physicians, nurses, and other health care professionals who practice in the institution. 

Pharmacies are continually looking for new and better ideas to differentiate themselves from other retail outlets and to offer additional health care services to their customers. The addition of in-store medical clinics allows customers to receive medical care that is quick, inexpensive, and convenient (Fig. 23-7). Staffed by nurse practitioners and physician assistants that have prescribing authority, patients can choose from a posted list of services provided, receive treatment, and be on their way in less time than at a medical clinic or emergency room. Patients who need OTC or prescription items can pick up these items right in the store. 

Another aspect of the market for any value-added pharmacy services that must be considered is the competition. When identifying competitors, it is important to acknowledge exactly what services the pharmacy will pursue. When identifying competitors for value-added services, pharmacists often limit their search to other pharmacies and pharmacists. While this may be appropriate for traditional pharmacy goods and services (e.g., dispensing drug products), pharmacists considering new value-added services must cast a much broader net. Many value-added services offered by pharmacists are still at the introductory point of their product life cycles. Few, if any, other pharmacies may offer these services in a particular market. On the other hand, other competitors maybe very well established. For example, while diabetes education services currently are not offered in many community pharmacies, physicians and certified diabetes educators (who can be physicians, nurses, pharmacists, and other health care professionals) have provided this service for a number of years (Zrebiec, 2001). 

A STATE PRACTICE ACT/BOARD OF PHARMACY PROVISION Trudy Hamilton, Pharm.D., is a licensed pharmacist and is currently the manager of a hospital pharmacy department. In the state where Dr. Hamilton is licensed, nonpharmacist personnel are prohibited by both statute (the state pharmacy practice act) and state board of pharmacy regulation from engaging in activities defined as the practice of pharmacy. The specific activities that fall within the definition of the practice of pharmacy are limited to being personally performed by licensed pharmacists only. Such activities include counseling patients about their medications and responding to drug information requests from other health care professionals (e.g., physicians and nurses). 

The use of standard dosage charts on nursing units in institutions and standard formulations in the pharmacy minimizes the possibility of error and makes calculations much easier. For example, in critical care units, physicians need to order only the amount of drug they want infused and list any titration parameters. No one has to perform any calculations because dosage charts can be readily available for choosing appropriate flow rates by patient weight (in kilograms) and dose ordered. 

Various strategies have been attempted to counteract this powerlessness phenomenon present in health care organizations. Health care literature is replete with efforts to empower the frontline health care practitioner. Empowerment is the sharing of power with those who actually do the work. For example, much has been written on the topic of shared governance within the nursing literature. There also has been recent discussion of shared governance within the profession of pharmacy. 

Customer dissatisfaction is one of the hardest costs to determine, but the most easily observable. Customers expect that products typically held by a pharmacy are readily available for purchase during normal business hours. Stockouts often produce frustrabon and dissatisfaction among customers, but, if infrequent, may be forgiven. However, frequent stockouts can result in a loss of business. In hospitals, frequent stockouts of commonly used products can result in a decline in the quality of patient care, create frustration among the medical and nursing staffs, and promote dissension between the pharmacy and other staffs. 

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