Pharmacist nutrition support

Nutrition support pharmacy addresses the care of patients receiving specialized parenteral or enteral nutrition. The nutrition support pharmacist is responsible for promoting restoration and maintenance of optimal nutritional status and designing and modifying treatment in accordance with patient needs. These specialists have responsibility for direct patient care and often function as members of multidisciplinary nutrition support teams. 

A credential is documented evidence of a pharmacist s qualifications. Pharmacist credentials include diplomas, licenses, certificates, and certifications. These credentials are reflected in a variety of abbreviations that pharmacists place after their names (e.g., Pharm.D. for doctor of pharmacy, an earned academic degree R.Ph. for registered pharmacist, which indicates state licensure and acronyms such as BCNSP for Board-Certified Nutrition Support Pharmacist, which indicates that an individual has demonstrated advanced knowledge or skill in a specialized area of pharmacy). 

American Society for Parenteral and Enteral Nutrition. Standards of practice for nutrition support pharmacists. Nutr Clin Pract 1999 14 275-281. 

Task Eorce on Specialty Recognition and Certification of Nutritional Support Pharmacists. Executive summary of petition requesting recognition of nutritional support pharmacy as a specialty. Am J Hosp Pharm 1991 48 1284. 

Joan has been serving as the clinical coordinator for the department of pharmacy in a 500-bed hospital for more than 9 years. She provides clinical services to patients admitted to the general medicine service, manages clinical programs for the department, and is responsible for the continued professional development of 12 clinical pharmacists. Joan is a member of the pharmacy and therapeutics committee, the nutrition support committee, and an ad hoc committee to improve the patient discharge process. She also chairs the hospital s smoking-cessation campaign. 

Certification programs formally confirm that an individual has successfully met the standards set by the organization (association) for a particular practice or area of specialty. For example, the Board of Pharmaceutical Specialties (BPS) certifies that a pharmacist has demonstrated an advanced level of education, experience, knowledge, and skills in one of five specialty areas nuclear pharmacy, nutrition support, oncology pharmacy, pharmacotherapy, and psychiatric pharmacy. 

To date, five specialties have been recognized by BPS 1) nuclear pharmacy 2) nutrition support pharmacy 3) oncology pharmacy 4) pharmacotherapy and 5) psychiatric pharmacy. As of August, 2002, 3414 pharmacists are certified as specialists in one or more of these specialties. Added Qualification is a process for providing recognition of pharmacists with further training and experience in areas of concentration within an existing specialty. 

Board of Pharmaceutical Specialties (BPS). Established in 1976 by the American Pharmaceutical Association, BPS is the only agency that offers certification at the specialty level in pharmacy. It certifies pharmacists in five specialties nuclear pharmacy, nutrition support pharmacy, oncology pharmacy, pharmacotherapy, and psychiatric pharmacy. As of June 2002, nearly 3500 pharmacists held BPS certification, distributed across the five specialties as follows ... 

Although not required, a pharmacotherapy specialist may become a Board Certified Pharmacotherapy Specialist (BCPS) through a process established by the Board of Pharmaceutical Specialities (BPS). In addition to pharmacotherapy, the BPS certifies pharmacists in several other specialties (e.g., nuclear pharmacy, nutrition support pharmacy, psychiatric pharmacy, oncology pharmacy). 

This chapter describes the activities performed by the pharmacist as a member of the nutritional support team, which involve a range of tasks from indications, assessment of nutritional state, and the preparation of artificial nutrition for adults and children to concepts on basic dietetics and mother-infant nutrition. Drug-nutrient interaction analysis is another duty. 

Further clinical experience and research fostered development of protocols that promoted better patient care and resulted in a decline in complications associated with parenteral nutrition (PN) therapy. The scope of practice for nutrition support clinicians has broadened as a result of increasing knowledge regarding the metabolic consequences associated with acute injury and chronic disease states. The pharmacist s role in providing safe and effective nutrition-support care requires knowledge of the principles of patient selection, initial therapy design, preparation and dispensing of the nutritional formu-... 

In addition to these basic responsibilities, consultant pharmacists provide a wide range of other primary care services to the nation s seniors, including pain management counseling, pharmacokinetic dosing services, intravenous therapy, nutrition assessment and support, and durable medical equipment services. 

During therapy, the pharmacist can be an important provider of patient edncation. Patients should receive information regarding acnte and chronic toxicides of the chemotherapy being administered, as weU as possible treatments for those toxicities. The pharmacist can also be an important resource for information regarding antibiotics, antiemetics, nutritional snpport, CSFs, and other supportive care issues. 

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