Clinical Skills for Pharmacists

A Patient-Focused Approach

Karen J. Tietze

• Publisher: Mosby
• Year: 2011
• ISBN:
  9780323082228
• Edition: 3
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Covering the skills needed for pharmaceutical care in a patient-centered pharmacy setting, Clinical Skills for Pharmacists: A Patient-Focused Approach, 3rd Edition describes fundamental skills such as communication, physical assessment, and laboratory and diagnostic information, as well as patient case presentation, therapeutic planning, and monitoring of drug intake. Numerous case examples show how skills are applied in clinical situations. Now in full color, this edition adds more illustrations and new coverage on taking a medication history, physical assessment, biomarkers, and drug information. Expert author Karen J. Tietze provides unique, pharmacy-specific coverage that helps you prepare for the NAPLEX and feel confident during patient encounters.

• Coverage of clinical skills prepares you to be more involved with patients and for greater physical assessment and counselling responsibilities, with discussions of communication, taking a medical history, physical assessment, reviewing lab and diagnostic tests, and monitoring drug therapies.
• A logical organization promotes skill building, with the development of each new skill building upon prior skills.
• Learning objectives at the beginning of each chapter highlight important topics.
• Self-assessment questions at the end of each chapter help in measuring your comprehension of learning objectives.
• Professional codes of ethics are described in the Ethics in Pharmacy and Health Care chapter, including confidentiality, HIPAA, research ethics, ethics and the promotion of drugs, and the use of advance directives in end-of-life decisions.
• Numerous tables summarize key and routinely needed information.
• Downloadable, customizable forms on the companion Evolve website make it easier to perform tasks such as monitoring drug intake and for power of attorney.

Chapter 1 Introduction

The Practice of Clinical Pharmacy

Learning Objectives

• Define pharmaceutical care and identify the four outcomes that improve a patient’s quality of life.

• Define medication therapy management.

• List the three goals and five core elements of medication therapy management.

• List the knowledge and skills needed for patient-focused pharmacy practice.

• State the requirements for pharmacy state licensure and relicensure.

• Differentiate between pharmacist board certification, pharmacist-specific disease-specific credentialing, multidisciplinary disease-specific credentialing, and pharmacy certificate programs in terms of eligibility and requirements.

• State the eligibility requirements for pharmacist board certification and identify the areas for which board certification is available.

• Define residency and fellowship and differentiate them with regard to length of training and mechanisms for credentialing.

• Identify and differentiate among the various types of health care settings and environments.

• Define health maintenance organization, point-of-service plans, and preferred provider organizations.

• State the purpose of the medical team and identify the roles and responsibilities of each team member.

• Identify and describe unresolved health care system issues.

Pharmacy practice is moving toward a model that integrates patient-focused care (also known as patient-centered care) and drug distribution services. To be successful, pharmacists must understand and speak the language of the health care system and function in a system that to the uninitiated is foreign and excessively complex. The variety of providers, rapidly evolving types of health care delivery systems, and complexities of relationships among the various heath care professionals working within the health care system add to the confusion. This chapter describes patient-focused pharmacy practice and the clinical environment in which patient-focused pharmacists function.

Patient-Focused Pharmacy Practice

The term clinical pharmacy historically described patient-oriented rather than product-oriented pharmacy practice. The term clinical pharmacist was used to describe a pharmacist whose primary job was to interact with the health care team, interview and assess patients, make patient-specific therapeutic recommendations, monitor patient response to drug therapy, and provide drug information. Clinical pharmacists, working primarily in acute care settings, were viewed as “drug experts”; other pharmacists could occasionally use “clinical” skills, but they remained focused on product management. The pharmacy profession has evolved to the point that many pharmacists find the term clinical pharmacy redundant; the term pharmacist implies the integration of patient- and product-oriented pharmacy practice.

Patient-focused pharmacists work closely with physicians and other health care professionals to provide optimal patient care. Some pharmacists in traditional product-centered practice settings use clinical pharmacy skills in a limited capacity, such as when they obtain a medication history or triage a patient to self-care with nonprescription drugs. Some pharmacists have no traditional product-centered responsibilities and instead provide full-time patient-focused care. Regardless of the setting and the degree to which patient-focused skills are used, patient-focused care is an integral part of the practice of pharmacy (Figure 1-1).

Figure 1-1 Patient-Focused Care in the Community Pharmacy.

Patient-focused care is an integral part of the practice of pharmacy in all patient care settings.

(Hopper T: Mosby’s pharmacy technician: Principles and practice, ed 2, St Louis, Saunders, 2007.)

The term pharmaceutical care is used to describe the broad-based, patient-focused responsibilities of pharmacists (see Figure 1-1). Hepler and Strand define pharmaceutical care as the “responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life.”¹ The four outcomes identified include the following:

1. Cure of disease

2. Elimination or reduction of symptoms

3. Arrest or slowing of a disease process

4. Prevention of disease or symptoms

Pharmaceutical care requires an expert knowledge of therapeutics; a good understanding of disease processes; knowledge of drug products; strong communication skills; drug monitoring, drug information, and therapeutic planning skills; and the ability to assess and interpret physical assessment findings (Figure 1-2).

Figure 1-2 Patient Care.

Patient care requires integration of knowledge and skills.

Medication therapy management (MTM) services provide pharmacists with new opportunities for direct patient care. The Medicare Pres...

Table of contents

• Cover
• Title Page
• Front Matter
• Copyright
• Dedication
• Preface
• Acknowledgments
• Table of Contents
• Chapter 1: Introduction: The Practice of Clinical Pharmacy
• Chapter 2: Communication Skills for the Pharmacist
• Chapter 3: Taking Medication Histories
• Chapter 4: Physical Assessment Skills
• Chapter 5: Review of Laboratory and Diagnostic Tests
• Chapter 6: The Patient Case Presentation
• Chapter 7: Therapeutics Planning
• Chapter 8: Monitoring Drug Therapies
• Chapter 9: Researching and Providing Drug Information
• Chapter 10: Ethics in Pharmacy and Health Care
• Acronyms by Chapter
• Index