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Quality Education for a Healthier Scotland
Pharmacy
Pharmaceutical Care PlanningVocational Training Scheme:
Level = Stage 2
Arlene Shaw
Specialist Clinical Pharmacist, NHS Tayside
Quality Education for a Healthier Scotland
Pharmacy
Aim and Objectives
AIM
To provide pharmacists with an overview of how to complete
pharmaceutical care plan as part of the Pharmacy Vocational
Training Scheme
OBJECTIVES to identify the key issues associated with a specific
pharmaceutical care plan to describe the care issues, actions and outputs associated with
a specific pharmaceutical care plan to record investigations as part of a pharmaceutical care plan
Quality Education for a Healthier Scotland
Pharmacy
Introduction
PHARMACY VOCATIONAL TRAINING SCHEME Competency based training scheme that enables pharmacists
to demonstrate competence through learning from experience in the workplace.
PHARMACY VOCATIONAL TRAINING SCHEME Competency based training scheme that enables pharmacists
to demonstrate competence through learning from experience in the workplace
Quality Education for a Healthier Scotland
Pharmacy
Evidence
Essential to demonstrate your personal involvement Include a variety of clinical areas Must reflect on each piece of evidence No patient identifiable information
Use Care Plan on NES Pharmacy Website Require 12 care plans, 4 of which should be
accompanied by a more detailed case study.
Quality Education for a Healthier Scotland
Pharmacy
Cover Page
Short summary (-200 words) Describe case Reasons for choosing case
Reflection Learning from developing the care plan Feedback from tutor Implications for future practice
Sign Off From the appropriate clinical specialist
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 1
Patient Details
Patient Stay What brought the patient into hospital? Symptom / signs not diagnosis
Medical History / Drug History Try and match these sections up
Non-Drug Treatment E.g. physiotherapy, speech and language therapy etc
Continuity of Care Discharge details
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 2
Factors affecting – Individual factors relevant to pharmacy practice Inform pharmaceutical issues
Absorption e.g. co-prescription of antacids Distribution e.g. plasma protein binding Metabolism e.g. age Excretion e.g. renal failure Ability to self medicate e.g. confusion Route of Admin e.g. target site of action
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 2 cont.
Clinical management Pharmaceutical need – requirement for pharmaceutical care Outcomes to consider:
cure elimination or reduction in symptoms arresting or slowing disease progression prevention of disease / symptoms
e.g. CAP – ensure appropriate antibiotics prescribed to correctly treat infection, minimise risk of adverse drug reactions
e.g. hypertension – maintain blood pressure control in order to reduce risk of future cardiovascular complications
Include acute and chronic disease
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 2 cont.
Current Medication List everything the patient was taking on admission Record allergies or NKA
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3
Pharmaceutical Care Plan
CARE ISSUE • “An element of a pharmaceutical need which requires to be
addressed by a pharmacist”.
• What is the problem? Something which prompts a pharmacist to “do” something.
Take into account patient and medication risk factors
Consider each problem in turn
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3 cont.
Categories to consider: Untreated indication Improper dug selection Sub-therapeutic dose Failure to receive medication Overdosage Adverse drug reactions Drug interactions Medication use without indication
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3 cont.
DESIRED OUTPUT Statement of what a pharmacist aims to achieve for a patient in relation to a care
issue
What do you want to achieve as a pharmacist?
SMART Specific Measurable Achievable Realistic Time-bound
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3 cont.
ACTION An action a pharmacist takes to address a care issue for a patient
What did you as a pharmacist do?
Relate to evidence base / demonstrate knowledge of EBM
Ideas to consider Recommending therapy Monitoring Patient counselling Confirm medication for discharge
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3 cont.
OUTPUT Response of the health team and /or patient to the pharmacists actions,
and/or the clinical outcome for the patient
What did you achieve as a result of your action?
Should be a direct result of your input.
Compare with desired output to evaluate
effectiveness of the action taken.
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3 cont.
Problem: - Patient admitted is found to be hyperkalaemic and is on an ACE inhibitor which may be contributing to this condition.
Care issue: - As above
Desired output: - Avoid medicines which may contribute to hyperkalaemia
- Potassium within reference range
- ? Appropriate treatment of hyperkalaemia as per local guidelines
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 3 cont.
Action: - Review all medicines for potential ADR
- Discuss potential ADR with the medical team and suggest witholding / stopping potential contributing agents
- Monitor Potassium
- ? Check local guielines to ensure appropriate treatment of hyperkalaemia
Output - ACEi witheld ?others
- Potassium within reference range
- ? Appropriate treatment
Quality Education for a Healthier Scotland
Pharmacy
Care Plan Page 4
Review Dates
Investigations Relate to care issues
TDM
Quality Education for a Healthier Scotland
PharmacyFinal Points....
Complete all sections of care plan
Choose simple cases
Remember training is progressive!
Quality Education for a Healthier Scotland
PharmacyQuestions
Any questions?
Email: [email protected]
