Dispensing to ambulatory patients

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DISPENSING TO AMBULATORY PATIENTS:

Ms.Wajiha Iffat DISPENSING TO AMBULATORY PATIENTS

objectives:

objectives After the end of this lecture, Define ambulatory patient Discuss categories of ambulatory patient Standard for provision of ambulatory services Minimum standard for for provision of ambulatory services

AMBULATORY PATIENTS:

AMBULATORY PATIENTS Ambulatory refers to patients not occupying beds in hospitals or other inpatient settings, and to care given in physician‘s offices ,clinics, other health centers, and other places where ambulatory patients usually go for health care.

CATEGORIES OF AMBULATORY PATIENTS:

CATEGORIES OF AMBULATORY PATIENTS EMERGENCY CARE REFERAL OR TERTIARY CARE PRIMARY CARE

GROWTH OF AMBULATORY CARE CLINICS:

GROWTH OF AMBULATORY CARE CLINICS Supplement its in-patient teaching program. The demand by the community. The new philosophy of hospitals. To exercise greater control over patients receiving investigational use drugs. The lack of a sufficient number of physicians in some areas. The emergency service of a hospital is always available.

PROVISION OF PHARMACEUTICAL SERVICES IN AMBULATORY CARE SETTINGS:

PROVISION OF PHARMACEUTICAL SERVICES IN AMBULATORY CARE SETTINGS Patient medication histories. Safety and efficacy of drug therapy. Providing drug information. Assisting prescribers. Utilizing assessment skills. Detecting and reporting adverse drug reactions. Educating and counseling patients.

PROVISION OF PHARMACEUTICAL SERVICES IN AMBULATORY CARE SETTINGS:

PROVISION OF PHARMACEUTICAL SERVICES IN AMBULATORY CARE SETTINGS Participating in drug-use reviews. Education of health care providers. Supervising the storage, preparation, dispensing, and administration of medications in the patient care area. Developing systems. Developing and utilizing systems.

Minimum Standard For Ambulatory-Care Pharmaceutical Services::

Minimum Standard For Ambulatory-Care Pharmaceutical Services: By a qualified pharmacist. Appropriateness of the choice of drug and its dosage, route of administration, and amount must be verified by the pharmacist. Maintenance of medication profiles for patients. All medications dispensed to patients will be completely and correctly labeled and packaged. Proper controlled.

Learning Objectives For Residency Training In Ambulatory Care Pharmacy Practice::

Learning Objectives For Residency Training In Ambulatory Care Pharmacy Practice : Definition Qualification of the training site Qualification of the pharmacy services Qualification of the preceptor Qualification of the applicant

LEARNING OBJECTIVES:

LEARNING OBJECTIVES Develop an appreciation for the organization and operation of an ambulatory-care pharmacy service. Obtain and document in the patient’s medical record, medication histories, and medication profiles.

LEARNING OBJECTIVES:

LEARNING OBJECTIVES Manage a patients drug therapy by: Provide drug information. Refer the patient. Monitor the safety and efficacy of drug therapy. Supervise the storage, preparation, and dispensing of medications. Participate in, or recommend alternative methods of, administering medications to ambulatory-care patients.

LEARNING OBJECTIVES:

LEARNING OBJECTIVES Identify and initiate strategies. Establish functional systems for detecting, reporting, and managing adverse drug reactions. Educate and counsel patients. Establish criteria for sale and effective drug use.

LEARNING OBJECTIVES:

LEARNING OBJECTIVES Organize an ongoing educational program. Develop and defend a proposal. Establish a quality-assurance program. Management of medical emergencies. Areas of emphasis.

Areas of Emphasis:

Areas of Emphasis Acute illnesses. Chronic illnesses. Preventive care. Self care. Emergency care. Family planning. Devices. Communications skills.

Location of out-Patient Dispensing Area: :

Location of out-Patient Dispensing Area: There is no set rule as to the best area to locate an out-patient dispensing pharmacy. This is evidenced by the fact that in today’s practice three equally suitable provisions are made for this area. A separate out-patient pharmacy is available. A combined in-patient and out-patient unit with service provided from the same “window”. A combined in-patient and out-patient unit with service provided from separate “window”.

  Types of Prescriptions Received: :

Types of Prescriptions Received: Private patients (where permitted by the state board of registration in pharmacy), indigent patients, non-indigent patients, employees, and patients being discharged from the hospital.

PowerPoint Presentation:

500 or more beds fill approximately 1 prescription per 3 out-patient visits, whereas the 100 to 199- bed hospitals average about 1¼ prescription for each visit.

  Dispensing Routine: :

Dispensing Routine: Clinical patients A prescription written by the physician. Pharmacy where it is compounded by a pharmacist.

  I.R.S Ruling on out-Patient Dispensing: :

I.R.S Ruling on out-Patient Dispensing: If a hospital pharmacy is open to the general public and prescriptions are filled for patients walking in from the street or if sales of non-prescription items are made under the same conditions, this revenue is subject to taxation. One of the rulings permits prescription sales without taxation by hospital which fills occasional prescriptions.

I.R.S Ruling on out-Patient Dispensing::

I.R.S Ruling on out-Patient Dispensing: Written by staff physicians who practice in consultation rooms provided by the hospital. . IRS has ruled that these were merely “casual” sales, made as a courtesy to staff physicians. In ruling that out-patients may have prescriptions filled in hospital pharmacies without subjecting the income received by the institution to federal taxations, IRS also included refills for former patients or prescriptions treatment.

I.R.S Ruling on out-Patient Dispensing::

I.R.S Ruling on out-Patient Dispensing: . it also extended the non-taxable income rule to treatment received in home care and extended care facilities operated by or supervised by a hospital.

DISPENSING TO EMERGENCY PATIENTS: :

DISPENSING TO EMERGENCY PATIENTS: After receiving treatment in the emergency ward of a hospital, the patient may receive a prescription. If the prescription is presented to a hospital pharmacist, he follows the methodology described earlier

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