Role of Pharmacist according to ASHP

According to American Society of Health-system

Pharmacist (ASHP), following are the roles of pharmacist
working in any setting i.e. Large hospital, small hospitals,
community pharmacies, or nursing homes:

1. Immunizations and travel vaccines.

2. Medication therapy management (MTM).
3. Collaborative drug therapy management (CDTM).
4. Focused specialty management of chronic diseases (e.g.,
anticoagulation, diabetes, heart failure).
5. Management of complex acute conditions or exacerbation of
chronic conditions (e.g., urinary tract infection, chronic
obstructive pulmonary disease, asthma).
6. Provision of personalized medicine (e.g. pharmacogenomics)
7. Patient counseling, education, and training.
8. Drug Information provision.
9. Family Planning.
10.Poison control centers.
11.Take-home pharmacy (medication reconciliation)
12.Point-of-care pharmacy services
 NURSING HOME
• A residential facility for people with chronic illness or
disability.
• Also known as a convalescent home and long term care
facility includes adults who suffer from chronic (long-
lasting) or such illnesses as stroke or Alzheimer’s disease .
• Both medical and residential care is provided.
 Methods of handling drugs

• Most extended care facilities and small hospitals do not

employ full time pharmacist, many of them contract for
such services.
• Medical staff rely upon community pharmacist to
dispense medication from local pharmacy and deliver the
facility .
• Pharmacy service in small hospital is provided by the
department of pharmacy of a nearby large hospital.
 Extended care facility and
pharmacy department

• If extended care facility has pharmacy department, a

licensed pharmacist is employed to administrate
pharmacy department.
• If there is no pharmacy depart. Then there is prompt &
convenient obtaining of required drugs & biologicals from
community pharmacist.
• If facility has only drug room where bulk drugs are stored,
the pharmacist is responsible for control of bulk drugs.
• Pharmacist dispense drugs from drug room after
appropriate labelling and make them available for nursing
personnel.
 Small-large hospital services
comparison
• The departments like :
1. Pharmacy
2. Radiology
3. Pathology Services
are provided by the pharmacist on call in large hospitals.
• While these departments are not present in small
hospitals and they utilize the outside services.
 Roles of pharmacist in Extended
care facility
• Drug regimen review : encompasses the clinical activities of
consultant pharmacist
• Drug regimen must be reviewed at least monthly by
pharmacist
• Any irregularity found during review must be reported to
physician and director of nursing.
• Examples of irregularities include Use of three or more
analgesics at a same time
• Use of iron therapy without red blood cells assessment,
Concurrent use of two or more hypnotics
Pharmacist should check the medication order for
appropriateness of:

Drug
Dose
Route of administration
Frequency
Indication (reason of use)
 Medication error and ADRs

The pharmacist should report and

document any drug irregularities, like
ADRs and MEs and clinical
recommendations promptly to the
attending physician or nurse-in-
charge and the nursing home
administrator and reporting body
 Interaction Checking

• Drug interactions, including interactions between

prescription drugs and over-the-counter drugs, drugs and
disease, and interactions between drugs and nutrients.
Should be checked along with contraindications and
precautions.
 Medication pass observation

To observe the preparation and administration of

medication

 Compare medication label with medicine administration

sheet
Ensure 5 RIGHTS (resident, drug, dose, time and route)
Adequate hydration when administering drug
 Stop dispensing

The pharmacist should ensure the automatic stop

order in case where duration and number of dose
is not specified.
 Allergies documentation

The pharmacist must ensure that all known allergies are

documented in plain view in the patient's medical record
 Inspection
Periodic inspection of nursing station and medication
cabinets should be done to ensure

LASA and other HAM medicine are separately placed

 No expired medicine is present
Proper record of narcotics being administered to the
patient
 Counselling

• The Pharmacist should counsel the patients about

medicine administration and device usage.
Counselling
Counselling