Pt Counseling 2

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Pt Counseling 2
2011-09-19 16:44:13
Pt Counseling

Pt Counseling 2
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  2. Four Componets of Communication




  3. SEGUE Guide

    (Northwestern University)
    • Set the stage
    • Elicit the information
    • Give the information
    • Understand the patient perspective
    • End the communication
  4. Communication needs to be a what of information
    two-way flow of information
  5. Which is more important, verbal or non-verbal communication
    NON Verbal Communication
  6. Cultural Jeopardy
  7. Do communication barriers exist, if so what do we need to do?

    Minimize communication barriers
  8. Examples of Communication Barriers
    • Perception à don’t want to bother you, not
    • enough time

    • Environmental
    • Social
    • Psychological
  9. Is Nevada a mandatory couseling state?
  10. Self Care is related mostly to what
    OTC Products
  11. IHS stands for
    Indian Health Services

    Federal Dept of Health Services
  12. PPCP

    Orginating from where?
    Patient Pharmacist Counsel Program

  13. What is the basis of PPCP?
    Ask open ended questions
  14. Where NOT to store prescriptions?


    Where kids can acccess
  15. What Federal Law established mandatory patient couseling?
    ORBA 90
  16. What are some of the requirements of ORBA 90?
  17. Open ended questions consist of

    • Why
    • When
    • How
    • What
  18. Don't assume the prescription is for the usual every day use
    off label uses are VERY VERY common
  19. What questions to avoid

  20. Prime Questions for New Rxs

    DR tell you what the Rx is for?

    DR tell you how to take RX

    DR tell you what to expect

    Final Verification --> Recap
  21. Final Verification
    Have the pt tell you how there going to take the medication
  22. What is the PAR technique


  23. When do we use the PAR technique
    in Challenging Situations
  24. Ex of a challenging situation
    Pt just found out about a terminal illness

    EX Cancer
  25. Always update the prescription profile with special notes
    EX Only wants capsules and tablets in manufacture bottles
  26. Patient Compliance
    Are they taking as prescribed

    dont jump to conclusions that they're are or aren't
  27. Mental Preprations for Pt Counseling
    EX Filling SSRI or other Anti-Depressant
  28. Look at previous RXs in prescription profiles for
    Drug Allergies

    Duplicate Therapy from Different Drs
  29. Personal Knowledge
    Get to know your pts

    Most pts come to the same Pharmacy
  30. The Challenging Patient
    Think about barriers:

    • Emotional
    • Function
    • Environmental
  31. Emotional Barriers
    EX getting SSRI for a loss

    Body Language

    How Pt is speaking
  32. Emotional Barriers 2
    Retention of information

    Logic impaired when depressed, fatiqued etc.
  33. Emotions can block logic
    Emotional Barriers
  34. Be aware of the multiple emotions you will come across
  35. Anger
    • Fear
    • Anxiety
    • Sadness
    • Depression
  36. Effective Listening
    Look for clues --> suppose to, late refills
  37. Functional Barriers
    • Sensory impairment
    • alternate beliefs,
    • language barriers
    • comprehension difficulties
  38. Accept what pt is saying without agreeing, condoning or condemning
  39. The non stop talker
    use LESS open ended questions

    say I would like to discuss more, but have other pts
  40. Aggressive Patients
    always find a positive before a negative
  41. Setting Limits
    • Be Factual
    • Use Feedback
    • Admit Fault
    • Goal --> desired outcomes with minimal barriers
  42. Self-Care Triage Options
    No tx

    Refer to PCP

    Self Care
  43. Self Care: Request for Specifc Products
    Do you know the active ingredients?

    Recommended, Advertisement, Condition
  44. In general patients under the age of 2 should be referred to primary care.
  45. What is the best measure for Pediatric Dosing
  46. Other Pedriatic Dosing Measurements
    • Young's Rule
    • Clarks Rule
    • Fried's Rule
  47. OTC products should only be used for a certain amount of time
    not chronically

    EX Prilosec should only be used for 14 days
  48. OTC Labeling
    • Claims for use:
    • Prevention
    • Treatment
    • Symptomatic Relief
    • Cure of Disease --> Very Rare
    • Cure of Injuries --> Very Rare
  49. How many componets are required by the FDA on OTC labeling

    always in the same order
  50. OTC Label Componets
    • Active Ingredients,
    • Purpose
    • Uses
    • Warning
    • Directions
    • Other Information
    • Inactive Ingredients
  51. Unlike food labeling, on OTC Labeling ingredients are listed in alphabetical order
  52. OTC Allergies
    The Dyes present in the OTC Product
  53. A lot of pts are allergic to yellow dyes
  54. Bacterial Infection... What is elevated
  55. 325 mg of Ferrous Sulfate is equilavalent to 60 g of elemental iron (Fe)
  56. Know the CBC Numbers