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Four Componets of Communication
SRIB
-Sender
–Receiver
–Information
–Behavior
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SEGUE Guide
(Northwestern University)
- Set the stage
- Elicit the information
- Give the information
- Understand the patient perspective
- End the communication
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Communication needs to be a what of information
two-way flow of information
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Which is more important, verbal or non-verbal communication
NON Verbal Communication
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Do communication barriers exist, if so what do we need to do?
Yes
Minimize communication barriers
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Examples of Communication Barriers
- Perception à don’t want to bother you, not
- enough time
- Environmental
- Social
- Psychological
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Is Nevada a mandatory couseling state?
YES
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Self Care is related mostly to what
OTC Products
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IHS stands for
Indian Health Services
Federal Dept of Health Services
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PPCP
Orginating from where?
Patient Pharmacist Counsel Program
IHS
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What is the basis of PPCP?
Ask open ended questions
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Where NOT to store prescriptions?
Bathrooms
Kitchen
Where kids can acccess
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What Federal Law established mandatory patient couseling?
ORBA 90
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What are some of the requirements of ORBA 90?
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Open ended questions consist of
4
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Don't assume the prescription is for the usual every day use
off label uses are VERY VERY common
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What questions to avoid
DID
DO
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Prime Questions for New Rxs
4
DR tell you what the Rx is for?
DR tell you how to take RX
DR tell you what to expect
Final Verification --> Recap
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Final Verification
Have the pt tell you how there going to take the medication
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What is the PAR technique
Prepare
Assess
Respond
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When do we use the PAR technique
in Challenging Situations
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Ex of a challenging situation
Pt just found out about a terminal illness
EX Cancer
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Always update the prescription profile with special notes
EX Only wants capsules and tablets in manufacture bottles
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Patient Compliance
Are they taking as prescribed
dont jump to conclusions that they're are or aren't
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Mental Preprations for Pt Counseling
EX Filling SSRI or other Anti-Depressant
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Look at previous RXs in prescription profiles for
Drug Allergies
Duplicate Therapy from Different Drs
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Personal Knowledge
Get to know your pts
Most pts come to the same Pharmacy
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The Challenging Patient
Think about barriers:
- Emotional
- Function
- Environmental
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Emotional Barriers
EX getting SSRI for a loss
Body Language
How Pt is speaking
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Emotional Barriers 2
Retention of information
Logic impaired when depressed, fatiqued etc.
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Emotions can block logic
Emotional Barriers
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Be aware of the multiple emotions you will come across
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Anger
- Fear
- Anxiety
- Sadness
- Depression
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Effective Listening
Look for clues --> suppose to, late refills
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Functional Barriers
- Sensory impairment
- alternate beliefs,
- language barriers
- comprehension difficulties
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Accept what pt is saying without agreeing, condoning or condemning
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The non stop talker
use LESS open ended questions
say I would like to discuss more, but have other pts
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Aggressive Patients
always find a positive before a negative
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Setting Limits
- Be Factual
- Use Feedback
- Admit Fault
- Goal --> desired outcomes with minimal barriers
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Self-Care Triage Options
No tx
Refer to PCP
Self Care
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Self Care: Request for Specifc Products
Do you know the active ingredients?
Recommended, Advertisement, Condition
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In general patients under the age of 2 should be referred to primary care.
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What is the best measure for Pediatric Dosing
BSA
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Other Pedriatic Dosing Measurements
- Young's Rule
- Clarks Rule
- Fried's Rule
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OTC products should only be used for a certain amount of time
not chronically
EX Prilosec should only be used for 14 days
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OTC Labeling
- Claims for use:
- Prevention
- Treatment
- Symptomatic Relief
- Cure of Disease --> Very Rare
- Cure of Injuries --> Very Rare
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How many componets are required by the FDA on OTC labeling
7
always in the same order
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OTC Label Componets
- Active Ingredients,
- Purpose
- Uses
- Warning
- Directions
- Other Information
- Inactive Ingredients
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Unlike food labeling, on OTC Labeling ingredients are listed in alphabetical order
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OTC Allergies
The Dyes present in the OTC Product
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A lot of pts are allergic to yellow dyes
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Bacterial Infection... What is elevated
RBC
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325 mg of Ferrous Sulfate is equilavalent to 60 g of elemental iron (Fe)
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