Pharmacy Clinical Support Technician Cardiac Sciences Program
Cardiology Patient Medication History This project started with a pharmacy technician in august 2009 The main objective is to get a medication history that is as accurate as possible, directly from the patient source rather than just extrapolating from the DPIN printout and an assortment of vials The patient population ranges anywhere from teens to elderly some of whom are well into their 90 s
Cardiology Patient Medication History There are basically 3 categories of patients on the cardiac unit that require medication reconciliation: Teaching, Consult patients and Procedure patients. Initially the focus of this trial project was to only interview the teaching patient, but it was expanded to include the rest of the patient population after approximately one month
Cardiology Patient Medication History We try to gather as much information about the medications the patient is using at the time of admission. This is valuable to the Medical Team during the patients hospital stay. This information is used by all members of the team.
Cardiology Patient Medication History Priority order is Teaching, Consult then Procedure Patients. Procedure patients are only interviewed if their stay becomes extended on the unit. Type of medication that the patient is currently on is one of the guides along with the pharmacist guidance determines the priority order of interview.
Cardiology Patient Medication History The best approach to an interview is generally a conversation between the technician and the patient. The more at ease the more information is gathered. The patient is often hazy after the heart event and unless there is a history of heart problems, can also be in denial The task is to get the truth, not to pass judgment or offer advice. Listening and passing along information is the task.
Cardiology Patient Medication History Patient histories help to make patient treatment more complete. Situations like finding a translator, talking to the spouse or care giver are also part of the interview process Family members at times can be less helpful than they realize by adding their own history during the interview
Cardiology Patient Medication History Observations during the interview can sometimes be helpful to the pharmacist or other medical team members, and can help improve the patient experience Patient medication history interviews have become an essential part of the patient care in the Cardiac area. Access to the patient can be challenging at times
Cardiology Patient Medication History In an ideal world post admission to the unit is the best time for the interview In the real world we have to coordinate our interview between lab tests, Nursing duties, Physicians rounds and a host of other disciplines that also require time with the patient to perform their jobs. Patients post procedures require rest and may not be at their best for an interview about their medications
Cardiology Patient Medication History Learning to read patient charts progress notes is another challenge Every discipline that has an interaction with the patient makes a note in the chart Referring to the chart prior to the interview can give you insight to the patient state of mind
DPIN Sample
Sample of Medication History Interview Form
Sample Medication History and Reconciliation Form
Cardiac Terminology These are just a few of the frequently used terms in the area. We hear and see these terms in charts, on prescriptions and lab requisitions quite frequently: CABG Coronary Artery Bypass Graft or often called Coronary Artery Bypass Surgery - creates new routes around narrowed and blocked arteries, allowing sufficient blood flow to deliver oxygen and nutrients to the heart muscle.
Cardiac Terminology CAD Coronary Artery disease occurs when atherosclerotic plaque (hardening of the arteries) builds up in the wall of the arteries that supply the heart. US Ultrasound used to examine many organs including the heart
Cardiac Terminology MI - Myocardial Infarction occurs when a plaque ruptures, allowing a blood clot to form. This completely obstructs the artery, stopping all blood flow to part of the heart muscle, and that portion of muscle dies. Angiogram - An x-ray of blood vessels which can be seen because the patient receives an injection of dye to outline the vessels on the x-ray.
Cardiac Terminology Angiography- A procedure performed to view blood vessels after injecting them with a radioopaque dye that outlines them on x-ray. Angioplasty- Procedure with a balloon-tipped catheter to enlarge a narrowing in a coronary artery. Also called Percutaneous Transluminal Coronary Angioplasty (PTCA).
Cardiac Terminology Aorta - The largest artery in the body. The aorta arises from the left ventricle of the heart, goes up a little ways, bends over, goes down through the chest and through the abdomen to where it ends by dividing into two arteries called the common iliac arteries that go to the legs.
1400 Cardiology Patient Medication History 1200 1000 800 600 400 200 0 *August *September October November December *January *February *March # Medication Histories # Medications Average interview duration # Medication Histories # Medications Average interview duration *August 48 457 49.69 *September 59 552 32.8 October 116 964 31.11 November 149 1234 27.35 December 113 982 20.31 *January 88 765 25.11 *February 77 668 24.61 *March 45 368 30.44
Clinical Support Technician This is just one of the ways the Pharmacy technician role has evolved from the time that I started to now. Prior to these expanded roles we basically counted the tablets and capsules. Now we are able to create positions in the pharmacy environment that enhance the lives of many people.
Questions? Thanks for your time