Ward Round: The groundlevel of patient care.......
Participation in ward rounds and meetings with the patient is of benefit to the pharmacist as well as the patients. This is the one of the most important and preliminary practical that the student undergoes in the pharmacy practice program. A clinical pharmacist as we know is the third pillar of the healthcare team following the doctor and the nurse. Thereby attending ward rounds and meeting wherever possible is important and beneficiary for a clinical pharmacist. On a ward round the pharmacist assist and helps the physician in prescribing a drug to the patient, which enables pharmacists to contribute to patient care through the provision of drug information and promotion of rational drug therapy. The pharmacist’s presence on ward rounds enables prescribing to be influenced at the time of decision making. To effectively participate in ward rounds, pharmacist should have well developed clinical and communication skills.
The goals of clinical pharmacist’s participation in ward rounds are to
• Gain an improved understanding of the patient’s clinical details, planned investigations and therapeutic goals
• Provide information on pharmacology, pharmacokinetics and other aspects of the patient’s therapy
• Optimize drug treatment by influencing therapy selection, implementation and monitoring
Prior to participation in a ward round, it is essential that the pharmacist is well prepared. If possible, a medication order review of all patients should be completed prior to the ward round. This allows the pharmacist to gain knowledge of drugs and disease states likely to be considered aspects of the patient’s drug therapy which are likely to be discussed.
The preparation of accurate and comprehensive patient profiles may be of assistance when preparing for a ward round. Attendance at relevant ward rounds and clinical meetings should be routine. If this is not possible, priority is given to those rounds in which the pharmacist can have the most impact and gather the most relevant information
Appropriate communication skills is used when discussing drug-related problems with other healthcare professionals on the ward round, and at all times when discussing problems in the presence of the patient and family.
The ward rounds provide an opportunity to:
• Contribute information regarding the patient’s drug therapy e.g.; suggestions for monitoring, information on new drugs
• Investigate unusual orders or doses
• Assimilate additional information about the patient which may be relevant to their drug therapy
• Detect ADRs and interactions
• Participate in discharge planning
At the completion of the ward round or meeting, the pharmacists follow up outstanding issues, including:
• Responding to any enquiries generated
• Communicating changes in drug therapy to other relevant personnel
• Completing necessary documentation
• Considering the impact of changes to the care plan, and making necessary alterations
• Discussing alterations to therapy with the patient where appropriate.
Pharmacist participating in Ward round