Tips For PRP : Outpatient Pharmacy Department

Outpatient Pharmacy Department , no doubt "THE MOST BUSY DEPARTMENT'. 

According to statistic in my hospital , 1 counter need to serve 100- 300 patients per day. Imagine if your pharmacy have 4- 5 counters , everyone in this mentally tensed , a small mistake would not allow as it can drag down the whole workflow.

I did admitted even I get annoyed few times , especially during peak hour. When newbie PRP did a very simple or very basic mistake that shouldn't done by a PRP. It definitely made me slightly irritated. 

In that split of moment , I saw myself,  myself when I  was newbie in OPD.

I did the same mistake too. Look at those anxiety overwhelming panic face , it really convince me to start on this topic.

WHAT THE COMMON MISTAKE PRP DO IN OPD?
WHAT SHOULD'NT PRP DO IN OPD? 

WHAT SHOULD PRP DO IN OPD?

Before we start , lets us briefly know about the flow in Outpatient Pharmacy Department.Over all we have 4 important sections

SCREENING 💨FILLING💨COUNTER CHECK💨 DISPENSING

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<WHAT THE COMMON MISTAKE PRP DO IN OPD?>

- Filled wrong medicine, wrong amount , wrong strength 

- Forgot to document the amount of supply, signature, and date supply behind the RX prescription

- Dint record in bin card when take out SRQ item

- DD dangerous drug , not tally physical amount and amount in DD book

- Forgot to document the take and return of DD key

- Dint screen well Rx. Received those expire Rx, other facility Rx, incomplete Rx  or inappropriate regimen Rx..ect

- Forgot important point during counseling or counselling wrong technique

- Borrow counseling kits , end up lost it / forgot to return it

- Bad time management during dispensing (KPI = 30 minutes of waiting time)

- Intervent doctor / query outcome wasn't clear / appropriate

- Not familiar with VAS service , tend to deliver wrong information / registered the inappropriate service 

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<WHAT SHOULD'NT PRP DO IN OPD?>

- Do not ask when not understand / not get it/ or cant find medicine (act like know, actually not)

- Struggling finding medicine alone without asking others, end up it take long time for filling

(in directly it drag down the work flow, might exceed 30 minutes of waiting time) For sure , your dont wish your name/ Rx number in hand was shout loud from dispensing counter

- Bad attitude / behavior ( Not puncture , selfishness , not complete task given on time. ect

-  Unwilling of teamwork / Bad relationship with co worker

- Attire over "outstanding" ( dressed like fashionista , colorful hair )

- Ego-ism ,dint accept criticism , always find excuse for mistakes 

- Rude or impolite toward PF/ PPF / senior  

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<HOW TO BE A QUALIFIED PRP>

Always have 3 colours pen , 1 marker , 1 note book , staple , name cop , and  name tag, pendrive

Why you need 3 colours pen ? 

Red pen for you to entry of stock , while black or blue for out of stock either in bin card or DD book. Marker for label the amount meds in box/batch number/ expired date on envelop for loose medicine. This is very important. 

Apart of that, kindly remind to stick / mark your name on it. Its a common things your pen lost mysteriously in OPD. 

 

I bought a name tag with good quality of ....what we call the rope?? the ribbon ?? the holder ??..

Yeah ,  as you need to hang all your stationary on your neck everyday, so it doesn't broke easily. 

Bring your labcoat with you. Buy labcoat with pockets, so can keep staple, scissor ,and name cop (if neccesary). Plus , I will keep small note book and Frank Shan in my pocket.

Note book, is very important as u need to note down those importance information or tasks.

Wrote it down as future reference. Never believe your brain can memories all , must write down.!!

I tend to be so forgotful.

My preceptor always sarcastic me in funny way

 "EMY , I believe your brain was same with gold fish, memory last for 7 seconds only."

My suggestion , at least have 2 lab-coats to interchange weekly. I ever saw my friend's labcoat turned brownish yellowish. 

He whispered : I forgot when is the last time I wash my labcoat. 

My face reaction was like , ewwwww ..gross...HAHA (Actually I wasn't better, but at least I wash it monthly.)

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I bought 3 books from KAMAL BOOKSTORE

<Frank Shann> is my medical bibble when come to paediatrics dose. 

<The Sarawak Handbook of Medical Emergency> is a little handbook of mine on guidelines on treatment of medical emergency case. It was quite useful for me , as we need to know why doctor start certain medication instead of other.

<The Sanford Antibiotic Guideline> wasn’t too helpful for me , as I download National Antibiotic Guideline from pharmacy official website .

Click link below to download :

National Antimicrobial Guideline 2019, 3rd Edition - Pharmacy.gov

When ever I come across antibiotic dose , indication I can always open my phone, its make everything easier.

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The life saving medical apps, u must have at least to check on the dose , pharmacology indication , drug interaction and so on  (These are only my recommendation which I personally more prefer)

<UPTODATE > 

I totally cant live without this app, I know I m kinda depend on this apps. When ever I meet some weird regimen or dose , I always check on my apps. Its even included study case / clinical study. I learned a lot as I like to scroll through it when bored

*I m weird * A little bit of excited when I found new things, new drugs, new regimen , enjoy of reading those knowledge.

<BLUE BOOK> 

its a very summary about indication and regimens of drug that available in Malaysia. Normally I will only use to check whether the drug available in FUKKM / indication available , decide of apply certain drug as KPK.

<NATIONAL ANTIMICROBIAL GUIDELINE> 

this not an apps but can download it and use as very good references. I have the primary antibiotic and alternative , renal dose, conversion dose.

Click link below to download :

National Antimicrobial Guideline 2019, 3rd Edition - Pharmacy.gov

<LEXICOMP / MICROMEDEX> 

These are good drug reference. I use Micromedex mostly during my ward rotation when come to check the IV compatible between drugs.

<CPG MALAYSIA>

Further, I would advise to download the all CPG from Academy of Medicine of Malaysia website. Management and treatment  as guidance in disease management, example, cardiovascular disease, diabetes DM, STEMI... and ect. I found CPG app from google store android ,not sure if available for IOS Iphone. Its quite helpful , I download all the cpg in app, easier for me to refer. As there were 2 type which is summary and also full guideline. I prefer summary , as I need a fast scan through and give good judgement to doctor/ preceptor regarding treatment management, but full reference would be a more detail reference in some specific case. 

Click the link below to download all the CPG:

CPG MALYSIA FROM ACADEMY OF MEDICINE OF MALAYSIA

Accomplished yourself with pharmacology / clinical knowledge. Keep update with latest medical information.

Bacteria and virus mutated / tolerance/ transformed, also treatment change from time to time. Its kinda impossible for us to remember everything, pharmacist dont have superpower. 

TOO MUCH TO REMEMBER

The most important is , you know where to find trust-able resource when having discussion, give the best outcome with good supporting reference.

I admitted myself wasn’t good enough , but I m still learning like you all too.

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1st First rule of PRP, be puncture. 

<Punctuality can create good first impression>

Instead of come on time , prefer to come early. Not mean to be hypocrite here.When u come earlier u can actually well prepared yourself  before the war start. Another way, actually give good impression to other.

During PRP , I contributed much time in hospital, like second home for me. Still remember, I used to stay back during my OPD rotation, overtime like my routine.Whenever PPF or PF ask , my answer always 

“Because I love Hospital so much”

 I know what you guy wanna ask,"Can claim time off?"

 The answer is ,Nope u cant claimed time off !!  because its your willingness to stay over after finish work to actually complete those task given / key in counseling in PHIS..ect. 

Hopefully these tips can help you, at least reduce the percentage to get scold by your preceptor.

*At last but not the least, serve patient with good heart , learn with passionate/ humble heart, treat everyone with truthful heart, I m sure your hardwork will get pay*

Coming up next I would upload about more detail about the tips of surviving in OPD specifically for screening, filling (DD and SRQ), intervention , counselling , and dispensing.

Maybe tips/ story of how to handle those fancy patients in a "brilliant" way...ect (OPD was the rotation I was scold by patients most of the time,because I m not good in handling. So I would like to share my experience so u can take it as lesson  )

Hopefully I can upload by next week, as I realize I have just so much to share with you guys. 

Those are my personal opinions, correct me if I m wrong. Or maybe if u have any to add on kindly comment below. I will be so appreciate. ^.......^