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Patient education and multi-layered checkpoints

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In GPP guidelines, pharmacists are required to provide advice to ensure that patients receives and understand sufficient information. This means pharmacist should provide sufficient drug education to patients. In Taiwan Good Dispensary Practice standards, it also requires that pharmacists should conduct patient education on medication therapy. In our pharmacy, we provide multiple patient education and consultation services, including inpatient and outpatient education and consultation, group education. For inpatients, We provide drug information leaflets, which clearly describe the drug name, indications, clinical effects, possible adverse effects, and special notice. For outpatients, essential information is printed on their medication bags. I will introduce the details about our medication bags in the following slides. In addition, we set up drug information kiosks near our pharmacies.
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Patients can simply insert their healthcare card or scan their prescription, then the kiosk can show the drug information related to this patient, including the education posters and videos. The educational posters are also displayed near the waiting area to disseminate correct healthcare information. In Taiwan Good Dispensary Practice standards, it requires that pharmacists should double check during dispensing process.
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In our outpatient pharmacy, We develop multiple checking process. The first checking point is our dispensing pharmacists. They should complete 3 checks and 5 readings to ensure the correctness of dispensing. The 3 checks include checking before dispensing, checking when putting the drug into drug bags, and checking when put back the drug. The 5 readings include assuring the right drug, right patient, right dose, right route, and right time.
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At the same time, the verifying pharmacist performing the second checking point. As I mentioned before, they verify prescriptions via computerized verifying system. Then the third checking point is our checking pharmacists. They double check the name, strength, dosage form, drug amount, and make sure medication is put into the right bags belonging to the right patient.
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Then the window pharmacists complete the fourth checking. At the picking up window, we apply barcode system. Pharmacists at the picking up window will receive the original prescriptions from patients. Then they scan the barcode on the prescription and on the drug bags to make sure the drug bags are given to the right patient. Then pharmacists give a brief patient education.
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In outpatient pharmacy, we perform the 4 checks. In inpatient pharmacy, we also perform multiple checks. The dispensing pharmacists perform the first check. And the verifying pharmacist and checking pharmacists perform the second check. Then, when we deliver medication carts, nurses would do the third check. And we design nine check points for chemotherapy medication dispensing. The automated dispensing machine can also print out patient and drug information on the package for the nurse double checking. In Taiwan Good Dispensary Practice standards, it requires that each unit dose should be labeled with patient’s name and medication name, dosage and quantity for inpatients. For our inpatients, we put unit dose into individual drawers in the medication carts.
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Patient name and room number is labeled on each drawer. Patient name and drug name, dosage and quantity are also printed on each unit dose package. And we also paste labels on the vials and bottles.
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Last, Taiwan GDP require that medication bags should have complete information and follow the regulations by the Ministry of Health and Welfare in Taiwan. Our medical bag provides essential information for patients, including dose and frequency, drug name, descriptions, and drug appearance, quantity, indications, and essential drug information. In addition, we provide Chinese-English bilingual description on our drug bag and provide information of possible side effects and their incidence. On the backside of bags, we print the general information, such as the storage method, the recommended administration time, and the contact number of pharmacy.

In practice, pharmacists should provide sufficient drug education to patients. However, due to the heavy workloads of pharmacists in hospitals in Taiwan, we have developed various tools to assist these tasks.

In this video, Ms Chou explains how patient education is conducted for inpatients and outpatients. There are various check procedures pharmacists need to perform during drug preparation. For example, an outpatient medication requires 4 checks, 3 checks. For inpatients, and chemotherapeutics, 9 checks are require. Drug bags must also contain relevant information to allow patients to do their own inspection. There will be another unit with more in-depth explanation to patient education.

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Good Pharmacy Practice: Introduction to Medication Delivery Systems

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