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Why LicensureStates' professional licensing laws help consumers identify who is a qualified practitioner to provide a particular set of specified services, known as the profession's scope of practice. Learn About Licensure Map and Statutes by StateThis map provides links to boards, statutes and rules, in addition to information about the type of nature of dietetics regulation in each state. Learn About Teleheath and LicensureRegistered dietitian nutritionists looking to relocate, practice telehealth or otherwise practice dietetics and nutrition or provide medical nutrition therapy to individuals in another state should be aware of certain legal implications. Learn About Therapeutic Diet OrdersThe Center for Medicare and Medicaid Services rules authorize the participation of RDNs in the issuance of therapeutic diet orders in hospitals and long term care if consistent with state laws and facility policy. Learn About Join the AcademyMembers of the Academy of Nutrition and Dietetics receive exciting benefits including complimentary continuing professional education opportunities, discounts on events and products in eatrightSTORE.org, invitations to exclusive members-only events and more! BackgroundAs discussed in the related primer on medication error, adverse drug events occur when exposure to a medication results in harm. Correct medication use occurs when the "five rights" are followed, meaning the right dose of the right medication is administered to the right patient, at the right time, and by the right route. However, this simple phrase obscures the fact that the five rights must be individualized, as they are affected by the patient's age, medical condition, physiologic status, and other factors such as allergies. While pharmacists' contribution to medication safety has been historically focused on dispensing, pharmacists' roles have expanded as medication therapy has increased in complexity, and many patients—even those with serious illness—can now receive care in the home and in community settings. According to the American Pharmacists Association, pharmacists in all settings have eight essential medication-related responsibilities linked to improving patient safety. These eight responsibilities and examples of how they can affect patient safety are outlined in the Table.
Pharmacists also have a crucial system-level role in planning and leading medication safety programs and improvement initiatives within health care organizations. These initiatives may include developing risk-specific protocols for high-alert medications; identifying and evaluating high-risk processes (e.g., total parenteral nutrition, compounding, pediatric dose preparation) that require special attention, protocols, and training; evaluating medication error data; evaluating and implementing new medication technologies; and fostering robust error reporting processes. Clinical trials are another area in which pharmacist leadership in designing safe protocols is critical, as there are fewer standardized safeguards in place to ensure correct medications and doses are delivered to patients. Current ContextPharmacists have a central role in ensuring medication safety across the continuum of care. The complexity of the medication prescribing and delivery processes can make it difficult to prove the beneficial effect of pharmacists on adverse outcomes directly, but pharmacist involvement has been shown to reduce errors, improve prescribing practices, and enhance patient monitoring across settings. For example, a cluster-randomized trial of pharmacist involvement in medication management planning on hospital admission showed a dramatic reduction in medication errors within the first 24 hours of hospitalization. A meta-analysis of 13 studies of pharmacist interventions at transitions of care estimated a 37% reduction in medication errors and a decrease in emergency department visits after hospital discharge. A recent randomized controlled trial of a pharmacist-led intervention in primary care practices in the United Kingdom tested an intervention bundle comprised of review of electronic medical records, prescriber feedback, education on error reduction, and support for improving local safety systems. This bundle of practices resulted in significant increases in appropriate prescribing and monitoring practices for specific error-prone situations, such as elderly patients taking loop diuretics or angiotensin-converting enzyme inhibitors. Despite these generally positive results, many health systems have found it difficult to hire enough qualified pharmacists, either because of a shortage in the available pharmacists or the costs of implementation. Given the latter factor, further studies that consider the return-on-investment of pharmacist-led safety programs should be considered. Is a health care professional who is specially trained in evaluating the nutritional status of a patient and developing an appropriate diet plan?The registered dietitian is currently the single identifiable group of health professionals qualified to provide nutrition therapy.
Which of the following would be considered a responsibility of a pharmacist?Pharmacists dispense prescription medications to patients and offer expertise in the safe use of prescriptions. They also may conduct health and wellness screenings, provide immunizations, oversee the medications given to patients, and provide advice on healthy lifestyles.
In which of the following areas can a physician assistant pursue a postgraduate educational program?Postgraduate educational programs are available in areas such as emergency medicine and psychiatry. To enter one of these programs, a physician assistant must be a graduate of an accredited program and be certified by the NCCPA.
How many years does the PharmD program generally take to complete?Three to four years of undergraduate pre-professional (prerequisite) coursework, followed by four academic years in the professional program. Most students need four years to complete their prerequisite courses. Thus, it usually takes eight years of college study to earn a Pharm. D.
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