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Clinical Decision Making - part 2
By Kazeem Olalekan
That said:
After conducting a clinical check, a decision must be made. The quality of that decision can make or break all the efforts expended on the clinical check. Clinical decision at the end of a clinical check is as important as the clinical check itself.
As an example, I received a simple prescription for 12 year old child for Ventolin Evohaler and Aerochamber Plus type 3 with child mask. I checked that the child can use a normal Aerochamber Plus type 3 (adult without mask) and it was confirmed to me by the parent that the later was what they were expecting not the child device. It makes sense, so I supplied the normal aerochamber and endorsed the script appropriately. Should I have sent the patient back to the doctor for an appropriate prescription - I think not!
Why do we know what we know if we cannot apply it day to day?
NB: There are some decision that require discussion with the doctor and the skill is knowing when to do what. A clinical decision must be appropriate to the circumstance, and that is the challenge we all face day to day.
26 Jun 2011
The theme of clinical decision making is one I will revisit from 
time to time over the lifetime of this blog series because as high street clinicians we are required to make these decisions. In my previous posting on this, I described how I used the resources at my disposal to make a clinical decision (1). These decisions are sometimes not as black and white as some might think. Sound judgement is important and I will explore this in another post.
In this post I will like to highlight the publication of a quick reference guide on Clinical Check by the Royal Pharmaceutical Society (RPS) which appear in this week’s professional matters of the journal (PJ, 25 June 2011- 2):
The guide describe the purpose of clinical check by pharmacists and the need to obtain information from relevant sources for a complete check to be undertaken. The guide describes patient characteristics to look out for (I posted about the need to take extra care for prescription written for children - 3). The guide also describe what issues surrounding medication regimen the pharmacist should be aware of (I posted about a patient with renal failure - 4) and finally it describes what aspects relating to administration and monitoring to look out for. It is a useful guide which is well worth looking at.
time to time over the lifetime of this blog series because as high street clinicians we are required to make these decisions. In my previous posting on this, I described how I used the resources at my disposal to make a clinical decision (1). These decisions are sometimes not as black and white as some might think. Sound judgement is important and I will explore this in another post.In this post I will like to highlight the publication of a quick reference guide on Clinical Check by the Royal Pharmaceutical Society (RPS) which appear in this week’s professional matters of the journal (PJ, 25 June 2011- 2):
The guide describe the purpose of clinical check by pharmacists and the need to obtain information from relevant sources for a complete check to be undertaken. The guide describes patient characteristics to look out for (I posted about the need to take extra care for prescription written for children - 3). The guide also describe what issues surrounding medication regimen the pharmacist should be aware of (I posted about a patient with renal failure - 4) and finally it describes what aspects relating to administration and monitoring to look out for. It is a useful guide which is well worth looking at.
And where to go for further information:
RPS Support: 0845 257 2570
Webform at www.rpharms.com
That said:
After conducting a clinical check, a decision must be made. The quality of that decision can make or break all the efforts expended on the clinical check. Clinical decision at the end of a clinical check is as important as the clinical check itself.
As an example, I received a simple prescription for 12 year old child for Ventolin Evohaler and Aerochamber Plus type 3 with child mask. I checked that the child can use a normal Aerochamber Plus type 3 (adult without mask) and it was confirmed to me by the parent that the later was what they were expecting not the child device. It makes sense, so I supplied the normal aerochamber and endorsed the script appropriately. Should I have sent the patient back to the doctor for an appropriate prescription - I think not!
Why do we know what we know if we cannot apply it day to day?
NB: There are some decision that require discussion with the doctor and the skill is knowing when to do what. A clinical decision must be appropriate to the circumstance, and that is the challenge we all face day to day.
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