Role of Pharmacist in Nursing Homes

Nursing homes are a place where those patient have resided who don’t need hospitalization but can't be cared for at home. Most nursing homes have aides and skilled nurses for 24 hours care.

Nursing homes mainly reside old age patients (sometimes nursing is purely called old age home). But it is not hard and fast for those patients who are chronic they may be young they are admitted there. Nursing homes basically reside those patient who are not critically ill but those patient who is not normal but the disease state is such that it is not critical and can't be cared for at a hospital because of high hospitalization expenses and burden on hospital and also it can't be treated well at home. 

Specialized units/spaces/homes are provided to them. Sometimes instead of a residing patient at the nursing home patient is treated by nurses at their own homes, this is also included in nursing home care.

Care Provided by Nursing Homes
Nursing homes provide both medical and residential care. Residential care involves all the care which involve social and physical need and spiritual needs of each individual patient accordingly.

Pharmacist and Nursing Home Relationship
The provision of pharmaceutical services is an integral part of the care provided to nursing home residents. Pharmacists in nursing homes provide routine emergency drugs and biologicals to the residents of nursing homes. 

The role of pharmacists in a nursing home is the same as it is considered in other health setups like hospitals. The fact is that drug cant be handled properly without the involvement of pharmacists in safe handling. But despite these facts majority of nursing homes don’t have a full-time pharmacist or some of them even do not acquire the services of a pharmacist at all.

Methods of handling drugs in Nursing Homes By Pharmacists
The majority of nursing homes don’t acquire the duties of full-time pharmacists. The main problem why they are unable to acquire the duties of a pharmacist is financial limitations. 

Secondly, the number of pharmacists is not enough to fulfill all the requirements of all nursing homes. Here are some approaches that how nursing homes acquire the duties of a pharmacist:
  1. Contract with a nearby hospital to provide pharmacy services.
  2. Non-pharmacist have involved just like aides and nurses itself go for medication management.
  3. In Hospital-based nursing homes, such facilities are provided by the main pharmacy of the hospital.
  4. Contract with the nearby community pharmacy to provide them services.
  5. There are also independent pharmacies specializing in meeting drug needs and consulting services specific to long-term facilities.
  6. By providing full-time pharmacy services.

Community Pharmacists and Nursing Homes
Although it is previously said that it is very difficult to have full-time pharmacy service the other better possible approach is to contract with a nearby community pharmacy. 

Pharmacists of the community pharmacy visit regularly for a specific duration of time for giving services to the patients. But some states in the US said that according to the law the duration and timing of pharmacists must be mentioned. And alternatives if a pharmacist is not there or on leave must be specified.

Pharmacies specializing in Nursing Homes
Point number 6 above is about independent pharmacies specializing in meeting the drug needs for nursing homes. Such pharmacies work on the communication process. Communication (i.e telephone, fax , email) etc are used to deliver the demand for pharmacists about drugs. 

Drugs are then delivered to the nursing home through courier services. Such type of specialized pharmacies usually serves for more than one nursing home and are located around 100 miles distance. In case of an emergency nearby community pharmacist is consulted instead of waiting for 100 miles to be covered.

Role of Pharmacist in Nursing Homes
The role of pharmacists in Nursing homes is not far different than the role of pharmacists in other health settings. But infect the role of a pharmacist is a bit challenging here in nursing homes, because of the facts that are
  1. The residents are usually chronically ill and in such cases, the chronic use of medication increases the chances of Adverse drug reactions and side effects are high.
  2. Residents usually take a combination of drug terms used as polypharmacy. A study shows that on average each resident of the nursing home takes 8-10 drugs, which is quite a favorable figure for drug interaction, and in the case of polypharmacy (8-10 drugs combination) the chances of drug interaction are above 50 percent.
  3. Nursing home residents are usually old people in such cases due to poor pharmacokinetics of drugs in the body chances of drug interaction are high.
  4. Comorbidities are also one of the facts which go in favor of drug interaction. Residents on average have at least 4 active medical diagnose. In such cases, drug-disease interaction, and drug-drug interaction may occur.

Due to the above facts and reasons, the role of the pharmacist is highly demanding in such types of extended care facilities.

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