Role of Pharmacist in Nursing Homes

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

Nursing home mainly reside old age patient (some time nursing is purely called old age home). But it is not hard and fast those patient 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 are not normal but the disease state is such that it is not critical and cant be cared at hospital because of high hospitalization expenses and burden on hospital and also it cant be treated well at home.  Specialized units/spaces/homes are provided to them. Sometime instead of residing patient at nursing home patient is treat 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 involve all the care which involve social and physical need and spiritual need 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. Pharmacist in nursing homes  provide routine emergency drug and biologicals to the residents of nursing home. The role of pharmacist in nursing home is same as it is considered in other health setup like hospitals. Fact is that drug cant be handled properly without the involvement of pharmacist in safe handling. But despite these facts majority of nursing homes don’t have 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 Pharmacist

Majority of nursing homes don’t acquire duties of full time pharmacist. The main problem why they are unable to acquire the duties of a pharmacist is financial limitations. Secondly the number of pharmacist is not enough to fulfill all the requirements of all nursing home. Here are some approaches that how nursing homes acquire duties of pharmacist:

• 1)    Contract with a nearby hospital to provide the pharmacy services.
• 2)    Non pharmacist 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 the drug needs and consulting services specific to long term facilities.
• 6)    By providing full time pharmacy services.

Community Pharmacist and Nursing Homes:

Although as it is previously said that it is very difficult to have full time pharmacy service the other batter possible approach is to contract with nearby community pharmacy. Pharmacist of the community pharmacy visit regularly for a specific duration of time for giving services to the patients. But some states in US said that according to the law the duration, timing of pharmacist must be mentioned. And alternatives if 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 pharmacist about drugs. Drug are then delivered to the nursing home through courier services. Such type of specialize pharmacies usually serves for more then one nursing home and are located around 100 miles distance. Incase of emergency nearby community pharmacist is consulted instead of waiting for 100 miles to be covered.

Role of Pharmacist in Nursing Homes

Role of pharmacist in Nursing homes is not far different then the role of pharmacist in other health setting. But infect the role of pharmacist is 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 used of medication increases the chances of Adverse drug reactions and side effects are high.
• 2)    Residents usually take combination of drugs a terms used a polypharmacy. A study show that on average each resident of nursing home takes 8-10 drugs, which is quit favorable figure for drug interaction and in case of polypharmacy (8-10 drugs combination)  the chances of drug interaction are above 50 percent.
• 3)    Nursing homes residents are usually old people in such case due to poor pharmacokinetics of drug in the body chances of drug interaction are high.
• 4)    Comorbidities is also one of the fact which goes in favor of drug interaction. Residents on average have at least 4 active medical diagnose [Patterson et al. 2010; Barber et al. 2009]. In such cases drug disease interaction , and drug-drug interaction may occur.

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