IPC final exam - communication Flashcards

Question

Second Generation (Atypical) Antipsychotics for Schizophrenia & Bipolar Disorder

Answer 1

Abilify aripiprazole “-prazole” but not a PPI Improved the ability to function Risperdal risperidone Risper  sounds like whisper Whispers are done Seroquel, Seroquel XR quetipine Quiet the voices Zyprexa olanzapine Lan  land on your feet Zap  zap the voices away Be careful with ”-pine” also suffix for CCBs

Answer 2

Lithobid lithium BID dosing Also bipolar  swings 2 ways Mania Depression Lithium battery  recharge back to baseline Ambien, Intermezzo zolpidem Z drugs for zzzz  sleep Non-benzodiazepine hypnotic Ambient light Set up light for sleep Restoril temazepam Benzodiazepine used only for sleep Rest = sleep

Answer 3

Use bed for sleeping or intimacy only Establish a regular sleep pattern Make the bedroom comfortable Relax before bed Exercise regularly* Avoid eating meals shortly before bedtime Avoid napping Avoid alcohol, caffeine, nicotine for at least 4-6 hours before bedtime Do not watch the clock at night If unable to fall asleep…

Answer 4

MOA: Increase GABA (inhibitory) “-azepam” or “azolam” Klonopin clonazepam Clonus  stiffening and relaxing of muscles (brain) Xanax alprazolam Sound like “z” makes you relax, feel sleepy Ativan lorazepam Nap at a van? “Van down by the river?” Valium diazepam Dial it back  relax V  available PO and IV Both used for seizures

Answer 5

BuSpar buspirone Take the bus to the park  relaxing Vistaril hydroxyzine pamoate 1st generation antihistamine Also used for pruritus (brand Atarax) Great options if we cannot use controlled medications (All BZDs are CIV) Patients with history of substance use disorder, alcoholism, etc.

Answer 6

Aricept, Adlarity donepezil Acetylcholinesterase Inhibitor keeps ACh around  helps w/ learning, memory, cognition Air  cognition is suffering  “airy” -cept  improve perception Namenda, Namenda XR memantine NMDA Receptor Antagonist Sounds like “Rememba” mem  memory

Answer 7

Adderall, Adderall XR sextroamphetamine & amphetamine Concerta, Daytrana, Metadate, Methylin, Ritalin methylphenidate CDMMR Concentrate Daily, Must Must Repeat! Focalin, Focalin XR dexmethylphenidate Helps you focus Vyvanse lisdexamfetamine Odd man out “f” Vyv

Answer 8

Strattera atomoxetine Not the same as SSRIs (fluoxetine, paroxetine) Norepinephrine Reuptake Inhibitor Strat  Straightens patients’ attention If you’ve got moxie – you’ve got determination and character (just need focus) Intuniv guanfacine Intun  in tune  spot on  focused -facine  facing forward  paying attention

Answer 9

Fluzone High Dose Quadrivalent, Fluarix Quadrivalent influenza virus vaccine Helps to prevent (or decrease severity) of the flu IM given annually Tamiflu oseltamivir Neuraminidase Inhibitor Osel  oscillation  flu moves back and forth every year -tamivir sounds like Tamiflu Tessalon Perles benzonatate Tess  tuss  anti-tussive

Answer 10

FEV1: SABA: LABA: ICS: SAMA: LAMA: LTRA:

Answer 11

Chronic inflammatory disease Reversible Allergen triggered inflammatory reaction Both acute and chronic inflammation Leads to airway remodeling and bronchial hyper-reactivity Tightened muscles constrict airway, thickened airway wall, mucus

Answer 12

10% of children by 5-17 years Pediatric Disease Diagnosis by 5 years Most have symptom resolution by adulthood 30-40% persistent adult asthma Environmental Risk Factors Family Size Tobacco Smoke in utero or infancy Allergen exposure Urbanization Respiratory viral infection Decreased exposure to childhood infectious agents

Answer 13

1) Assess symptoms Wheezing History of any of the following: Cough, worse at night Recurrent wheeze Recurrent difficulty breathing Recurrent chest tightness Symptoms occur or worsen at night, waking the patient Symptoms worsen with triggers 2) Confirm with spirometry testing FEV1 (forced expiratory volume in 1 second) before and after SABA

Answer 14

intermittent symptoms: <2 days/week step 1 - rescue (PRN) Mild symptoms: 2-6 days/week step 2 - rescue (PRN) + maintenance moderate symptoms: daily step 3 - rescue (PRN) + maintenance severe symptoms: throughout the day step 4-5 - rescue (PRN) + maintenance Symptoms occur: >2 times per week Uncontrolled STEP UP Therapy Symptoms occur: 0-2 times per week Controlled If >3 months, STEP DOWN therapy Caution with close monitoring

Answer 15

Airflow limitation that is not fully reversible Chronic and progressive Umbrella term of chronic bronchitis, emphysema, or mixed Does not affect treatment

Answer 16

12.1 million people in US 9 million have chronic bronchitis 3.1 million have emphysema or combination 4 leading cause of death Only leading cause of death to increase (projected to become 3rd) By 2020 5th highest cost burden on US Healthcare 2nd leading cause of disability Cigarette smoke is leading cause Currently 25% of population

Answer 17

Exposure Environmental tobacco smoke Occupational dusts and chemicals Air pollution Patient factors Genetic predisposition (AAT deficiency) Airway hyper-responsiveness Impaired lung growth Chronic sputum production, dyspnea, chronic cough History of exposure FH of COPD >40 years old

Answer 18

Global Initiative for Chronic Obstructive Lung Disease (GOLD) Classified into Groups A, B, C, or D Based on symptoms, airflow limitation, exacerbation history

Answer 19

ICS Pulmicort budesonide Pulm  pulmonary Flovent fluticasone “-sone” Vent  ventilate, breathe ICS + LABA Combination Breo fluticasone & vilanterol Advair fluticasone & salmeterol Symbicort budesonide & formoterol “-terol”  LABA Work symbiotically to help asthma/COPD

Answer 20

ProAir, Ventolin, Proventil albuterol SABA Combivent ipratroprium & albuterol Atropine is anticholinergic (antimuscarinic) Combination of SAMA and SABA Spiriva tiotropium LAMA Spirometry revitalized Singulair montelukast LTRA Single ingredient to help breathe air luk  leukotriene

Answer 21

Estrogen Estrace, Vagifem, Vivella dot, Alora, Climara estradiol Premarin conjugated / equine estrogen Progestin Prometrium progesterone

Answer 22

Fosamax alendronate Bisphosphonate -dronate

Answer 23

All contain ethinyl estradiol & a progestin Nuvaring etongestrel Vaginal ring Aviane, Seasonique, Twirla levonorgestrel Transdermal, weekly Necon, Junel, Loestrin norethindrone Yaz, Yasmin drospirenone Won’t drop the potassium

Answer 24

Transitioning away from medication-centered care Or “task-centered care” RPhs accepting more responsibility Depends on RPhs ability to: Develop trusting relationships Engage in an open exchange of information Involve patients in decision-making regarding treatment Help patients reach their therapeutic goals

Answer 25

Medication-related morbidity and mortality Omnibus Budget Reconciliation Act of 1990 OBRA 90 Mission statements Patient-care responsibilities: Communication between patient and healthcare professionals serves 2 functions: To establish an ongoing relationship To exchange information so that you can effective utilize the Pharmacist Patient Care Process (PPCP)

Answer 26

1. Practitioners must understand _social_ and __psychological as well as the biomedical factors that affect the patient’s illness experience 2. “Patient as person” – providers must understand that each patient’s illness is a unique experience 3. Providers and patients share power and responsibility; active dialogue and collaboration in the decision-making 4. “Therapeutic alliance” – patient perceptions, mutual agreement regarding _therapeutic goals__ , a trusting relationship between patient and healthcare professionals. 5. Providers must be aware that their responses to patients and their behaviors may have significant effects on patients

Answer 27

the patient

Answer 28

Understand the patient’s illness experience Acknowledge that each patient’s experience is unique Foster a mutually respectful relationship with patients Establish a “therapeutic alliance” with patients to meet mutually understood goals of therapy Develop self-awareness of personal effects on patients

Answer 29

Process begins with perception and interpretation of the problem Identifying symptoms Previous experiences Cultural differences Knowledge of the problem Misinformation? Health beliefs Patient may take action Self-care therapy Medical/medication therapy Complimentary medicine Power transfers to the provider? Patient has final say

Answer 30

Meeting therapeutic goals Self-monitoring Obtaining information from providers Being more assertive Joint Commission tips

Answer 31

Unanswered questions Misunderstandings Therapy-related problems Self-monitoring Decision-making

Answer 32

The ability of the provider to elicit and understand patient concerns, to explain healthcare issues, and to engage in shared decision-making if desired

Answer 33

Better adherence Improve patient outcomes Improved QOL Patient satisfaction Improved mental health Trust/relationships established with healthcare team

Answer 34

The Sender The Message The Receiver Feedback Barriers

Answer 35

Simple or complex Two-way process Focus is typically on the message (may miss the opportunity to provide appropriate feedback) How can we ensure understanding and proper interpretation of the message?

Answer 36

As the sender, you must ensure that the message is transmitted effectively In clearest form In terminology understood In an environment conducive to clear transmission Be fully aware of barriers Improve communication skills to ensure appropriate message transmission

Answer 37

Factors influence how people assign meaning to verbal and nonverbal messages Past experiences Previous definitions Languages/dialects Incongruent messages

Answer 38

Anticipate how others may translate your message We interpret messages based on the individual as well as what we believe the message is What is said may not actually be what the receiver (patient) actually hears Know the person to whom you are delivering the message Use feedback to check for or ensure understanding

Answer 39

Self-awareness Process awareness Changing behavior when necessary

Answer 40

The five dimensions of patient-centered care. Why it is important? How has it changed from medication-centered or provider-centered care? The importance of active participation by patients in medication use and therapeutic monitoring. The interpersonal communication model The different parties involved The message – how and why it can be misinterpreted The importance of feedback

Answer 41

Pharmacists talking with patients about their meds in order to educate them about medication-related issues and to help them get the most benefit from their medications. Today’s focus: Counseling pts on NEW Rx’s

Answer 42

Educate patients to follow medication regimens and monitoring Assess patient understanding, knowledge and skill Motivate patients to learn/know about meds Empower patients to be active partners in their own care

Answer 43

Adhere to medication regimen Monitor for drug effects _efficacy_______________ _safety_______________ Report experiences Difficulty with adherence/cost Medication effects

Answer 44

Ideal environment Pharmacist with knowledge and communication skills

Answer 45

Conducive to learning Private and comfortable Safe and confidential Free of distractions/interruptions Equipped with learning aids Written materials/pamphlets Medication administration devices/memory aids Audiovisual resources

Answer 46

Pharmacotherapeutics Knowledge Cultural awareness/competence Understand patient’s health beliefs, attitudes, and practices Understand patient’s feelings about the healthcare system Understand patient’s views of their role in managing their care

Answer 47

Ask effective questions Be active listener Interpret patient’s nonverbal cues Be adaptable Health literacy level Language Cognitive ability Learning style Physical and sensory abilities

Answer 48

Open-ended Patient answers in their own words Shows RPh’s willingness to listen Patient - centered approach Engages patient as an ACTIVE participant in a dialogue Helps determine level of understanding Begin w/ the 5W’s and 1 H: Who, What, When, Where, Why and How Closed-ended Patient can answer with “Yes” or “No” Very impersonal Pharmacist - centered approach Patient is a PASSIVE participant in a monologue/lecture

Answer 49

Medical Jargon __technical______________________ terms that are understood mostly by medical professionals/scientists Intimidates most patients Lay Language _______________________ terms that can be understood by the general public Avoid words w/ > 3 syllables if possible Need to be able to speak to pts at a 4th or 5th grade level

Answer 50

kidney HBP tired, sleepy liver chest pain swelling, redness allergic rxn under tongue heart attack stomach

Answer 51

Part 1: Introduction Part 2: Profile Verification Part 3: Counseling Part 4: Closing Part 5: Communication (Style)

Answer 52

Identifies SELF Purpose: establishes who you are and your role, helps establish trust and caring relationship “Hi, my name is _________. I am the Pharmacist who filled your prescription today.” Identifies PATIENT Purpose: verifies who the medication is for. If it’s not the patient picking up, may be legal limits of what you can say. Use OPEN-ENDED questions to identify patient name + DOB +/- Address, ideally all 3 “What is your name and date of birth? What is your address?” Explains PURPOSE OF INTERACTION Purpose: to get patient buy-in to the importance of the interaction “I would like to discuss some important information about your medication to ensure you are getting the most benefit from it” Request PATIENT’S TIME Purpose: establishes respectful and caring relationship “Do you have ____ minutes to talk about this information?”

Answer 53

Purpose: to confirm that patient profile is accurate and complete Used in advanced assessments of drug regimen: DDI’s, dosing appropriateness, etc. Use OPEN-ENDED questions to verify all info in this section DRUG ALLERGIES “What drug allergies do you have?” OTHER MEDS (OTC, Rx, herbals) “What prescription medications do you currently take?” “What medications, including herbals, supplements, or vitamins, do you purchase without a prescription?” HEALTH CONDITIONS/DISEASE STATES “What other health conditions (diseases) do you have?”

Answer 54

3 Main components Medication Description/Purpose Medication Use Other Medication Information Purpose: Find out and reinforce what patient knows Fill in any gaps or inaccuracies Each component should start with its corresponding Prime Question

Answer 55

PRIME QUESTION 1: (OPEN-ENDED) Purpose: Assess patient understanding of which med they are expecting and what it’s for “What medication did your doctor (provider) prescribe for you and what is for?” NAME Give name of drug as dispensed If Rx is written for brand name and generic is substituted, give both generic and brand names. Lexicomp  Brand Names: US Must pronounce name(s) correctly to receive credit during lab/application sessions STRENGTH (with units) mg/mcg/etc DOSAGE FORM Tablet, capsule, liquid, suspension, patch, inhaler, etc Lexicomp  Preparations: US INDICATION (Purpose/use) for THAT patient Lexicomp  Uses; Dosages

Answer 56

PRIME QUESTION 2: (OPEN-ENDED) Purpose: to assess patient understanding of how to take/use the medication “How did your doctor (provider) tell you to take (use) this medication?” DOSE How many units to take/use at a time (tablet/capsule/tsp/etc) ROUTE OF ADMINISTRATION How/where the medication is to be taken/used/applied Use the appropriate VERB! FREQUENCY How often the medication should be taken/used Helpful to relate to regular daily activities such as mealtimes, waking or bedtime DURATION How long patient should expect to use this medication As outlined on Rx - often noted if acute (short-term) If not on Rx, give patient idea of short-term/long-term need for medication Indication/purpose is the best way to judge this Short-term: antibiotics/antifungals/antivirals/pain (days or weeks) Long-term: HTN/diabetes/thyroid/ADHD Qty/ DS/ refills may also be helpful Remember some Rx’s are limited in these areas by law ADMINISTRATION/ TECHNIQUE/ STORAGE Explain what the patient needs to know to optimally use the medication Relation to meals and need to avoid/limit alcohol, other drinks, or foods Relation to other medications How to use devices (inhalers, injections, etc.) How to apply (patches, topicals, etc.) Storage/Disposal Lexicomp  Administration and Storage Issues QUANTITY / DAYS SUPPLY / REFILLS QTY: Number of units dispensed DS: How long quantity dispensed should last REFILLS: If refillable explain: How many refills and when they expire How/when to get a refill If NOT refillable explain: What patient should do if they need more medication

Answer 57

PRIME QUESTION 3: (OPEN-ENDED) Purpose: to assess patient’s understanding of expectations (both efficacy and safety) “What did your doctor (provider) tell you to expect from this medication?” SIDE EFFECTS Explain common/expected SE’s of the medication What to watch for/do if they occur Ways to minimize/avoid SE’s Explain possible serious/rare SE’s (and Black Box Warnings) What to watch for/do if they occur Explain carefully – do not scare them into not taking the medication! Allergic Response What to watch for and do if allergic reaction occurs Lexicomp  Adverse Reactions; Warnings/Precautions MISSED DOSES (for all meds except PRN) Purpose: Explain what to do if patient misses a dose of their medication Be as clear and specific as possible Lexicomp  Dosages; Administration and Storage Issues Specific instructions may be provided by manufacturer (package insert/monograph) for some medications If specific instructions not provided: Do not just say “Do not take it if it’s too close to the next dose”? My general rule of thumb: ½ the frequency Example: Q12 hrs - do not take if <6 hours to next dose

Answer 58

Asks patient to REPEAT KEY POINTS Purpose: to assure patient understands information provided above “Just to make sure that I did not leave anything out, would you repeat back to me the information we talked about today?” CLOSES APPROPRIATELY Purpose: to let the patient know the encounter is over Ask if patient has questions using an OPEN-ENDED question “What questions/concerns do you have for me about your medications?” Provide contact information for future questions/concerns Thank them for coming in and talking with you

Answer 59

USES OPEN-ENDED QUESTIONS for all areas outlined above ID Pt, Profile Verification section (3), Prime Questions (3), Closes appropriately Miss or use closed-ended questions for any of these = deduction APPROPRIATE NON-VERBAL COMMUNICATION Eye contact, facial expressions, attitude APPROPRIATE PACE Don’t speak too fast or too slow APPROPRIATE FLOW Logical order/flow is important for patient understanding PATIENT FRIENDLY LANGUAGE PATIENT SPECIFIC INFO Male vs female: Do NOT educate males or females >/= 55 y/o about pregnancy/lactation Patient vs agent If Rx is for child, counsel parent or care giver (aka agent) appropriately: “Give Johnny 5 milliliters by mouth…” instead of “Take 5 milliliters by mouth…”

Answer 60

When playing the part of the pharmacist: Focus on the process provided in the rubric Content and order are most important Learn how to pronounce drug names correctly! Lexicomp Online for generic names of drugs Manufacturer’s website/commercials for brand names of drugs When playing the part of the Patient: Be the patient on the Rx regardless of gender, age, etc. EXCEPTION: If Rx is for a child, be the parent/caregiver Use the info on the Rx for patient name, DOB, address, etc. Pretend you are a patient with no knowledge of the medication Don’t make the counseling difficult for the pharmacist or take up too much time Don’t be too helpful either – don’t “lead” the pharmacist Responses should be short and simple

Answer 61

barriers conflict the angry patient assertiveness customer service

Answer 62

Environmental Personal Administrative Time

Answer 63

Pharmacist visibility (can see how busy you are or cannot even see you) Privacy (are you publicizing their issues or can you provide privacy) Noise level solutions:

Answer 64

people are still people our personality or communication style may not be for everyone step out of comfort level solutions - use patient-friendly language

Answer 65

Pharmacists talking with patients about their meds in order to educate them about medication-related issues and to help them get the most benefit from their medications. Today’s focus: Counseling pts on NEW Rx’s

Answer 66

Educate patients to follow medication regimens and monitoring Assess patient understanding, knowledge and skill Motivate patients to learn/know about meds Empower patients to be active partners in their own care

Answer 67

Adhere to medication regimen Monitor for drug effects - efficacy - does it work? Like for lisinopril: is it lowering the blood pressure - safety Report experiences Difficulty with adherence/cost Medication effects

Answer 68

Ideal environment - Conducive to learning Private and comfortable Safe and confidential Free of distractions/interruptions Pharmacist with knowledge and communication skills

Answer 69

Conducive to learning Private and comfortable Safe and confidential Free of distractions/interruptions Equipped with learning aids Written materials/pamphlets Medication administration devices/memory aids Audiovisual resources

Answer 70

Pharmacotherapeutics Knowledge Cultural awareness/competence Understand patient’s health beliefs, attitudes, and practices Understand patient’s feelings about the healthcare system Understand patient’s views of their role in managing their care

Answer 71

Ask effective questions Be active listener Interpret patient’s nonverbal cues Be adaptable Health literacy level Language Cognitive ability Learning style Physical and sensory abilities

Answer 72

Tone of voice Vocally produced noises Body posture Body gestures Facial expressions Body behavior provides a nonverbal message as well - general appearance, attire, odor, personal care, and touch Physical environment

Answer 73

Unique for three reasons: Mirrors innermost feelings and thoughts Difficult to “fake” during interpersonal interaction If not consistent with verbal communication, people will be suspicious of intended meaning of your message

Answer 74

Physical elements of nonverbal communication: Body movements and gestures - kinesics Distance between persons trying to communicate - proxemics Physical environment

Answer 75

Lack of eye contact is the most distracting form of nonverbal communication Many pharmacists do this unconsciously This may limit your ability to assess if a patient understands the information you are giving - This does not mean you must continually stare at the patient! It might make them feel uncomfortable

Answer 76

Patients may judge your willingness to talk to them based on your body position Closed posture: A person guarding their space with arms folded, putting up a closed barrier with crossed legs and turning away from another person. Eyes - averted or a strong and challenging stare. Open posture: A person seems more open and caring. Hands are apart, arms resting in the lap or on the arms of the chair. There is an interest in the other person, a willingness to listen.

Answer 77

Proxemics is the distance between people when they communicate – “personal space” Distance is a powerful nonverbal tool We are more comfortable when interactions occur at a distance of 18-48 inches between people

Answer 78

Sometimes personal space may have to be invaded when counseling patients on certain medications Can you think of some medications that may require having a conversation within the personal zone? Ideally pharmacies should have private areas

Answer 79

Inadvertent facial expressions may send a message that you did not intend to transmit!

Answer 80

Environment plays an important role in communicating nonverbal messages Color, lighting, temperature, music, scent, architecture, and décor have also been documented as important nonverbal factors. Pharmacy counters and general appearance

Answer 81

What you wear, along with how you communicate with others both verbally and nonverbally, can impact the image others form about you. Your choice of clothing: Makes a first impression! Communicates that you take your job seriously Represents your company/position Gives you confidence Presenting a positive representation of yourself is a key component of experiencing professional success.

Answer 82

Tone People may interpret a message in not only what is being said but how it is being said A sarcastic or angry tone will produce a much different effect than if spoken with an empathic tone Pausing while speaking, silence while waiting for someone’s response, and the rhythm of communication are all nonverbal cues that also convey meaning.

Answer 83

Patients with ADHD may be fidgeting or appear to not listen when spoken to Patients who are clinically depressed may avoid questions and appear uninterested in interaction Patients with PTSD may avoid eye contact and appear hyper-vigilant, anxious, irritable, distracted or nervous Patients with Parkinson’s Disease may have a flat affect and appear uninterested

Answer 84

Studies have shown that patients are more satisfied with healthcare providers who are skilled at translating nonverbal language to emotional states As the pharmacist- observation of a patient’s nonverbal communication may help you to address a special need Patient with hearing difficulties may come closer or tilt head one way Patients reluctant to ask a question or with a language barrier may hold back from counter or limit eye contact Autistic/Asperger’s patients may avoid eye contact but that does not mean they are not listening/interested

Answer 85

Body movements and gestures May illustrate respect and manners Pointing may have different meanings - different cultures have varied interpretations for hand gestures, for example.

Answer 86

Eye contact Valued in Western society but may be considered an insult in some Asian cultures Latin American, Caribbean and African cultures may avoid eye contact as a sign of respect Touch Kissing, hugging, and shaking hands are used more or less in different cultures Cultures with more restraint are less likely to touch (English, Germans) while others encourage signs of emotions and touch (Latin America, Middle Eastern, south European)

Answer 87

Paralanguage A loud voice communicates strength and sincerity for Middle Eastern cultures, authority for Germans, impoliteness or lack of control for other cultures Proxemics Cultures that stress individualism demand more personal space African, Middle Eastern and Mexican cultures tend to stand much closer when speaking than Western or European cultures

Answer 88

Nonverbal communication can be more powerful than verbal If spoken word contradicts nonverbal behaviors, the nonverbal messages are often what are believed Some nonverbal behaviors are universal but many are culturally specific Environment, appearance, colors, and images are also forms of non-verbal communication Know your patients and populations to the best of your ability in order to tailor all forms of communication to their needs

Answer 89

Humans have two ears, but only one mouth. Some people say that’s because we should spend twice as much time listening as talking. Others claim it’s because listening is twice as hard as talking.

Answer 90

Helpful - when patients feel they are being heard trust - patients report increase trust in health care providers that listent collect - patients are more willing to share info to someone willing to listem comfort -patients will be at ease at listening removes the feelinng of intitmdiaton (anxiety of health care environemtns; whte coat synndrome)

Answer 91

hear - Focus all attention on the patient's question/concern backchannel - syaing things like ah huh, nodding, mmm I see clarification - ask follow-up questions (to gain fiirthur understanding, or demonstrate interest) mirror.summarize.paraphrase - repeat back what you heard - confirm udnerstanding to assure lsietjing emoathy - identify the feeling - empathetic facila expression/body language and repsonse

Answer 92

Multitasking - Focusing attention on other things at the same time plannign your response while soemone is talking premature conclsuon - determineing a recommendstaion before listening fully to what the speaker said faking interest - pretending to listen

Answer 93

Observation: Identify the baseline facts of the situation while avoiding assumptions or generalizations Feelings: Identify the feeling the other person is experiencing Needs: Identify the other person’s needs Request: Propose a request of the other person with an achievable goal

Answer 94

Identify the feeling the other person is expressing (empathy) NOT the feeling you have or would have (sympathy) NOT telling them how to feel Use reflective speech to confirm the feeling

Answer 95

Summarizing and Paraphrasing Review the patient’s main points with them This bridges the gap between listening and empathetic responding Use this step to identify feelings Answer any further questions they have as a result of you summarizing their concern

Answer 96

Should do: Hear Backchannel Clarification Mirror/Summarize/Paraphrase Empathy Avoid Multi-tasking Planning your response Premature conclusion Faking interest

Answer 97

How could a pharmacist demonstrate “hearing”: How could a pharmacist demonstrate “back channeling”: How could a pharmacist demonstrate “clarification”:

Answer 98

Reflective speech *“Ihear....” “Iunderstandthat....” Open up * “I’m so glad you told me that...” “Thank you for sharing this...”' Be judgment free * Don’t judge the person for being in this circumstance. Give the benefit of the doubt. Offer help * When within your ability, in a patient-centered way. Just listening is also helping. Physical comfort (when appropriate) * Most people are ok with touches of the hand or arm. ASK if anything more than that. * Know culture norms. * Read body language.

Answer 99

Blame *Avoid blaming others or the speaker for their problem Silver lining *Avoid telling the speaker all the ways it could be worse Promises *Don’t promise things that are out of your control Rude/aggressive behavior *Even if the patient is communicating in a rude or aggressive way. *Continually try to de-escalate the situation.

Answer 100

Environmental Personal Administrative Time

Answer 101

Pharmacist Personality Communication style Comfort level Cultural awareness Patient Perception of pharmacists, using medicine, etc. Beliefs about the healthcare system Individual Familial Cultural

Answer 102

Inevitable Opportunity for growth and problem solving What are some causes of conflict in a pharmacy setting?

Answer 103

Lack of awareness Incompatible goals Scarce resources Dependence Values

Answer 104

Stressor Painful core feelings Trigger statements Anger Acting out

Answer 105

Listening Avoid getting trapped in the negative filter Empathy Respect Self Others Assertiveness

Answer 106

Assertion: the action of stating something or exercising authority confidently and forcefully. Standing up for personal rights and expressing thoughts, feelings and beliefs in direct, honest and appropriate ways that do not violate another person’s rights.

Answer 107

Assertion does not equal Deference Each patient has the right to be treated fairly and with respect We are not responsible for how others feel or for their actions Being assertive: Take responsibility for your own thoughts, actions and feelings Setting boundaries

Answer 108

Respond in a way to de-escalate conflict Avoid using “you” statements that will escalate conflict Identify feelings Identify behaviors that are causing conflict Help individuals resolve the present conflict and prevent future conflicts

Answer 109

Broken record Fogging Negative inquiry Workable compromise Sorting issues Disarming anger Selective ignoring

Answer 110

The customer deserves respect

Answer 111

Unnecessary drug therapy Drug selection not optimal Clinical significant drug interaction Medication dosing regimen not optimal Adverse drug reaction Needs additional drug therapy Failure to receive drug therapy appropriately Needs additional follow-up

Answer 112

Sharing: Responsibilities Values Interventions Commitment to patient-centered care Partnering: Collegial and productive relationship Honest communication Mutual trust and respect Common goals! Interdependency: Not autonomous Work together to meet common goals Power: Shared among partners All participants are empowered Based on knowledge and experience Not only titles and functions

Answer 113

Introduce yourself Don’t blame the provider, explain the situation, focus on the problem Tone of voice and body language is important Know the role of the person with whom you are speaking (but be cautious…) Don’t presume that you’re recommendation will be accepted Be confident

Answer 114

Must use lay terms - these are basic termswhile jargon are technical terms Don’t scare your patient Remember that preconceived ideas and experiences may shape medication use

Answer 115

Standardized approach to communication in healthcare This will be used: In future courses (including PPP lab) On rotations (IPPE and APPE) Whenever communicating with a healthcare professional!

Answer 116

Situation Identify yourself, the patient, and the prescriber. Briefly state what the problem is, when it occurred, and how severe it is or appears to be. In general, a concise statement of the problem

Answer 117

Background Provide pertinent background information related to the situation. May include diagnoses, allergies, current medications, etc.

Answer 118

Assessment Summarize the facts and give your best assessment. What is going on? What might happen if this problem is not addressed?

Answer 119

Recommendation What do you want to happen next? State your recommendation and/or the actions you are requesting of the other person