The bond between pharmacists and long-term care nurses is one of great trust and professional respect. It requires open, unfiltered and unfettered communication. And it feeds on reliability and teamwork. Experts focus here on this unique and very vital team inside nursing homes — one that is constantly tested by ever-changing rules and a fluid staffing dynamic in so many facilities.
1. Lives depend on a strong connection between pharmacists and long-term care nurses.
“This relationship has become increasingly vital, particularly as facilities focus on meeting the needs of more clinically complex residents,” said Curt Bicknell, PharmD, co-president of Guardian Mid-South Pharmacy.
Key benchmarks for success include sustaining low hospital readmission rates and ensuring medications are available to residents during an impending crisis, he added.
“Through education, medication optimization and medication reconciliation, the consultant pharmacist is a vital expert the nurses can rely on to improve the care of residents, whether the consultant pharmacist is suggesting a transition off sliding scale insulin or other, often unnecessary, high staff impact treatments,” added Matthew Palmer, PharmD, manager of Clinical Operations for PharMerica.
Both need to share and be partners in each other’s success, according to TJ Griffin, chief clinical officer at PharMerica.
“It’s all about care, commitment and collaboration,” he said. “Both need to be able to achieve the same outcomes — clinically, quality-wise and financially.”
2. These relationships are constantly tested by a variety of forces, including communication lapses.
“The nurse staffing shortage is currently the most critical issue, with no close second,” added Bicknell. “The orders we now receive have a higher level of inaccuracies, such as missing information on strengths, duration of antibiotics, and directions. Delays ensue.”
One solution is a staff member setting aside time each day to respond to pharmacy inquiries. Chad Worz, PharmD, chief executive of the American Society of Consultant Pharmacists, also advises the consultant pharmacist and director of nursing to have good lines of communication and efficient procedures for addressing recommendations.
“Through electronic medical records, the consultant pharmacist is able to review much of the clinical information and medication changes month-to-month online,” he said. “This allows them to triage their work in the building, but it may also interrupt communication lines.”
3. Above all else, getting the med pass right is critical to resident care.
“There are countless times I have made valuable recommendations based on observations from med pass — many that save nursing time and prevent medication errors,” said Jana Jennings, PharmD, director of Clinical Services for Turenne PharMedCo.
“Facilities must remain steadfast in their commitment to improve the safety of the care environment and resident outcomes,” added Trish Richardson, MSN, president of the North Carolina Nurses Association.
“Incorporating clinical policies for medication administration that include medication reconciliation, medication order verification, medication allergies, and calling out and resolving discrepancies prior to administering any medications encourages a safe and effective process,” Richardson said.
“Important tips for medication passes include paying special attention to narrow therapeutic index drugs, especially if lab work has recently been conducted,” added Erin M. Donatelli, Pharm D, vice president of Clinical and Consulting Services for Remedi SeniorCare. “This will prevent potential significant medication errors.”
4. Manage the challenge of nursing shortages and staff turnover.
“It’s about rebuilding that collaborative relationship, getting back to the basics and ensuring they understand the technology they have at their disposal,” added Griffin.
Collaboration with your consultant pharmacist to review resident profiles for unnecessary medications to discontinue can give the nursing staff back valuable time, said Donatelli.
Worz suggested training long-term care pharmacists to vaccinate and perform assessments testing required for people on antipsychotic medications.
He also advised the consultant pharmacist to spend time with a new hire or new nursing manager to familiarize them with pharmacy procedures
and systems.
Mistakes to avoid
» Taking the pharmacist-nurse relationship for granted. Success requires building trust.
» Devaluing communication. The partnership demands open and constant access.
» Allowing lapses in med passes. Avoid any delays and inaccuracies with pharmacists’ help.
