PHA 303 Communication Skills for Pharmacists Exam Questions and Answers ( Latest Version).

PHA 303 Communication Skills for Pharmacists Exam Questions and Answers ( Latest Version). Define Communication: A circular process where people are sending and receiving messages "55% or more of our understanding of a message comes from the __________________ component." Non-Verbal "When the verbal and non-verbal don't match, we tend to believe the ________________." non-verbal Feedback primarily has what 2 components? 1. Non-Verbal 2. Verbal "Meanings do not reside in words, but in our ______________ of words." interpretation Anything that distorts a message from being received Barriers Internal Barriers are... factors within pharmacists and/or patients that distort/block effective communication. Selective Attention is when... pharmacists and/or patients are too distracted by their own thoughts to receive or send messages accurately. Name 4 factors that affect the credibility of a Pharmacist: 1. The Pharmacists' Professional Attire 2. Display of Diplomas/Licenses 3. Counseling/Expanded Services 4. Community Involvement External Barriers are... Factors occurring in the environment that can distort/block effective communication. Name 3 examples of External Barriers: 1. Raised platform 2. Telephone 3. Lack of privacy "Providing a Product" = Dispensing "Providing Information" = Warning Counseling is when the pharmacist... (2) 1. Provides information 2. Assists with drug usage Explain how a Pharmacist can create psychological privacy: (3) 1. Stand fairly close to the patient 2. Lean forward towards the patient 3. Lower your voice Societal Role of Pharmacists in the 1930's: "There were a few cases where courts hesitatingly found that pharmacists had expanded duties beyond dispensing." Societal Role of Pharmacists in the 1970's: The courts regarded Pharmacists as "Super Technicians" Societal Role of Pharmacists in the 1980's: (3) 1. There was a legal trend against imposing a duty to warn on the Pharmacist (i.e. society didn't think it was our duty to warn just yet). 2. Generally, Pharmacists of this time argued that there wasn't a duty to for us to advise because the Doctors/Prescribers should do the warning. 3. However, a newfound view that recognized the Pharmacist as having a duty to warn was beginning to emerge. Societal Role of Pharmacists in the 1990's: "The Pharmacist is a professional who has a duty (to the patient) to exercise the standard of care required by the pharmacy profession in the same or similar communities as the community in which he/she practices his/her profession." (e.g. OBRA '90) OBRA '90 mandates that... all Pharmacists perform Prospective Drug Utilization Review (DUR) when filling prescriptions for Ambulatory Medicaid patients. "Ambulatory" aka... Outpatient Drug Utilization Review (DUR) is the... routine review of medication use by looking at the patient's chart or profile to identify any possible errors/problems. What are the 2 types of Drug Utilization Review (DUR)? 1. Prospective (before) 2. Retrospective (after) Prospective Drug Utilization Review (DUR) involves... evaluating a patient's planned drug therapy before a medication is dispensed. This process allows the Pharmacist to identify and resolve problems before the patient has received the medication. Prospective Drug Utilization Review (DUR) is generally seen in which healthcare setting? Retail/Community Pharmacy Retrospective Drug Utilization Review (DUR) is generally seen in which healthcare setting? Hospital/Clinical Pharmacy What is the overall responsibility of the Pharmacist during a Prospective Drug Utilization Review (DUR)? Review the patient's profile/medical history BEFORE dispensing to see how the prescribed medication(s) will react to the medication(s) that the patient is actively/already taking, if applicable. What is the overall responsibility of the Pharmacist during a Retrospective Drug Utilization Review (DUR)? Review the patient's profile/medical history AFTER drug therapy is initiated to determine what problems, if any, may be linked to that/those drug treatment(s). This is different than Prospective DUR, because with Retrospective DUR, the Pharmacist is looking at how the patient reacted to the drug therapy AFTER they've taken the drug, rather than looking at their medical history BEFORE they take the drug, as seen in Prospective DUR. "Omnibus" means... that the law/act covers many areas of Federal Law simultaneously; i.e. broad coverage OBRA '90 stands for... Omnibus Budget Reconciliation Act of 1990 What are the 3 components of a Prospective Drug Utilization Review (DUR)? 1. Patient Profiles 2. Screening 3. Patient Counseling What components should be evaluated when reviewing a Patient's profile? (7) 1. Patient's Full Name 2. Patient's Date of Birth 3. Patient's Biological Sex 3a. plus Gender Identification 4. Patient's Home Address 5. Patient's Phone Number 6. Individual History: Allergies, Patient's updated Drug Responses, etc 7. Healthcare provider('s)' commentary relevant to drug therapy/overall treatment When is effort considered "reasonable"? Effort is considered "reasonable" if others can view it and understand what has occurred. What are the 7 components of Prescription Screening? 1. Therapeutic Duplication 2. Over/Under-Utilization 3. Drug-Allergy Contraindications 4. Drug-Disease Contraindications 5. Drug-Drug Contraindications 6. Incorrect Drug Dosage/Duration 7. Abuse, Misuse, & Irrational Prescribing Define Therapeutic Duplication Drug overlap: tends to occur when a patient sees more than one prescriber Over/Under-Utilization is... Too much or too little of a medication is used for too long or too short of a time Drug-Disease Contraindications: (2) 1. Disease aggravates Drug metabolism 2. Drug aggravates Disease (T/F?) OBRA '90 allows Pharmacists to consult the corresponding prescriber if they feel the patient is abusing medication(s). True What are the 8 components of Patient Counseling? 1. Drug (and/or Medical Device, if applicable) Name and Description 2. Formulation, Dose, Route, and Duration 3. (Special) Directions and Precautions 4. Common-Severe Side/Adverse Effects 5. Self-MonitoringTechniques 6. Appropriate Storage 7. Prescription Refill Information 8. Directions for any Missed Dosages When is a Pharmacist excused of their legal duty to counsel a patient? If/When the patient refuses the counseling OBRA '90 vs State Regulations: OBRA '90 applies to Ambulatory Medicaid patients, while State (Georgia) Regulations require that ALL Ambulatory (Outpatient) Patients receive patient counseling, unless patient refuses. "Pharmacists must give the offer to _____________, not just _____________." discuss, counsel "Discussion must be ______-___-_______ in __________ ______________." face to face, spoken language "Only _____________ and ______________ information needs to be discussed when reviewing medication(s) with patients." necessary, relevant "A Pharmacist should never ________ a patient into refusing counseling." coax When did OBRA '90 officially become effective? January 1993 In GA, is counseling on refills required? Not required, if professional judgement allows it "Cognitive Services" are known as... non-dispensing services performed by a Pharmacist "Cognitive Services" are either _______________ or ________________ because you are.... judgmental, educational judging the medication therapy for problems or educating the patient Name the 3 components of Non-Verbal Communication: 1. Personal Space 2. Body Movements 3. General Appearance Intimate Space (Length): 0-18 inches Conversational Space (Length): 18 inches-12 feet Patients who defer to you are usually doing what 3 things? 1. Say they understand when they really don't 2. Fail to ask questions 3. Tell you what they think you want to hear Open Motions are... positive circular wide motions Closed Motions are... angular gestures "The _________ are the most telling sign of being open or closed to communication." hands Name 5 things you should evaluate when interpreting Non-Verbal Behavior: 1. Gestures 2. Facial Expression 3. Personal Space 4. Eye Contact 5. Sound of Voice Non-Verbal Cues: Touching nose = doesn't agree Non-Verbal Cues: Tugging/Pulling ear = doesn't understand Non-Verbal Cues: Rubbing eye = doesn't understand Non-Verbal Cues: Tilting head to one side = interesting Non-Verbal Cues: Hand on chin = decision making Non-Verbal Cues: Leaning back = negative thought pattern Non-Verbal Cues: Leaning forward = positive thought pattern Non-Verbal Cues: Hand on bridge of nose = stop talking to compose their thoughts Non-Verbal Cues: Cleaning glasses = buying time Non-Verbal Cues: Glasses in mouth = buying even more time.. Non-Verbal Cues: Hands on hip = ready to go Non-Verbal Cues: Siting, hand propped on leg, leaning forward = ready to go Non-Verbal Cues: Clasped hands = frusturation Non-Verbal Cues: Wringing of hands = frusturation Non-Verbal Cues: Crossed arms = angry/irritated Non-Verbal Cues: Rubbing neck = "what a pain in the neck" Non-Verbal Cues: Pulling collar = "I'm hot under the collar" Non-Verbal Cues: Covers mouth and looks to the side = self doubt and/or lying Non-Verbal Cues: Flick of the resting hand a few inches upward = wanting to interrupt Non-Verbal Cues: Tugging of ear = wanting to interrupt Non-Verbal Cues: Index finger on mouth = wanting to interrupt Non-Verbal Cues: Steepling of hands = confidence HIPAA stands for Health Insurance Portability and Accountability Act Compliance with HIPAA is NOT ______________. optional HIPAA training is required for... any health care provider that conducts billing in an electronic form What are the 5 aspects of HIPAA? 1. Provides patients greater control over their health information. 2. Limits the use and release of health information. 3. Establishes safeguards to protect the privacy of health information. 4. Establishes civil and criminal penalties for violations. 5. Permits exceptions in the interest of protecting public health. Protected Health Information (PHI) is... individually identifiable health information transmitted or maintained in any form and via any medium. A pharmacy must implement policies and procedures that limit how Protected Health Information (PHI) is: (3) 1. Used 2. Disclosed 3. Requested A pharmacy must develop a ___________ ____ _____________ ______________ (_________). Notice of Privacy Practices (NOPP) Notice of Privacy Practices (NOPP) is... a document that clearly explains to patients their rights and how the pharmacy protects their information. Name the 6 basic elements of a Notice of Privacy Practices (NOPP): 1. A description of the types of uses and disclosures that the pharmacy is permitted to make in the course of providing patient services/treatment, processing payment and operation of business 2. A description of other uses and disclosures that the pharmacy is permitted to make without the patient's consent (e.g., law enforcement, public health). 3. An explanation that the pharmacy will not use or disclose information for other purposes without the patient's authorization. 4. An explanation of the patient's right to inspect and copy his/her medical records and receive an accounting of disclosures. 5. An explanation of the pharmacy's duty to maintain confidentiality. 6. A description of how patients can register a complaint about privacy practices. A pharmacy must do what 5 things with their Notice of Privacy Practices (NOPP)? 1. Make the NOPP available to any person who asks for it 2. Prominently post the NOPP in the pharmacy 3. Post the NOPP on its website, if applicable 4. Provide the NOPP to patients the date of first service/Rx received 5. Obtain patient's written acknowledgment of receipt of NOPP HIPAA allows a pharmacy to design its own ___________ ___________________ process. written acknowledgement Notice of Privacy Practices (NOPP): A patient's written acknowledgement must be kept for ____ years of the day it was signed or when the prescription was received, whichever comes later. 6 HIPAA Compliance: A pharmacy must do what 3 things concerning their employees? 1. Train all employees who have access to patients or PHI. 2. Maintain documentation of training. 3. Retrain employees when changes are made to PHI procedures. Business Associates (BAs) are... people or entities that perform certain activities involving the usage of PHI on behalf of a pharmacy. HIPAA Compliance: A pharmacy must designate a ___________ ___________. privacy officer Which Department of Government is in charge of enforcing HIPAA's privacy standards? Department of Health and Human Services: Office of Civil Rights