Medical Appliances and the Clinical Governance Framework - Essay Example

Introduction The National Health Services (NHS) has prescribed several ways of wound care available in England. It is, however, d that the choice of dressing should be of high quality so that the patients can enjoy good delivery of services all times. Choice of the appropriate ways of treating wounds should be pegged on the stage of the healing and the type of the wound. The appropriate ways of treating wounds may vary as the clinical conditions of the wound or the patients themselves changes. This study examines the best practices of treating wounds and offering appliances by pharmacies - in a manner that can yield guiding principles (MeReC Bulletin, 2010). The paper focuses on the effective use of primary care and dressings in community services for patients with wounds that are not surgical, and delivery of medical appliances by these pharmacies. Literature reviewed . There are a reasonable number of guiding principles, which have been developed to help health care providers improve the dressing and systems and processes. These guidelines are designed to comply with the National Health Services (NHS) cycle. Determination of the most appropriate approach for a particular pharmacy depends on the local approach in consistence with the NHS guiding principles. The guiding principles are used to support several aspects, including providers and commissioners in their evaluations of wound management services; providers and commissioners to improve systems to make sure those patients get the effective and appropriate services; and help in improving the treatment, identification and evaluation of patients with wounds (NICE, 2005). Although acute prescriptions for dressing wounds can be made by non-medical prescribers (NMPs), pharmacies are better placed in offering such services because NMPs do not have adequate facilities to sign and issue repeat prescriptions. The outcome of the prescription is usually taken by the clinician who signs it. As such, pharmacies are in a position to undertake clinical responsibility for wound management products that is not associated with them, but which is under a therapeutic field that they have limited clinical expertise. Ordinarily, Pharmacies prescribe primary care dressing on short term basis, accompanies with sporadic clinical review (NICE, 2005). Pharmacies are charged with the responsibility of dispensing prescriptions for appliances that are used in treating or managing wounds. In their duties, the pharmacists are required to advise their customers regarding the importance of requesting only the items that they really need. This practice is the same as the ordinary requirement when dispensing prescriptions for medicine. The pharmacy contractor is required to make sure that the patients understand how the appliances are used, stored, and disposed without causing them or the environment, any harm. The pharmacy contractors should also assist the patients to consult experts regarding the appliances, is they so wishes (Srinivasiah et al., 2007). The pharmacist are also better placed in dispensing medical appliances because they are guided by the clinical governance framework, which guides them how to use prescribing patterns for the patient and advise them on the use and ordering of appliances, as well as the significance of minimizing waste. When the appliances are dispensed, the pharmacy note is usually issued to the patient, which contains the name of the pharmacy, address and telephone number. This information together with all the prescription detains are entered onto the Patient Medication Record – this ensures that the patient have the contact information related with the dispensation of appliances to assist contacting of the pharmacists in case of any problem (Srinivasiah et al., 2007). Part IX of the Drug Tariff reviewed the procedures that pharmacies follow when dispensing appliances in 2010. These changes ended the long consultation procedures that were followed by patients there before. In addition, these improvements harmonized the logistics of supply of appliances between the pharmacy and the Dispensing Appliance Contractor (DAC), hence enhancing the services provided to patients. Pharmacy contractors provide very essential services to their patients. As per the Drugs Tariff, the patients are given the freedom to decide whether they can have the appliances delivered in their homes or they can collect them form the pharmacy. When services are delivered at the home of the patients, the pharmacies ensures that all requests are in accordance with the formulary items, which is achieved by using prepared prescription requests forms. This ensures that all the necessary appliances are delivered to the patients without failure (Srinivasiah et al., 2007). It is also an advantage to get appliances from the pharmacies because the appropriate advice they offer. The pharmacy contractors are required to make sure they offer their patients appropriate advice, regarding incontinence or stoma appliances that are delivered to them so they can be able to use, dispose, or store them in the right way. These contractors are also obliged to ensure that, if the patient wishes, they can consult experts to obtain important advice about the appliances (PSNC, 2013). Methods This study involved a qualitative approach to data collection. The guiding principles was collected and examined through two focus groups. A variety of pharmacists are invited to participate in the focus group – to be included, the pharmacists must have participated in provision of wound care services. There was also a group of expert group, which was to play the part of examining the problems associated with dispensing of dressing appliances, and also provide an idea of an appropriate wound management service (Srinivasiah et al., 2007). The study started with the first focus group meeting, which was used to further develop on the operational problems with the dispensing of dressing appliances by the expert group and propose improvement that could help the ensure the patient gets the best services possible. The discussion notes were evaluated and sorted out by the project lead using the National Health Services cycle of commissioning as a sorting out framework. The provisional details of the guiding principles were developed from this cycle. The ultimate guiding principles were then adjusted and confirmed by a group of participants chosen from the focus and expert groups. Following the confirmation of the guiding principles, they were distributed to the stakeholders for possible remarks, and then additional fine-tuning done on the content of the guiding principles. All the discussions were noted in a note book, all through (Srinivasiah et al., 2007). References MeReC Bulletin, 2010. Evidence-based prescribing of advanced wound dressings for chronic wounds in primary care. Volume 21 Number 01 July 2010 National Institute for Health and Clinical Excellence (NICE), 2005. The management of pressure ulcers in primary and secondary care. Clinical guideline 29. September 2005 PSNC, 2013. Changes to the supply of Appliances: Summary of the changes to Essential services and new advanced services linked to the supply of Appliances. (Online) Available from: [14 March 2013] Srinivasiah, N. et al., 2007. A point prevalence survey of wounds in north-east England. J Wound Care 16 (10), pp. 413 – 420 Read More