9 months ago

2017 HCHB_digital

Initial Assessment Every

Initial Assessment Every day, complete strangers walk into a pharmacy to purchase products off the shelf. While many happily self-select what they need, pay for it, and then leave, often without discussing their purchase with anybody, as a staff member working on the shop floor there are times when it may be in your customer’s best interest that you intervene, or at least offer some advice about their purchase. But deciding who does and who doesn’t need extra assistance and advice can be a challenge. In addition, some customers quickly brush aside all offers of help, although the time of purchase always allows another opportunity to try to engage with them. Try to always remain friendly and open, instead of “Can I help you?”, tailor your approach to what they are looking for, for example “I can let you know the pros and cons of each cough medicine”, or “We have an informative fact sheet about head lice treatment that you may be interested in”. An initial visual assessment can tell you a lot about a person and provide a good basis for asking a few questions, but always be mindful that it is your own subjective opinion and you need to be careful not to come across as judgemental or offensive in your questioning. When somebody approaches you in the pharmacy, or if you see somebody looking at medicines on the shelf, take note of their age, body shape and overall look, mood, posture, and general mobility and involve yourself in their purchase if you have any concerns. The heading Initial assessment within each chapter offers some pointers about approaching customers or key symptoms to look for, for that particular topic. Frame your questions tactfully. Instead of jumping in with “You look pregnant. Are you?”, ask instead “Is there a possibility you could be pregnant?”. Age As a rule, any purchases for infants under the age of two should be referred to a pharmacist. Many products are not recommended for babies, and babies are often more susceptible to the side effects of medicines, so even if the parent has self-selected a product for their child, ask if they are happy for you to check with the pharmacist for suitability. Older people are more likely to have reduced kidney function, other health conditions and be on other medications. Side effects are therefore more likely with medicines such as non-steroidal anti-inflammatory drugs (eg, ibuprofen, aspirin) and sedating antihistamines, and a pharmacist’s involvement is necessary. Body shape People who carry excess weight are at higher risk of cancer, heart disease, high blood pressure, high cholesterol, gout, reproductive problems, sleep apnoea, type 2 diabetes, and osteoarthritis. Overeating is best viewed as an addiction, and it can be very difficult for some people to lose weight, so ensure you are empathetic in your approach without being condescending. Some pain-relieving medications, cough and cold remedies, and motion sickness treatments may not be suitable with some of the conditions listed above. Overall look Most people who look unwell, are unwell, and this can provide a lead-in to ask about their health, particularly if your customer is a regular who usually appears healthy. Take note of the colour and condition of somebody’s skin. A grey or a blue tinge suggests a lack of oxygenated blood that could be caused by a breathing problem, cancer or late-stage disease such as heart failure or kidney failure. A yellowish discolouration (jaundice) may indicate a problem with the liver or with bile flow. In newborns, jaundice is relatively common and usually improves with light treatment. Very pale skin or mucous membranes could signal anaemia. Be careful not to assume your customer has a specific underlying condition; that may just be their natural colouring. However, you could ask if they have any This infographic summarises key features to note during an initial assessment Always invite your customer to talk in a private area of the pharmacy underlying health issues that may impact on what products they buy. Be observant for any skin rashes or significant blemishes. Seniors and people with fair skin are prone to skin cancers, such as basal or squamous cell carcinomas, and melanoma. Most skin cancers can be successfully treated if found early, and with regular customers you may like to point out any blemishes of concern and ask if they have seen a doctor about them. Many creams and topical products sold over the counter may irritate some people’s skin, particularly those with eczema, allergies, or psoriasis so refer people with sensitive skin to a pharmacist. Mood We all feel anxious or a bit down at times, but, while we readily admit to having a cold or the flu, most of us tend to hide our times of emotional fragility. Recognising a low mood in a customer and sensitively asking “Are you under any stress at the moment?”, or “You don’t seem your normal self today”, shows compassion, and you may well be the only person who has reached out to them that day. Listen to what they have to say, and talk with a pharmacist if you have any serious concerns about their mental health. Posture and mobility A person’s posture may give some clues as to what other underlying medical conditions they may have. For example, osteoporosis is the most likely cause of a stooped posture in elderly people, pain may be a reason younger people appear doubled over. A shuffling or slowness of movement can be associated with conditions such as Parkinson’s disease; involuntary movements of the tongue or jaw may reflect a side-effect of antipsychotics. When to refer to the pharmacist Once you have conducted your initial assessment, you need to make a decision about whether to refer the customer to a pharmacist or sell them a product yourself. ALWAYS refer customers to the pharmacist in the following situations: • the customer requires a pharmacist only product (eg, for vaginal thrush) • the customer has had no success with other treatment products • the customer has other medical conditions or takes other medicines • the customer is particularly unwell • the customer is pregnant or breastfeeding • the customer indicates that they would prefer to talk to the pharmacist • the medicine sought is for an infant or an elderly person • there are symptoms of concern (eg, listed under the different chapters) • you have concerns about the customer’s behaviour or intentions. Page 6 HEALTHCARE HANDBOOK 2017-2018 Introduction

Head and scalp • Condition of hair and scalp: dandruff, dermatitis, hair loss, itching, oiliness. • Ears: discharge, hearing loss, pain • Eyes: discharge, itchiness, pain, presence of contact lenses, reactivity to light, redness • Face: acne, cold sores, dermatitis, facial droop, shingles-like rash (typically occurs around one eye) • Mouth and Throat: difficulty swallowing, enlargement around thyroid gland, lesions, odour, pain, presence of dentures, sore neck, swelling, thrush on tongue • Nose: congestion, difficulty breathing, discharge, sneezing • General: confusion, dizziness, headache, sedation Skin • Colour: blue-grey, flushed, jaundiced (yellow), pale • Quality: calloused, numerous veins, paper-thin, rough, sun-damaged • Temperature: clammy, cold, hot, sweaty • Wounds and lesions: discharge, infection, state of healing, swelling, tenderness • General: bruising, irritated, itchy, moisture content, rash Whole body • Breathing: heavy, noisy, shallow, wheezing • Mood: anxious, depressed, friendly, reserved, stand-offish, suspicious, tired • Movement: difficult, limping, painful, shaking, shuffling, uncoordinated • Posture: clutching abdomen, curvature of spine, deformities, stooped • Size: frail, overweight, pregnant, underweight • General: smells of cigarette smoke or alcohol Page 7

  • Page 1 and 2: HEALTHCARE HANDBOOK incorporating t
  • Page 3 and 4: 2017-2018 HEALTHCARE HANDBOOK PUBLI
  • Page 5 and 6: Index Common Disorders Acne--------
  • Page 7: Asthma and COPD CONTINUING OTC EDUC
  • Page 16 and 17: Acne Acne is a common skin problem
  • Page 18 and 19: Allergies An allergy occurs when th
  • Page 20 and 21: Asthma and COPD Asthma New Zealand
  • Page 22 and 23: Baby Feeding Breastfeeding is best
  • Page 24 and 25: Bites and Stings Bites and stings c
  • Page 26 and 27: Bruises, Scars, Spider Veins Bruise
  • Page 28 and 29: Childhood Diseases and Immunisation
  • Page 30 and 31: Childhood Diseases and Immunisation
  • Page 32 and 33: Childhood Diseases and Immunisation
  • Page 34 and 35: Childhood Diseases and Immunisation
  • Page 36 and 37: Childhood Pain and Baby Teething Pa
  • Page 38 and 39: Colds A cold is a contagious viral
  • Page 40 and 41: Cold Sores Cold sores are fluid-fil
  • Page 42 and 43: Constipation Constipation is the te
  • Page 44 and 45: Contraception & Sexual Wellbeing Co
  • Page 46 and 47: Contraception: Emergency Emergency
  • Page 48 and 49: Coughs: Dry Coughs are called dry o
  • Page 50 and 51: Coughs: Productive Coughs are consi
  • Page 52 and 53: Cuts, Abrasions and Blisters This t
  • Page 54 and 55: Cystitis [Bladder Infection] Cystit
  • Page 56 and 57: Dandruff Dandruff is a common condi
  • Page 58 and 59:

    Dermatitis/Eczema Dermatitis is a g

  • Page 60 and 61:

    Diabetes Diabetes is a condition in

  • Page 62 and 63:

    Diarrhoea and Vomiting Diarrhoea an

  • Page 64 and 65:

    Dry Skin Dry skin is skin that lack

  • Page 66 and 67:

    Ear Conditions Our ears allow us to

  • Page 68 and 69:

    Eye Conditions Almost two-thirds of

  • Page 70 and 71:

    Eye Conditions (continued) Type Sym

  • Page 72 and 73:

    Eyes: Contact Lenses Contact lenses

  • Page 74 and 75:

    Fever What is fever Fever is define

  • Page 76 and 77:

    Foot Care Common foot problems incl

  • Page 78 and 79:

    Fungal Infections: Superficial Supe

  • Page 80 and 81:

    Fungal Nail Infections (Onychomycos

  • Page 82 and 83:

    Gout Historically known as the “d

  • Page 84 and 85:

    Haemorrhoids Haemorrhoids (also cal

  • Page 86 and 87:

    Hair Loss Alopecia is the medical t

  • Page 88 and 89:

    Hay Fever Hay fever (also called in

  • Page 90 and 91:

    Hay Fever (continued) TREATMENT OPT

  • Page 92 and 93:

    Headache Headaches are common and c

  • Page 94 and 95:

    Head Lice Head lice (pediculosis ca

  • Page 96 and 97:

    Heart Health Cardiovascular (CV) di

  • Page 98 and 99:

    Indigestion, Heartburn and Gastriti

  • Page 100 and 101:

    Influenza Influenza (flu) is a comm

  • Page 102 and 103:

    Influenza (continued) TREATMENT OPT

  • Page 104 and 105:

    Iron Deficiency Iron is an essentia

  • Page 106 and 107:

    Irritable Bowel Syndrome Irritable

  • Page 108 and 109:

    Menopause Menopause - the “change

  • Page 110 and 111:

    Migraine Migraines are a type of se

  • Page 112 and 113:

    Muscular Aches, Pains and Tightness

  • Page 114 and 115:

    Nappy Rash Nappy rash is a red rash

  • Page 116 and 117:

    Oral Health Oral health disorders i

  • Page 118 and 119:

    Osteoarthritis Osteoarthritis is th

  • Page 120 and 121:

    Osteoporosis Osteoporosis (meaning

  • Page 122 and 123:

    Period Pain and Endometriosis Perio

  • Page 124 and 125:

    Poisonings Any substance that has t

  • Page 126 and 127:

    Pregnancy Tests and Supplements Hom

  • Page 128 and 129:

    Preventive Health There are certain

  • Page 130 and 131:

    Probiotics and Prebiotics Probiotic

  • Page 132 and 133:

    Psoriasis Psoriasis is a long-term

  • Page 134 and 135:

    Scabies Scabies is a very contagiou

  • Page 136 and 137:

    Shingles Shingles (herpes zoster) i

  • Page 138 and 139:

    Sinus and Nasal Problems Sinuses ar

  • Page 140 and 141:

    Sleep Problems and Snoring Sleep is

  • Page 142 and 143:

    Smoking Cessation Almost 5000 New Z

  • Page 144 and 145:

    Sore Throat Sore throats are very c

  • Page 146 and 147:

    Strains and Sprains Sprains and str

  • Page 148 and 149:

    Sun Care Sunburn Sunburn occurs fro

  • Page 150 and 151:

    Sun Care: Eye Protection Protecting

  • Page 152 and 153:

    Sweating: Excessive (Hyperhidrosis)

  • Page 154 and 155:

    Toothache Toothache is the term use

  • Page 156 and 157:

    Travel Health (including Vaccinatio

  • Page 158 and 159:

    Travel Sickness Travel, or motion,

  • Page 160 and 161:

    Urinary Incontinence Urinary incont

  • Page 162 and 163:

    Urticaria (Hives) Urticaria refers

  • Page 164 and 165:

    Vaginal Health The vagina is a clos

  • Page 166 and 167:

    Varicose Veins and Support Stocking

  • Page 168 and 169:

    Vitamins and Dietary Supplements Vi

  • Page 170 and 171:

    Warts Warts are benign (non-cancero

  • Page 172 and 173:

    Weight Loss Obesity has reached epi

  • Page 174 and 175:

    Worms Pinworms (Enterobius vermicul

  • Page 176 and 177:

    Wound Care Our skin acts as a barri

  • Page 178 and 179:

    Wound Care (continued) Wound type M

  • Page 180 and 181:


  • Page 182 and 183:

    Chapter References (continued) Diar

  • Page 184 and 185:

    Chapter References (continued) Gord

  • Page 186 and 187:

    Significant learning opportunity: W

  • Page 188 and 189:

    PharmacyToday A part of your everyd

  • Page 190 and 191:

    OTC Medicines: Interactions When se

  • Page 192 and 193:

    OTC Medicines: Interactions OTC Med

  • Page 194 and 195:

    OTC Medicines: Interactions OTC Med

  • Page 196 and 197:

    OTC Medicines: Interactions OTC Med

  • Page 198 and 199:

    OTC Medicines: Precautions OTC Medi

  • Page 200 and 201:

    OTC Medicines: Precautions OTC Medi

  • Page 202 and 203:

    OTC Medicines: Adverse Effects OTC

  • Page 204 and 205:

    Herbal Supplements: Interactions He

  • Page 206 and 207:

    Herbal Supplements: Interactions He

  • Page 208 and 209:

    Herbal Supplements: Interactions He

  • Page 210 and 211:

    Herbal Supplements: Interactions He

  • Page 212 and 213:

    Drugs in Sport Treating Athletes Me

  • Page 214 and 215:

    Drugs in Aviation AVIATION - PRECAU

  • Page 216 and 217:

    Drugs in Pregnancy Drug use in preg

  • Page 218 and 219:

    NZ Support Groups ADHD Association

  • Page 220 and 221:

    NZ Support Groups New Zealand AIDS

  • Page 222 and 223:

    HEAT or INFLAMMATION Unlike heat ru

  • Page 224 and 225:

    OTC Products Over-the-counter produ

  • Page 226 and 227:

    OTC Products Index Foot Care - Fung

  • Page 228 and 229:


  • Page 230 and 231:

    »» Childhood Pain and Baby Teethi

  • Page 232 and 233:


  • Page 234 and 235:


  • Page 236 and 237:


  • Page 238 and 239:


  • Page 240 and 241:


  • Page 242 and 243:


  • Page 244 and 245:


  • Page 246 and 247:

    »» Foot Care - Fungal Infections

  • Page 248 and 249:


  • Page 250 and 251:


  • Page 252 and 253:


  • Page 254 and 255:


  • Page 256 and 257:


  • Page 258 and 259:

    »» Irritable Bowel Syndrome GASTR

  • Page 260 and 261:


  • Page 262 and 263:


  • Page 264 and 265:


  • Page 266 and 267:

    »» Sexual Wellbeing - Contracepti

  • Page 268 and 269:


  • Page 270 and 271:


  • Page 272 and 273:


  • Page 274 and 275:


  • Page 276 and 277:


  • Page 278 and 279:

    An ENHANCED ELearning Experience As

  • Page 280 and 281:

    Product Index ANIME LUBRICANT 50ML-

  • Page 282 and 283:

    Manufacturer’s Index AFT Pharmace

  • Page 284:

    Topiramate Actavis Topiramate 25mg,

national list of essential medicines sri lanka - World Health ...
Full colour PDF of the pages as they appeared in -
1420-1440 RevisedEGray_NIBSC_RM_v2 [Read-Only ... - NASCOLA
Inquiry into Contribution of Community Pharmacy - Association of ...
Get Out! GAY Magazine – Issue 309 – March 29, 2017
Objectives OTC/RX/Herbal Background RX/OTC vs ... - sowega ahec
VMGN 11 - Veterinary Medicines Directorate - Defra
(CPD) Programme for Pharmaceutical Staff
Asthma and Older Adults - National Asthma Council Australia
National Competency Standards Framework for Pharmacists in ...
Swissmedic Annual Report 2017: achieving success through collaboration
Product Monograph -
is it all in yOUr HeaD? - CD8 T cells - The Body
Riverine Buoyancy Aid (Multi Role) - International Safety Products Ltd
Focus on - Greater New York Dental Meeting
Guide to Biological Medicines: A Focus on Biosimilar ... - Europabio
guideline on advertising of medicines and medicinal products to ...
Guide to Biological Medicines: A Focus on Biosimilar ... - Europabio