Safe medicines for nigerians young pharmacists care

Safe Medicines for Nigerians:

Young Pharmacists Care!

Introduction...Greetings from San Diego!

Know your Speaker...... Who is Remi ADESEUN?

According to the Organisers...

1. Seasoned Pharmacist

2. Industrialist

3. Communicator par excellence

4. Pioneer President of NIROPHARM

According to me...

1. A Pharmacist

2. Young (at heart at least!)

3. Inclined to Innovation

4. Interested in networking

Young Pharmacists Forum..

Add to the organisers’ 4 reasons for inviting me as guest speaker tonight, the event itself has 4 main elements:

1. Guest Lecture

2. Quiz

3. Inauguration of Young Pharmacists Group

4. Dinner

Remi ADESEUN

Why are we here?

“address various issues that militate against Young Pharmacists’ delivery of safe medicines to Nigerians”, to wit:

1. Indiscipline

2. Unethical Practices

3. Impatience

4. “Register and Go”

Remi ADESEUN

4 Key Issues

1. Safe Medicines for Nigerians

2. Role of the Pharmacist

3. Role of the Young

4. Values, Virtues, Ethics & Professionalism in Pharmacy Practice

In the final analysis,...

Adopting the following 4 Cs’ as Young Pharmacists, will help us “move the Pharmacy profession from

the growing pessimism and gloom to sustainable

professional fulfilment” (OAKPCO 2012).

1. Conviction (based on regularly updated

knowledge and built on strong values, virtues, ethics and professional foundation.

2. Communication (with patients as the

centrepiece)

3. Collaboration (Intra and Inter-Profession)

4. Common Good

Safe Medicines For Nigerians...

Who Cares?

Individuals

Patients

Society

Healthcare Professionals

Government

International Bodies/NGOs/Advocacy Groups

Young Pharmacists Care!

Safe Medicines...Patient Safety

Concept:

Health

Preservation

Prevention

Treatment

Use of Medicines Diagnosis

Prescription

Procurement

Dispensing

Storage

Usage

Patient safety is defined as the prevention of harm to patients, including through errors of commission and omission

Goes beyond “safe medicines”

Safe Medicines...Challenges

Major Challenges:

protection of consumers against counterfeit or contraband medicines

Securing the medicines supply chain

Physician/Pharmacist Error

Patient Error

Self-Medication

Prescription Medicine Control

Medication Error...Definition

"any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer”.

*The definition of "harm" includes both

"temporary or permanent impairment of body function/structure requiring intervention and

an error resulting in death"

Medication Error...Context

May be related to:

professional practice

health care products

procedures, and systems including:

Prescribing

Order communication

Dispensing

Product labelling; packaging; and nomenclature; compounding; distribution

Use

administration; education; monitoring

Medication Error...Index

Type of Error Category Result

NO ERROR A Circumstances or events that have the capacity to cause error

ERROR, NO HARM B An error occurred but the medicine did not reach the patient

C An error occurred that reached the patient but did not cause patient harm*

D An error occurred that resulted in the need for increased patient monitoring but no patient harm*

ERROR, HARM E An error occurred that resulted in the need for treatment or intervention and caused temporary patient harm*

F An error occurred that resulted in initial or prolonged hospitalisation and caused temporary patient harm*

G An error occurred that resulted in permanent patient harm*

H An error occurred that resulted in a near-death event (e.g.anaphylaxis, cardiac arrest)

ERROR, DEATH I An error occurred that resulted in patient death

Medication safety...1 a) improvement of packaging

and labelling of medicines as well as the proprietary and non- proprietary naming, in cooperation regulators and the industry;

b) safer selection and procurement of medicines, including a medication errors risk assessment of medicines during formulary and purchasing decisions ;

c) safer storage of medicines in clinical areas in hospitals and community where high risks medicines stock should be restricted ;

d) safer prescribing of medicines, helped by the availability of complete patient records, electronic prescribing, decision support and clinical pharmacy services ;

e) safer medicines preparation, by minimizing the preparation in clinical areas and supplying ready-to-use medicines;

f) safer dispensing of medicines, enhancing the ability to intercept medication errors, and reducing dispensing errors by the use of automated dispensing systems;

Medicine Safety...2

g) safer administration of medicines, helped by the clear and legible label of medicines up to the point of care, barcoding,

minimising the storage of high risk medicines and the use of standardised procedures;

h) safer monitoring of medicines supported by regular medication reviews and the proactive detection of adverse drug events ;

i) independent, updated and accessible information on medicines must be available to health care providers and patients, and considered with patient information when prescribing, dispensing, and administering medication;

j) and patient education for a safer medicines’ use, considering patients as active partners in their care;

k) safer communication about medicines for individual patients between health care providers.

Remi ADESEUN

Role of the Pharmacist...1

the guardians/safeguards against

"poisons"

Preventing Medication Error.

responsibility to ensure that when a patient

receives a medicine, it will not cause harm.

the involvement of pharmacists in patient

safety can be as early at the prescribing

phase and up to the administration of the

medicines.

Role of the Pharmacist...2

Individual

making appropriate intervention at each stage of the medication-use process

National working with other healthcare professionals,

governments and regulatory agencies

Global working with pharmacy organisations on a

global basis, e.g. FIP

Role of the Pharmacist...3

Individual

Commit to & Promote a “Safety Culture” acknowledgment of the high-risk, error-prone

nature of an organisation’s activities

a blame-free environment where individuals are able to report errors or close calls without fear of reprimand or punishment

an expectation of collaboration across ranks to seek solutions to vulnerabilities

a willingness on the part of the organisation to direct resources for addressing safety concerns

Innovation and Collaboration

Role of the Pharmacist...4

National

PSN commitment to “Access to Safe Medicines as a Human Right”

Collaboration with the National Human Rights Commission

Collaboration with Regulatory Authorities

PCN, NAFDAC, NDLEA

Collaboration with Patient Groups, Consumer Protection Organisations

Role of the Pharmacist...5

Global FIP STATEMENT OF PROFESSIONAL STANDARDS

MEDICATION ERRORS ASSOCIATED WITH PRESCRIBED MEDICATION

complementary to the FIP Statement of Professional Standards in Pharmaceutical Care and should be used in conjunction with that Statement

The Role of the Young Pharmacist

Definition

≤ 5 years post-grad?

≤ 35 years age?

Character Traits

Innovation

Collaboration

Malleable

Change Agent

Remi ADESEUN

The Role of the Young Pharmacist

Concerns:

1. Indiscipline

2. Unethical Practices

3. Impatience

4. “Register and Go”

Solution:

1. Values

2. Virtues,

3. Ethics &

4. Professionalism

Remi ADESEUN

Ethics & Integrity in Nigeria….A Call to Action

To Paraphrase Emeritus Prof. O.O.Akinkugbe: “The topic we engage today reflects the

cumulus in our present sky:values upturned, integrity short-changed, discipline outraged and merit marginalised. A dawn is upon us and each Nigerian must make some contribution to the total national effort”.

Of Monks & Monkeys-The Wages of Integrity in Nigeria’s Polity. 1999. Government College Ibadan 70th Anniversary Lecture

The Importance of Ethics & Integrity in the Nigerian Context

“National Ethics” is item 23 in Chapter II of the Constitution of the Federal Republic of Nigeria 1999.

Code of Conduct is item 209 under section C Part “ (State Executive)

..states inter alia: “A Person in the Public Service of a State shall observe and conform to the “Code of Conduct”

Ethics & Integrity….Many Questions

What is “Ethics”? “Integrity”?

How does Ethics contrast with Law?

Why the Focus on Ethics & Integrity?

What is the nexus between Ethics, Integrity, Leadership & Good Governance?

What is the goal of Good Governance?

What is the Goal of Good Governance?

Nigeria

Remi ADESEUN

What is the Goal of Good Governance?

What does ETHICS mean to you?

“Ethics has to do with what my Feelings tell me is right or wrong”

“Ethics has to do with my Religious beliefs”

“Ethics is doing what the Law requires”

“Ethics is the standard of behaviour Society accepts”

We are what we repeatedly do. Excellence, then, is not an act, but a habit. Aristotle

What is ETHICS?

Ethics refers to:

well founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues.

the study and development of one's ethical standards.

How does Ethics contrast with the Law?

Ethics is the study of right or wrong conduct in situations where there is a choice of behavior involving human values

Ethics Is the collection of rules of conduct imposed by an authority

Law

Relationship between Ethics and the Law

Purpose

•With ethics, human values are the primary binding social mediator

•With law, rules of conduct are the primary binding social mediator

Target

•Societies, communities and people

Goal

•People to live well together

Need

•Ethics governs society’s moral standards, a realm that the law can’t always reach

•The law imposes a specific conduct on society, a realm that ethics can’t always reach

Ethical Principles

Obligations

Respect Values

Consequences

Integrity in Relation to Value Systems & Ethics

What is Integrity? A concept of consistency of actions, values,

methods, measures, principles, expectations, and outcomes.

A value system may evolve over time while retaining integrity provided those who espouse the values account for and resolve inconsistencies.

A Person can be described as having ethical integrity to the extent that everything that person does or believes (actions, methods, measures & principles) all derive from a single core group of values.

Integrity in Modern Ethics

3 key requirements:

Discerning what is right and what is wrong

Acting on what you have discerned, even at personal cost

Saying openly that you are acting on well founded standards of what is right and what is wrong

Benefits:

Leads to increased performance for individuals, groups, organisations and societies.

Results in improved quality of life and value-creation for all

What is an Ethical Culture?

An ethical culture is an intangible

structure of organizing and characterizing a group of people to constitute a framework influencing the behavior of each individual in

the group

How to Evaluate an Ethical Culture

Collect feedback from: Front-line employees Established confidential or anonymous reporting

mechanisms Human Resources Department

Evaluate whether: Ethical values are properly interpreted, clear and

working as desired A swift and consistent way to deal with ethical

concerns exists Ethical values provide a sense of trust and confidence

in the public Ethical values are enforceable and revisable, or not

How to Evaluate an Ethical Culture

• Benchmark with data you collect from peer institutions

• Perform ethics audits

Remi ADESEUN

Influences of Ethical Behavior

Personal values

Credible enforcement of ethics violations

Attitude and behavior of supervisors

Attitude and behavior of senior managers

Friends and co-workers

Internal drive to succeed

Ethics related legislation

Pressures that Compromise

Following boss’s directive

Meeting aggressive financial objectives

Helping the organization survive

Meeting scheduled pressures

Wanting to be a team player

Saving jobs

Pressures continued

Advancing boss’s career interest

Rationalizing that others do it

Feeling peer pressure

Resisting competitive threats

Advancing own career interests

Why Ethical Lapses Occur

The “Bad Apple”

Corrupt Individual; Eliminate

The “Bad Barrel”

Organisational/Societal Culture; Overhaul, Commit to adequate personal integrity

Competitive Pressures

Short-term focus, unsustainable

Opportunity Pressures

Temptation; the greater the reward or the smaller the penalty, the greater the probability of unethical conduct

Globalisation of Business

Negative cultural “cross-pollination”

A conflict of interest is a situation where a public

office holder exploits relationships with the

institution for personal financial or other gain, which

may compromise or have the appearance of

compromising professional judgment when making

decisions or influencing the decisions of other public

office holders.

What is a Conflict of Interest?

Types of Conflicts of Interest

TANGIBLE

The personal gain is financial/material

INTANGIBLE

The personal gain is professional or non-

material

Potential Conflicts of Interest

Conflict of effort or conflict of obligation is when work time is spent on a secondary personal activity

Conflict of conscience is when personal, political, or religious views influence objectivity

Political conflict of interest is when one responds positively to an idea/proposal/person because it represents or is presented by a person/group with whom one is politically affiliated, or where one may act to delay/prevent access or opportunity of an alternative idea/proposal in order to strengthen the interested individual or group’s chances

Potential Conflicts of Interest

Using institutional facilities, resources or time for personal gain and/or activities for which one is paid by anyone other than the employer, except when such activities have been approved in compliance with institutional policies and procedures

Accepting or soliciting any gift, hospitality, favor, service, benefit, or monetary award that one should reasonably know is offered to influence decisions or

actions (bribes, kickbacks, etc)

Doing personal business with the institution, employees or trustees, or their immediate family members or business partners

Potential Conflicts of Interest

Participating in the hiring of or having supervisory authority over a family member or a relative

Accepting additional employment which competes or conflicts with one’s primary duties

Excessively browsing the web, participating in social media, or participating in entertainment or leisure activities during official time and for reasons not related to official duties

Accountability

Appoint Organisation’s Compliance Officer

Internal Audit Team

Training

Highest Level Mgt Responsible

Code of Conduct

An outline of responsibilities of or best practice for an individual or the organization

Set of principles of good organisational behavior adopted by the Organisation

Training and Communication

Ethics and Integrity

1. New employee orientation

2. Policy and/or employee handbook

3. Periodic discussions in meetings

4. Formal annual communication

5. Performance reviews

6. Employee hotline

Encourage Whistle-blower

A whistleblower is an employee, former employee, or member of an organization, especially a business or government agency, who reports misconduct to people or entities that have the power and presumed willingness to take corrective action.

Generally the misconduct is a violation of law, rule, regulation and/or a direct threat to public interest -- fraud, health, safety violations, and corruption are just a few examples

Discipline

The punishment should fit the crime

Unintentional

Write-up

Impact on performance review

Deliberate

Termination

Imperatives Establishing & Maintaining High Ethical and

Socially Responsible Standards must be a Priority

Organisations must be aware of and committed to enthroning conditions and structures that are favourable to the development of integrity and ethical behaviour

Leaders must recognise the key role they play in influencing the people’s ethical behaviour. The Leaders’ actions speak louder than words.

Characteristics of a Professional

A good professional is one who:

1

5

2

6

3

7

4

8

Let’s look at each in detail. Copyright © 2008 - 2012

managementstudyguide.com. All rights reserved.

Characteristics of a Professional

1 Has a good image: Image is the way a person presents his physical self to the others. A good image helps the professional to portray confidence and positive attitude. The key aspects of image are:

o Clothing: An employee must wear clean, well-ironed formal or semi-formal clothes.

o Footwear: Shoes should be coordinated with clothing.

o Accessories: Should be minimal. o Hair and Nail: Should be clean and

trimmed. o Makeup and Perfume: Should be light. o Everything else from head to toe:

Should be appropriate for corporate environment.

Characteristics of a Professional

2

Has a good attitude: • Respect supervisor and seniors • Be friendly with all colleagues • Have a ‘win-win’ approach • Work hard, work smart

Characteristics of a Professional

3

Takes ownership and responsibility: • Meet Deadlines • Complete work effectively and efficiently • Accept your faults and be open to learning • Be open to taking more responsibilities

Characteristics of a Professional

4

Is prompt and orderly: • Keep office space clean and hygienic • Respond to meeting requests, emails, calls

promptly • Respect other’s as well as your time • Organize tasks , events and manage work in

a calm and orderly way

Characteristics of a Professional

5

Uses proper speech: • Avoid abusive, defamatory, offensive or

obscene language • Avoid informal abbreviations, language • Avoid sensitive and racist comments • Respect others and be courteous

Characteristics of a Professional

6

Follows office etiquette, rules and policies: • Smile and greet others • Follow queue system • Do not fight in work floor • Do not speak loudly • Rise up when a senior comes to your desk • Understand company policies and procedures

and follow them at all times • Be respectful to women

Characteristics of a Professional

7

Has Integrity and honesty: • Do not steal or misuse office resources. • Do not participate in any dealings which

compromise your honesty and integrity • Report any issues that are questionable to HR

or Supervisor • Do not indulge in any malicious actions that

can risk company’s or your credibility

Characteristics of a Professional

8

Is a good Communicator: • Follow etiquette for verbal

communication(email, telephone, meeting) • Be aware of Non-Verbal communication and

Body language • Be an active listener

Conclusion: 4Cs 4 Safe Meds!

Adopting the following 4 Cs’ as Young Pharmacists, will help us “move the Pharmacy profession from

the growing pessimism and gloom to sustainable

professional fulfilment” (OAKPCO 2012).

1. Conviction (based on regularly updated

knowledge and built on strong values, virtues, ethics and professional foundation.

2. Communication (with patients as the

centrepiece)

3. Collaboration (Intra and Inter-Profession)

4. Common Good

Thank You!

Contact Information:

Remi ADESEUN

Chairman

Rodot Group

.Healthcare

.Water Technology

.Architecture

.Consulting

08057713769/07065156473

r.adeseun@rodot.org

kojere@yahoo.com