A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health. Usually at least one ward round is conducted everyday to review the progress of each patient outcome. Pharmacist’s participating in medical ward rounds promotes health care Participation of the Pharmacists in ward rounds in various practice settings helps to provide rational drug use.

1. Ward Round Participation
SOURABH KOSEY
ASSOCIATE PROFESSOR
DEPT. OF PHARMACY PRACTICE
ISF COLLEGE OF PHARMACY
WEBSITE: - WWW.ISFCP.ORG
EMAIL: SOURABHKOSEY@GMAIL.COM
ISF College of Pharmacy, Moga
Ghal Kalan,nGT Road, Moga- 142001, Punjab, INDIA
Internal Quality Assurance Cell - (IQAC)

2. Definition
A Ward round is a visit made by a
medical practitioner, alone or with a
team of health care professionals and
medical students to hospital in-patients
at their bedside to review and follow-up
the progress in their health.
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3. 3Introduction
 Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
 Pharmacist’s participating in medical ward
rounds promotes health care
 Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.

4. Decreases adverse drug events,
improve patient care, and reduce
length of hospital stay and health
care cost.
Enables Pharmacist to contribute
prospectively to patient care
through the provision of patient
care through the provision of drug
information and promotion of
rational use of drugs.
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5. Goals and objectives
The goals of clinical Pharmacist’s
participation in ward rounds are
to:-
Gain an improved understanding of
patient’s clinical status and
progress, current planned
investigations and therapeutic
goals.
Provide relevant information on
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6. Optimize therapeutic management
by influencing drug therapy
selection, drug administration,
monitoring and follow-up,
Investigate unusual drug orders or
doses.
 Additional information about the
patient co-morbidities, medication
compliance or alternative medicine
use that might be relevant to their
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7.  Detect , manage and prevent,
Adverse drug reaction drug
interactions.
 Participate in the in-patients
discharge planning
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8. Ward rounds participation also
provides many learning
opportunities for pharmacists. It
allows pharmacists to see first hand
how drugs are used and prescribed
to see the effects of these drugs on
patients
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9. Classification of ward rounds
Classification based on purpose of
the round and composition of the
healthcare team
 Pre-rounds
 Registrar / resident rounds
 Professor / chief rounds
 Teaching rounds
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10. Pre-rounds
Usually by interns or medical
postgraduates students in teaching
hospital.
Only few management decisions are made
during these rounds.
Trainee clinical pharmacist may join
the interns or PGs in their pre- rounds
and complete the patient medication and
clinical review at this time.
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11. Registrar / resident rounds
 In teaching hospitals, the registrars and the
residents individually or as a team conduct
ward rounds.
 At least once a day at a fixed time usually
in the morning.
 Useful rounds for clinical Pharmacist of all
levels of experience to join.
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12. Professor / chief rounds
In teaching hospitals, the chief unit
or the professor in a specialty
conducts rounds together with other
healthcare professionals.
Conducted for all patients under
their care on a daily basis.
More challenging for clinical
pharmacist in terms of their clinical
knowledge.
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13. Teaching rounds
In teaching hospitals, academic medical
staff conducts bedside clinical teaching
rounds for residents, medical PG
students, interns ,medical UG students
and PharmD students
It is usually extensive rounds and is
conducted only a few times a week
It provides an opportunity for clinical
pharmacist to improve their clinical
knowledge
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14. Pre-ward round preparation
Pharmacists need to prepare well
before participating in ward
rounds. Accurate and up-to-date
information on the patients’ health
status, disease management and
past medical history is essential for
effective participation in clinical
decision making
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15. Pre-ward round preparation
 Review of the medication chart and the case
record should be completed prior to the ward
round
 Pre-ward round preparation gives an overview
of the drug and diseases related issues that
may arise during a ward round
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16. Pre-ward round preparation
 Identify and prioritize the drug related
problems.
 Prepare remedial action for the identified
drug related problems.
 Maintenance of individual patient profiles,
which summarize information relevant to the
patient’s drug therapy.
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17. Practical tips for ward round
participations
 Complete the pre-ward round preparation
well ahead of the commencement of the round.
 Prioritize the ward round (in case of more) to
those rounds in which you can contribute
more.
 In hospitals with a formulary, ensures that all
prescriptions are in accordance with the
hospital formulary.
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18.  Carry appropriate references while working in
the ward [BNF , CIMS ,Drug review]
 If potential DRPs identified, prepare to suggest
alternatives to resort the problem
 If many DRPs are identified, prioritize them
and discuss the most important DRPs
 Avoid entering into discussions concerning
diagnosis
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19. Interventions during ward round
 A Pharmacy intervention is defined as, any
action by pharmacists that directly results in a
change in patients management of therapy.
 Intervention by pharmacist to assist
prescribing can take several forms.
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20. Interventions can be:
Active
[use of guidelines, particularly backed up
by personal visits in influence prescribing]
Passive
[drug Information services]
Reactive
[monitoring prescriptions]
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21. Intervention during ward round
The major drug related queries that may arise
during ward rounds relate to:
1. Dose and frequency
2. Choice of medication
3. Adverse effects
4. Drug interactions
5. Formulation
6. Duration of therapy
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22. 7. Actions and uses / pharmacology
8. Drug availability / supply
9. Identification of patient’s medications on
admission
10. Legal and administrative issues
11. Miscellaneous such as storage conditions
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23. Communication during Ward rounds
 Clinical Pharmacist should work closely with
other health care staffs to meet the health care
needs.
 Effective communication skills and clinical
knowledge are pre-requisites for effective
participations in ward rounds.
 Good inter-personal relationships are a key of
success.
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24.  Try to resolve differences in opinion in a
direct manner but in a way that conveys
respect for others.
 Learning of regional language helps the
pharmacist to follow the conversation between
the clinicians and the patients.
 It also helps you to interact effectively with
the patients.
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25.  Be cautious while discussing drug-related
issues on the ward round in the presence of
patients
 Avoid bluffing or guessing, but rather
undertake to retrieve the relevant information
and then communicate the same to the
prescriber
 Not to challenge a medical practitioner’s
integrity.
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26. Ward round follow-up
Completing documentation:
 Recommended actions or interventions made
by the pharmacist during a ward round may
need to be documented appropriately
Making necessary alterations:
 The pharmacist may need to make alterations
to the patient’s care plan to meet the
requirements resulting from changes in
patient management
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27. Discussion with the patients:
 If appropriate the pharmacist should discuss
drug therapy issues with the patients
(example- The reason for alteration in
therapy, drug administration or self-
motivating techniques and cautious regarding
likely adverse effects)
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28. THANKS
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