Harambee University

Adama Main Campus

Health faculty
Department of Pharmacy
TVET Program

Alemayehu Mengesha

(Phar.PHO)
Unit of Competence: Provide
Compassionate, Respectful and Caring
(CRC) Service

Module Title: Providing Compassionate,

Respectful and caring (CRC) Service

MODULE CODE: HLT PHS3 M04 0621

Compiled by Alemayehu Mengesha (phar.PHO)
• Module Descriptor:-This module
defines knowledge, skills and
attitude required to effectively
perform professional duties and
responsibilities with
compassionate, caring and
respectful manner by applying basic
principles of professional, ethical and legal
aspects of the profession.
 Learning Outcome
• At the end of the competence the trainees able
to:
– LO1: Apply professionalism and ethical practice
principles
– LO2: Apply humanistic care to clients
– LO3: Demonstrate effective health care
communication
– LO4: Provide respectful care for clients
– LO5: Function with legal and ethical framework
through responsibility and accountability
 Definitions of concepts
Ethics
– Ethics means meeting the expectations of profession
and society and acting in specified ways toward
patients
Morality
– Morality is the science concerned with the distinction
with “right” and “wrong”
– A moral act which in conformity with moral law is called
good, if opposed to moral, it is called bad
Law
– A rule of conduct or procedure recognized by a community
as binding or enforceable by authority
 Definitions of concepts
Policy
– It sets up boundaries for decision making: which
decisions to make and which not
Rules
– Statement of specific actions in a given situation
Procedures
– A detailed set of instructions for performing
sequenced actions (regular occurrence)
Professional
– A person who is expert at his or her work
 • The need for legislation on pharmaceutics
The major reasons for legislation dealing with
pharmaceuticals are:
• To ensure proper implementation of
pharmaceutical policy.
• To determine the role of Pharmacy law executive
agency, medical practitioners, Pharmacy personnel,
manufacturers, whole sellers, retail outlets, health
institution and customers in ensuring availability,
quality assurance, proper storage, distribution and
use of pharmaceuticals.
• To ensure that the final customers receive
pharmaceuticals of proven quality, safety and
efficacy.
• To ensure the implementation of the
pharmaceutical sector as to the required
standard. i.e. pharmaceutical:
• Manufacturing
• Import
• Export
• Local procurement
• Storage
• Inventory control
• Whole distribution
• Use
– Prescribing
– Dispensing
– Patient use
• Control & administration
– Licensing
– Registration of professionals
– Marketing Authorization/Evaluation & Registration
– Inspection
– Clinical trials
 – Post marketing surveillance
• Adverse drug reaction reporting
• quality defective drug reporting
• Efficacy related complaint reporting
– Promotion & advertisement
– Laboratory Analysis
– Provision & control of pharmaceutical information
– Control of controlled substances
• Narcotic drugs & psychotropic substances
• Poisons
• Radiopharmaceutical
 Profession and professionalism
• A profession is a calling that requires special
knowledge and skilled preparation. A
profession is generally distinguished from other
kinds of occupation by:
a) Its requirement of prolonged specialized training
acquiring a body of knowledge pertinent to the role
to be performed and
b) An orientation of the individual to ward service,
either to community or organization
Strategies for the assuring drug quality, safety and efficacy

• Professional registration
• No Pharmacist or other Pharmacy personnel
are legally allowed to practice the profession
Pharmacy unless or otherwise he/she is
registered.
• Professionals should be registered in order to
ensure their competence.
• Pharmacists and other Pharmacy personnel
registration can be issued by:
• Drug regulatory authority
• Board of Pharmacy
• Professional association
• Ministry of Health
• N.B. The law should clearly indicate should do
the professional registration.
• Requirements to be registered
• Education
• Age usually not less than 21 years
• Good moral characters
– Non-drug addict
– Non – alcohol addict
– Free from violation of laws governing the sector
• Experiences and training
– As part of training
– After graduation – apprentices
• Health conditions
– Free from mental illness, physical condition
• Citizenship
• Examination
– Theoretical
– Practical
Characteristics of a Professional
– Honest
– Skilled
– Courteous
(Polite)
– Reliable
– Considerate
(caring)
– Dependable
(loyal)
– Cooperative
– Committed

15
How are you Judged as a Professional?
– Your Communication
– Your Image
– Your Competence
– Your Manner
– Your Appearance
– Your Behavior
– Your Attitude

16
 Role of the professional Pharmacy
1. Care provider: Caring /Comforting involve
knowledge and sensitivity to what matter and
what is important to the client

2. Communicator / Helper: Effective

communication is an essential element of all
helping profession, including pharmacy
professionals. It helps the client to explain the
internal feeling
 Role of the professional Pharmacy
3. Teacher/educator: teacher refers to activities by
which the teacher helps the student to learn. The
client also need education based on the case
4. Counselor: counseling is a process of helping a
client to recognized and cope with stressful
psychological or social problem, to develop
improved interpersonal relation ships and promote
personal growth
5. Client advocate: An advocate plead the cause of
others or argues or pleads for a cause or proposal
 Role of the professional Pharmacy
8. Manager: management defines manager as
who plans, gives direction, developing staff,
monitoring operations, giving rewards fairly and
representing both staff member and
administration as needed
9. Researcher: majority of researchers in
pharmacy are prepared at doctoral and post
doctoral level. Although an increasing number
of clinicians and pharmacy professionals with
masters degree are beginning to practice it
 Professional responsibility
1. Competency
2. Honesty/integrity
3. Confidentiality
4. Appropriate relations with patient
• The Pharmacist/Druggists should:
– Respect the skills and competencies of other
health care providers and endeavor to work
cooperatively with them.
– Do not enter into any secrete arrangements or
negotiation, with other health professionals.
– Do not recommend a particular medical
practitioner to the patient.
– Endeavor to maintain the confidence and trust
placed in other health professionals by patients.
 – Expose any act of malpractice committed by other health
professionals through the appropriate channel.
– Always
• Communicate
• Correct
• Cooperate
• Support
• Respect
• Just accept that we are not alone; so play your
position well and leave others play theirs.
• Drug without proper diagnosis is simply a shot in the
dark.
• Drug without proper care is a bed room without bed.
• Hippocratic oath: ” I will use treatment to
help the sick according to my ability and
judgment but never with a view to injury
or wrong doing”
 Code of Conduct
• A set of conventional
principles and
expectations that are
considered binding on any
person who is a member
of a particular group

24
 Ethical Principles
• The major principles of health ethics are:
1. Respect for Autonomy (or Person)
• Respect the decisions of autonomous persons and
protect persons who lack decision-making capacity (e.g.,
confused pts, mentally ill).
2. Beneficence
• Act in the best interests of patients
3. Non-maleficence
• Health professionals should not inflict harm on patients
4. Justice
• Requires that people be treated fairly; benefits and
burdens be distributed fairly within society
 LO2: Apply humanistic care to clients

Humanity and justice

• Humanity:
• Refers to the human race or mankind as a whole,
to that which is characteristically human, or to
that which distinguishes human beings from other
animals or from other animal species primal
nature.
• it is to mean the tenderness to reach out for those
who are suffering
• Justice:
• Justice is fair, equitable and appropriate
treatment. Justice refers to fair handling and
similar standard of care for similar cases;
and fair and equitable resource distribution
among citizens. It is the basis for treating all
clients in an equal and fair way. A just
decision is based on client need and fair
distribution of resources. It would be unjust
to make such decision based on how much
he or she likes each client
• Example:
• Resource scarcity is the common issue in
healthcare settings. For example, there may be
only one or two neurosurgeons and many patients
on the waitlist who need the expertise of these
neurosurgeons. In this case we need to serve
patients while promoting the principle of justice
in transparent way. Example, the rule of first
come first serve could be an appropriate rule.
• Justice requires the treatment of all patients
equally, irrespective of their sex, education,
income or other personal backgrounds.
 • Confidentiality
• Confidentiality in healthcare ethics
underlines the importance of respecting
the privacy of information revealed by a
patient to his or her health care provider,
as well the limitation of healthcare
providers to disclose information to a
third party. The healthcare provider must
obtain permission from the patient to
make such a disclosure.
 Cont----------
• The information given confidentially, if
disclosed to the third party without the
consent of the patient, may harm the
patient, violating the principle of non-
maleficence. Keeping confidentiality
promotes autonomy and benefit of the
patient.
• The high value that is placed on
confidentiality has three sources:
• The right of patient to confidentiality
• All identifiable information about a
patient's health status, medical
condition, diagnosis, prognosis and
treatment and all other information of a
personal kind, must be kept confidential,
even after death. Exceptionally, family
may have a right of access to
information that would inform them of
their health risks.
• Confidential information can only be disclosed if
the patient gives explicit consent or if expressly
provided for in the law. Information can be
disclosed to other healthcare providers only on a
strictly "need to know" basis unless the patient
has given explicit consent.
• All identifiable patient data must be protected.
The protection of the data must be appropriate
to the manner of its storage. Human substances
from which identifiable data can be derived must
also be protected.
Providing CRC Service
 Compassionate Care
• Compassion: A profound feeling + a merciful action
• Empathy: a deep understanding of the feelings of
patient
• Sympathy: feeling patient’s emotions
 Compassionate Care
• Compassionate care is defined by the following four
essential characteristics
1. Empathy, emotional support and efforts to
understand and relieve the patient’s distress and
suffering
2. Effective communication within interactions over
time and across settings
3. Respect for and facilitation of patient’s and family’s
participation in decisions and care
4. Contextual knowledge of the patient as an individual
within a network of relationships at home and in the
community
 THE IMPACT OF COMPASSIONATE CARE ON
HEALTH OUTCOMES
Effective communication is shown to improve:
Diabetes Decreases anxiety,
Pain control depression .
Physical and mental Reduces readmission
quality of life in rates for heart failure
cancer patients and pneumonia
Primary care patients
Geriatric care Blood pressure
 RESPECTFUL CARE
– Respect for beliefs, traditions and
culture
– Respect the right to information and
privacy
– Respect the freedom of movement
CRC: Effective Communication
 Principles of effective
communication
• Good communication is one of the keys to your
success as an early intervention provider.
• It is the means of establishing and building
relationships with families, with your co-workers
and teammates, and community agencies.
• Your communication skills will play an important
part in your ability to
• Support families and their children as they learn
new skills.
 Principles of effective communication
• Communication requires good listening
skills, awareness of cultural differences,
sensitivity to nonverbal cues,
dissemination of information, and
appropriate documentation.
• Using good listening skills involves
asking open-ended questions, and active
listening strategies
 Components of effective communication
• We know that communication is a process of transmitting
and receiving messages (verbal and non-verbal).
Communication is a dialogue not a monologue. So, a
communication is said to be effective only if it brings the
desired response from the receiver.
Communication consists of six components or elements.
• Context
• Sender/Encoder
• Message
• Medium
• Receiver/Decoder
• Feedback
 Ethical issues related to patients rights

1. Right to truth: The right of patients to know the

truth about their condition, prognosis, and
treatment is an issue between the physician
and the patient
2. Right to refuse treatment: For reasons that are
sometimes known only to themselves patient
may refuse treatment even though
lack of treatment may result in their death
 Ethical issues related to patients rights

3. Informed consent: Patients have the right to be

given accurate and sufficient information about
procedures, both major and minor, so that their
consent to undergo those procedures is based
on realistic expectations
4. Human experimentation: responsibilities and
ethical decisions are related to making sure that
informed consent is given for participation in the
research experiments and that the safety of their
patients is protected
Health related Legal issues in Ethiopia:

1. Abortion:
– You shall dispense Medication abortion or MVA if
the physician is sure that an abortion is performed
for the purpose of saving the endangered life or
health of women
– You shall not attempt or carry out abortion
– You shall report to the concerned authorities of
criminal abortion in the absence of physician
– You have all the right not to participate in all
procedures of criminal abortion
 Abortion:
Article 551: cases where law allows termination
of pregnancy
1. When the pregnancy is the result of rape or incest
or
2. When continuance of pregnancy endangers the life
of the mother or the child or
3. Where the fetus has an incurable and serous
deformity or
4. Where the pregnant woman is physically as well as
mentally unfit to bring up the child
 Health related Legal issues in Ethiopia:

2. Suicide
– If you are taking care of a patient with a suicidal
tendency you shall remove all items that facilitate
suicide such as sharp instruments, ropes, belts,
drugs and make sure that the outlets are graded
3. Euthanasia
– You shall never assist; collaborate in taking life as
an act of mercy even at the direct request of the
patient or patient's relatives
 Health related Legal issues in Ethiopia:

Types of euthanasia
1. Active euthanasia: Is a deliberate attempt to end life. e.g.,
deprivation of oxygen supply, administering an agent that
would result in death (e.g. Belgium, Netherlands etc)
2. Passive euthanasia: allowing death by withdrawing or
withholding treatment. No special attempt will be made to
revive the patient. (e.g. Switzerland, Some states in USA
like, California, Washington)
 All forms of euthanasia are illegal except in states where
right to die status and living will exist
 Negligence
• Failure to exercise due care, resulting in injury to
another
• The failure to exercise due care may be the
omission to perform an act that a reasonable
person, would perform, or it may be the
commission of an act that a reasonable person
would not commit
• Negligence implies that the careless conduct
was in violation of a legal duty
Blessed!!!