PHAR 760 – IPPE 3 INTRODUCTION TO INSTITUTIONAL HEALTH ...

PHAR 760 – IPPE 3

INTRODUCTION TO INSTITUTIONAL

HEALTH-SYSTEMS PHARMACY

PRECEPTOR & STUDENT MANUAL

OSU/OHSU COLLEGE OF PHARMACY 1 | PAGE IPPE STUDENT MANUAL Revised 5/2019

CONTACTS

EXPERIENTIAL EDUCATION TEAM

Juancho Ramirez, Pharm.D.

Assistant Dean of Experiential Education [email protected]

541-974-2421

Shannon Starwalt, Pharm.D.

Director of Introductory Pharmacy Practice Experiences [email protected]

541-737-8035

Nancy Baker

Experiential Education Program Specialist (P4) [email protected]

541-737-6745

Miriam Steele

Experiential Education Program Specialist (P1-P3) [email protected]

541-737-2336

Nic Bookman, MPH

Academic and Experiential Assessment Analyst [email protected]

503-346-4522


INTRODUCTION The goal of this course is for students to gain familiarity with the provision patient centered care by experiencing a selection of acute care pharmacy services offered within the institutional health-systems pharmacy. The experiences include introduction to inpatient pharmacy, acute care clinical pharmacy services, transitions of care, longitudinal project, and APPE Student Topic/Case Presentation. The emphasis is on learning how the pharmacy team in this environment collectively provide patient centered care and ensure patient medication safety. Students, through the experiences stated above, will know the various roles of the pharmacy personnel and how they utilize processes, protocols, and policies for preparing and distributing medication, collecting and analyzing relevant patient information, and providing guidance regarding medication administration and monitoring. *See PHAR 760 Syllabus for the complete academic policy Learning Objectives At the conclusion of this experience, the student will be able to:

1. Know the operational organization of the Pharmacy Department a) Know the roles and responsibilities of the various Pharmacy personnel e.g. administration,

staff pharmacists, technicians, clerk. b) Know the types of staffing models/schedules e.g. AM, PM, Swing, Overnight, Centralized, De-

Centralized. c) Know the types of pharmacy services offered and the purpose of each as it pertains to the

delivery of care. 2. Know how to prepare drug products appropriately for distribution and administration to patients.

a) Know the various parts of a patient chart including medication orders, progress notes (Physician, Pharmacist, Nursing) and laboratory values

b) Describe the preparation and drug distribution system and workflow. c) Read and interpret a drug order and how to enter all needed information into the EMR. d) Prepare sterile drug products utilizing aseptic technique. e) Perform pharmacy calculations accurately and in a timely manner. f) Know the types of technology used e.g., Auto Med Cabinet, Bar coding system, Carousel,

EMR, TPN machines, Pumps, WOWs etc. g) Conduct a medication review of a patient and identify any potential and/or actual drug-

related problems. h) Utilize findings from electronic chart review to identify discrepancies, redundancies and

omissions and assist with an appropriate course of action. 3. Develop an understanding of the Patient Centered Care process as outlined by the Joint Commission

of Pharmacy Practitioners (JCPP), “Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes.” Using principles of evidence-based practice pharmacists: Collect, Assess, Plan, Implement, and Follow-up: Monitor and Evaluate

a) Accurately gathers and organizes all relevant subjective and objective information (e.g., comprehensive medication list, allergies, medical history, pertinent lab/physical assessment findings, and social determinants of health).

b) Evaluates drug therapy regimen for appropriateness in achieving optimal patient outcomes (considering safety, efficacy, adherence). Appropriately prioritizes potential or current pharmacotherapy problems.


c) Develops or revises, implements, and evaluates a patient-centered care plan to optimize drug therapy and clinical outcome.

4. Develop an understanding of the inventory used in this setting. a) Demonstrate knowledge of preparation/receipt of inventory stock orders and emergency

drug procurement. b) Know the various medication formulations used and the proper storage. c) Review medications for appropriate dating and demonstrate knowledge of procedure for

disposal of expired medications. d) Understand dispensing and record keeping for controlled substances.

5. Know the legal, professional and regulatory requirements in pharmacy practice. a) Describe the role of the Joint Commission or other accrediting body. b) Know pertinent Board of Pharmacy rules in this setting. c) Understand the functional role of the committees such as the Pharmacy and Therapeutics

(P&T) Committee. d) Describe policies and procedures for preventing and handling medication errors.

6. Know the appropriate behavior needed to interact with members of the health care team and patients.

a) Take responsibility for attaining excellence in providing care as a team member of the pharmacy department.

b) Know the appropriate level of verbal and written communication used in this setting. c) Response to request in a timely manner.

Requirement for Credit Grading is on a PASS/NO PASS basis. Students must:

• Satisfactorily complete all of the required learning objectives and obtain a favorable evaluation as determined by the preceptor.

• Develop and submit a Phar 760 Packet containing documentation of activities. Final PHAR 760 Packet

The following items must be completed by the student and included in the Packer in the order listed. The packet should be paper-clipped or stapled and submitted to the Assistant Dean of Experiential Education no later than the end of the Spring Term.

1. Cover Page (Include Student Name, Site, site location, Preceptor(s), Preceptor’s contact (see Sample Cover Page).

2. Journal of inpatient experience 3. Journal of clinical experience 4. Journal of transitions of care 5. Journal of APPE topic/case presentations 6. Journal of longitudinal project 7. Closing Self-Reflective Statement 8. Final Student Evaluation (by preceptor) Form 9. Site Evaluation (by student) From


BACKGROUND The minimum hours required to complete this course is 120 hours and the types of required activities are divided into 5 distinct sections that are designed to develop the P3 student’s introductory level knowledge, skills, and behavior in preparation for the APPE year.

1. Inpatient = 40 – 60 hrs 2. Clinical = 20 – 40 hrs 3. Transitions of care = 20 – 30 hrs 4. APPE P4 topic/case presentation = 4 hrs 5. Longitudinal Project = 20 – 30 hrs

The P3 students are assigned to hospital sites throughout Oregon and some select States by the College of Pharmacy Experiential Education Office (EEO) based on their preferences and the bandwidth of the site to accommodate the educational needs of the student. Students must complete all 5 categories listed above under the supervision of a Pharmacist and Preceptor who is licensed by the Board of Pharmacy (depending on the State). The Preceptor has the responsibility of creating a lesson plan, assigning relevant activities and evaluating whether the student achieves the stated learning objectives. The preceptor may use any personnel (technicians and other members of the health care team) to help guide the student through the activities that, in aggregate, allows the students to meet the stated learning objectives. Evaluation: At the conclusion of the experience the preceptor must complete and return to the student the signed final evaluation form that is included in this manual. The students are expected to include the completed evaluation in their packet. CLASSROOM INTRODUCTION

The classroom lecture series (total = 5 hours) is delivered in the College of Pharmacy (COP) classroom during the P2 year by COP faculty and invited guest lecturers who serve as preceptors. The lectures cover foundational hospital pharmacy knowledge such as:

• Classification and Types of Hospitals • Pharmacy Departments/Services • Pharmacy Staff and Scheduling/Shifts • Pharmacy Personnel Roles • Clinical vs Verification duties • Workflow and Technology used • Pharmacy Services Review (Inpatient, Clinical -ID, ED, Med/Surge, ICU, Peds, etc.) • Types of Pharmacy Committees • Order entry – Verification – Medication Prep – Verification – Delivery • Safety Policies & Procedures (drug prep and dispensing) • Types of inventory (specialty, 340B, Controlled) • Procurement (tech duty, where it comes from) • Dosage forms (Pre Drug use visuals, unit dose, continuous infusion, bolus, etc.) • Regulatory (The Joint Commission, BOP, OSHA hazardous classification, Disposal Rules with

narcotics, USP 795,797,800) • Other health professions roles

The hours must add up to a minimum of 120 hours.


INPATIENT EXPERIENCE

This experience is to introduce students to inpatient pharmacy and is completed at the practice site typically during the Summer Term which is from the end of June to September. The goal is to expose students to the activities and to allow them to demonstrate the knowledge, skill, and behavior as described listed in the student section of this manual. The primary focus is on developing the foundational knowledge, skill and professional behavior necessary for drug preparation, distribution, intra/inter professional communication, and other relevant pharmacy activities related to the care of patients in a hospital setting. Preceptor Instructions Scheduling: Typically, sites choose to complete the required (minimum) hours within a 2-3 week period in order to allow students to complete as many consecutive days in order to reach or surpass a minimum of 40hrs. However, other scheduling strategies are acceptable as along as the students are able to complete the activities. It is important to note that this section may require more than 40 hours and a variety of schedules e.g. swing and weekend shifts may be needed in order to expose students to a more complete picture of the daily operation of the pharmacy department. Professional Conduct: The preceptor must provide the students a list of expected behavior which can be a hybrid of internal HR policies and the preceptor’s own expectations from an IPPE learner. Inform the Assistant Dean of Experiential Education if there are any violations of policies and/or if the student is unable to meet the minimum expected professional behavior. Lesson Plan: The preceptor must also identify segments within the pharmacy work flow and related personnel that will provide students with the opportunity to meet the learning objectives via direct observation and subsequent demonstration of knowledge, skills, and professional behavior. For example, allowing student to work alongside the technicians during the medication preparation and distribution stage gives the students to ability to directly observe and, if appropriate, demonstrate the knowledge, skills, and professional behavior associated with all 5 learning objectives. In contrast, allowing students to attend pharmacy committees or observe a nurse or a pharmacy medication safety officer in action only maps to 1 or 2 objectives. Examples of activities

• Assign an assignment that allows students to navigate an electronic medical record to find pertinent patient information and to clarify physician orders.

• Assist with preparing medication orders and understand the process for transmitting or processing these orders. The student should also participate in receiving the stock order and aid in restocking the inventory. Intravenous fluids, miscellaneous supplies, durable medical equipment and any other applicable stock should be included. Emphasis in concepts such as stock rotation, order points and company selection when ordering medications should be given.

• Practice verifying the drug, dose and frequency of administration are appropriate for the patient.

The student should shadow the pharmacist in the order verification process.

• Calculate the doses, ingredient amounts and prices for at least two different products assigned by the preceptor.


• Assign to a technician activity in order to allow the student to accurately fill floor stock meds and supplies for one floor or unit of the hospital. The student should accurately describe the facility’s drug distribution system in detail, beginning with product selection by the P&T committee or provider, continuing to ordering and shipment from the wholesaler and ending with final delivery to the patient.

• Prepare an intravenous medication using good aseptic technique. This technique should comply with

standards set by the institution and USP 797.

• Participate in an inventory review and remove outdated medications and pending outdates. The student should assist in returning expired medications (if applicable). Emphasis should be placed on the importance of removing expired medications from inventory and financial repercussions to the pharmacy department.

• Assign the student to research the system and documentation required to fill a controlled substance

prescription for use by an inpatient, when filling a discharge prescription and how to supply limited quantities for use as floor stock. The student must be able to describe the legal requirements for ordering, storage, periodic inventory and disposal of controlled substances at the site.

• Investigate and complete one ADR report (Med Watch Form). The student should meet with the

person responsible for monitoring ADR’s to discuss the importance of ADR reporting and learn the process the institution uses to detect, report and track such occurrences.

• Read through the policies and procedures manual of the accreditation agency or advisory

organization establishing standards of practice in this institution setting (The Joint Commission, etc.). If the institution is preparing for an accreditation visit, the student should assist with preparations (if possible).

• Review the sites policies and procedures regarding medication error management and reporting.

Resources, such as the Institute for Safe Medication Practices, and the Oregon Patient Safety Commission, should be utilized to determine ways to improve medication safety.

CLINICAL SERVICE EXPERIENCE This experience is to introduce students to acute clinical pharmacy service and is completed at the practice site typically between the Summer and Winter Terms of the P3 year which is from July to December. It is important to note that this section may require more than 40 hours and a variety of schedules e.g. swing and weekend shifts may be needed in order to expose students to a more complete picture of the daily operation of the pharmacy department. The goal is to expose students to:

• Clinical service such as General Medicine, ED, ICU, ID, Oncology, Pediatrics, Surgery, Trauma etc. • A typical P4 clinical rotation day.


The primary focus is on developing the student’s knowledge, skill, and behavior relative to the patient centered care process (see illustration) and how the pharmacy department delivers patient care through services other than the inpatient pharmacy e.g. “clinical services” and “transitions of care service”.

Patient Care Process According to the Joint Commission of Pharmacy Practitioners (JCPP), “Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes.” Using principles of evidence-based practice pharmacists: Collect, Assess, Plan, Implement, and Follow-up: Monitor and Evaluate Collect The pharmacist assures the collection of the necessary subjective and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient. Assess The pharmacist assesses the information collected and analyzes the clinical effects of the patient’s therapy in the context of the patient’s overall health goals in order to identify and prioritize problems and achieve optimal care.

Plan The pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective. Implement The pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver. Follow-up: Monitor and Evaluate / Outcome The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver is needed. Preceptor Instructions Scheduling: Students are more flexible in their schedule during the Summer months i.e. there are no formal classroom work and the students can usually report to the site in the morning and/or afternoon. However, from mid-September to December, students are in the classroom from 8am to 1pm so sites typically choose to complete the required hours by scheduling the students in the afternoons e.g. 2pm to 6pm. Professional Conduct: Provide the students a list of expected behavior which can be a hybrid of internal HR policies and the preceptor’s own expectations from an IPPE learner. Inform the Assistant Dean of Experiential Education if there are any violations of policies and/or if the student is unable to meet the minimum expected professional behavior.


Lesson plan: Assign students to any acute care clinical pharmacists e.g. general med, ICU, ED, surgery or any combination thereof. The assigned clinical pharmacist must provide the students with the opportunity to learn the patient centered care process as shown above. Sample patient care questions to ask the student

1. Why was the patient admitted? Where did you find this information?

2. What vital signs and labs are pertinent?

a. Where did you find this information?

b. What Clinical Summary Reports are pertinent to the care of your patient?

3. What is their height and weight?

4. What is their estimated creatinine clearance? How did you calculate this?

5. What medications is the patient on at home?

a. Where can you find this information?

b. What resources can help determine if this list is accurate?

c. Have all the home medications been restarted? Why or why not?

6. What medications have been started inpatient on this patient?

a. Is it the appropriate indication? What resources did you use to determine this?

b. How does the medication work? What resources did you use to determine this?

c. Is it the appropriate dose? What resources did you use to determine this?

d. Is it the appropriate frequency? What resources did you use to determine this?

e. What side effects are you monitoring for? What resources did you use to determine this?

f. Where can you find pertinent lab information in Epic?

g. What labs should be drawn in the next 24 hours? Any drug levels?

7. Have any medications been held by the RN? If so, why?


8. Is the patient on DVT prophylaxis? If yes, is it dosed appropriately? If no, should the patient be

started on prophylaxis? What would you recommend?

9. Who is the primary team taking care of the patient?

10. Are there any consult services involved in the care of the patient?


TRANSITIONS OF CARE

This experience complements the clinical pharmacy experience by allowing students to gain experience in transitions of care pharmacy services that patients receive in a health-system such as medication reconciliation and meds to beds services. The activities include: direct patient interaction, patient chart review, reconciling outside pharmacy records with records, patient interviewing, and documenting consult


notes in the electronic medical record (EMR). The activities also must provide students with the opportunity to orient themselves to the hospital environment including the opportunity to work with a diverse array of patients and health care personnel. Preceptor Instructions Scheduling: Typically, sites choose to complete the required hours within a 2-3 week period in 4-5 hour segments e.g. 5 shifts x 4hr each or 4 shifts x 5hr each experiences. However, other scheduling strategies are acceptable as along as the students are able to complete the activities. Professional Conduct: The preceptor must provide the students a list of expected behavior which can be a hybrid of internal HR policies and the preceptor’s own expectations from an IPPE learner. Inform the Assistant Dean of Experiential Education if there are any violations of policies and/or if the student is unable to meet the minimum expected professional behavior. Lesson plan: Assign students to any transition of care service e.g. medication reconciliation or meds to beds or any combination thereof. The assigned clinical pharmacist must provide the students with the opportunity to learn the patient centered care process as shown above.

LONGIDUDINAL PROJECT

This experience is to develop the student’s knowledge of continuous quality assurance (CQA) or continuous quality initiative (CQI) projects that are a standard part of institutional health-systems pharmacy. It is important that students understand that pharmacists and pharmacies are not just concerned with the provision of care but the outcomes of the pharmacy services that they provide.

Preceptor Instructions

Scheduling

Identify a CQI or CQA project and integrate the student into the weekly process of data gathering and/or analysis. Sites typically use afternoon time frames during the Fall and Winter Terms (Sept to Feb) because students are in class (M-F) from 9am to 1pm. One strategy is to schedule the student for 2 hour experiences per week for 10 weeks in order to meet the 20 hour minimum. Lesson Plan Sites and preceptors are free to identify projects that are critical to ensuring the safe, effective, and cost-conscious provision of any pharmacy services. Examples of categories include; Practice Management, Medication Use Policy Development, Medication Use Monitoring, Optimizing Drug Therapy, Drug Procurement, Medication Delivery, Research.

APPE TOPIC/CASE PRESENTATION

It is widely accepted that professors and preceptors are powerful motivators for students and serve as role models for professional behavior. IPPE students also need insight from APPE students in terms of how to execute key competencies and behave professionally in practice. Attending APPE topic/case discussions is a good forum for this type of crosspollination and therefore, students are required to attend 4 sessions between August and February. The vast majority of this opportunity will be provided at the OHSU Medical Center.


THE NEXT SECTION OF THE MANUAL IS FOR DEVELOPING THE STUDENT PACKET


SAMPLE Cover Page

PHAR 760 - IPPE 3 Introduction to Institutional Health-Systems Pharmacy

Student Name Site Name

Preceptor Name Site Address


PHAR 760 - IPPE 3 Introduction to Hospital Pharmacy Final Student Evaluation Form (2 pages)

Student: _______________________Preceptor:____________________Site:________________________ The final assessment for this course is a pass / no pass system. These assessments should be completed by the assigned preceptor at the conclusion of the experiences and the student should submit the form with his/her Phar 760 Packet. All student pharmacists will be assessed using the following four (4) point performance rating scale for each of the ten (6) global learning objectives that apply to the rotation experience. A rubric describing each achievement level of performance is provided to assist the preceptor in determining the rating that best represents the student pharmacist’s performance for each applicable outcome. The performance rating must fall between the range of 1 and 4. This rating scale is based on increasing performance levels such that the student pharmacist achieves competency, relative to an IPPE student. Once the performance rating is selected, please use the comment section to provide additional feedback regarding the student pharmacist’s strengths and achievements as well as areas of improvement and continued development. Comments will be REQUIRED if the entered score is 2 or lower to provide specific examples of areas needing improvement. Each student pharmacists will be assigned a final assessment of either PASS or NO PASS which will originate directly from this evaluation. Once the final assessment is submitted by the preceptor, the College (through the Assistant Dean for Experiential Education) will be responsible for validating the assessment. To successfully pass each rotation, the student pharmacist must receive a final score of 2 or higher on the final assessment in ALL learning objectives that apply to each specific rotation experience. Receiving a rating of 1 in any outcome equates to a failed rotation. The student completed all necessary activities/lessons that are mapped to the learning objectives and I recommend the student to receive a grade of: Circle One: 0 (Incomplete) 1 (Deficient) 2 (Marginal) 3 (Competent) 4 (Exceptional) General Comments

Preceptor (Signature): ____________________________________________ Date: ________________


GRADING RUBRIC

Exceptional (4) • Consistently

performs above expected level. Performance can be described as impressive or exceptional.

• After initial instruction, the student can confidently complete all basic tasks and most complex tasks.

• Requires little to no intervention. Demonstrates near-readiness for practice in early APPEs and performs at the level of an entry-level practitioner in later APPEs.

• Performs at a level beyond that of an entry-level student.

Competent (3) • Meets expectations

and performs consistently at expected level. Performance possesses strengths with room for improvement in a few areas.

• After initial instruction, the student confidently completes all basic and routine tasks and requires limited prompting or guidance to complete most complex tasks.

Marginal (2) • Meets

expectations and performs consistently at expected level in only some areas. Several performance areas have room for improvement.

• Requires frequent intervention. Demonstrates very few performance deficits as an IPPE Student.

Deficient (1) • Performs well

below baseline expectations. Performance demonstrates worrisome deficits.

• Student is unable to satisfactorily and consistently complete most basic and routine tasks despite directed and repeated guidance. The preceptor or other pharmacy personnel must often complete the tasks.

• Requires repeated intervention. Demonstrates multiple performance deficits as an IPPE Student and is clearly not ready for practice as an APPE.

Incomplete (0) • Not able to

address the vast majority of the learning objectives.

• Student was unable to complete the minimum required hours.

Learning Objectives






b) Describe the preparation and drug distribution system and workflow. c) Read and interpret a drug order and how to enter all needed information into the EMR. d) Prepare sterile drug products utilizing aseptic technique. e) Perform pharmacy calculations accurately and in a timely manner.


f) Know the types of technology used e.g., Auto Med Cabinet, Bar coding system, Carousel, EMR, TPN machines, Pumps, WOWs etc.

g) Conduct a medication review of a patient and identify any potential and/or actual drug-related problems.

h) Utilize findings from electronic chart review to identify discrepancies, redundancies and omissions and assist with an appropriate course of action.

3. Develop an understanding of the Patient Centered Care process as outlined by the Joint Commission

of Pharmacy Practitioners (JCPP), “Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes.” Using principles of evidence-based practice pharmacists: Collect, Assess, Plan, Implement, and Follow-up: Monitor and Evaluate




4. Develop an understanding of the inventory used in this setting. a) Demonstrate knowledge of preparation/receipt of inventory stock orders and emergency

drug procurement. b) Know the various medication formulations used and the proper storage. c) Review medications for appropriate dating and demonstrate knowledge of procedure for


5. Know the legal, professional and regulatory requirements in pharmacy practice.

a) Describe the role of the Joint Commission or other accrediting body. b) Know pertinent Board of Pharmacy rules in this setting. c) Understand the functional role of the committees such as the Pharmacy and Therapeutics


6. Know the appropriate behavior needed to interact with members of the health care team and

patients. a) Take responsibility for attaining excellence in providing care as a team member of the

pharmacy department. b) Know the appropriate level of verbal and written communication used in this setting. c) Response to request in a timely manner.


PHAR 760 - IPPE 3 Introduction to Hospital Pharmacy Journal of Experience

INPATIENT PHARMACY

Review the learning objectives below prior to each day of rotation and create a journal that, in detail, explains the daily/weekly experience as it pertains to how they helped meet the learning objectives. List and describe the activities, assignments, and/or discussions experienced that allowed for completion of the stated learning objectives. In addition, list the rotation schedule including the dates and times for this section.






b) Describe the preparation and drug distribution system and workflow. c) Read and interpret a drug order and how to enter all needed information into the EMR. d) Prepare sterile drug products utilizing aseptic technique. e) Perform pharmacy calculations accurately and in a timely manner. f) Know the types of technology used e.g., Auto Med Cabinet, Bar coding system, Carousel,

EMR, TPN machines, Pumps, WOWs etc. 3. Develop an understanding of the inventory used in this setting.

a) Demonstrate knowledge of preparation/receipt of inventory stock orders and emergency drug procurement.

b) Know the various medication formulations used and the proper storage. c) Review medications for appropriate dating and demonstrate knowledge of procedure for




5. Know the appropriate behavior needed to interact with members of the health care team and patients.

a) Take responsibility for attaining excellence in providing care as a team member of the pharmacy department.

b) Know the appropriate level of verbal and written communication used in this setting. c) Response to request in a timely manner.



CLINICAL PHARMACY SERVICE

This experience will expose P3 students to a clinical pharmacy practice setting that is focused on providing pharmaceutical care to acute care patients. Example services include the following: Emergency Department, General Adult Medicine, ICU, Infectious Disease, Oncology, Pediatrics, Surgery, Transplant. The goal of this experience is to simply allow the P3s to gain valuable insight on the level of care that is provided by a clinical pharmacist, residents, and how P4s are involved as a student on rotation. During the interaction, the clinical pharmacist, resident, and/or P4 student should impart any helpful advice in terms of how the P3 should prepare for the P4 year in terms of the clinical process as illustrated below.

Students are expected to create a self-reflection journal that, in detail, lists and explains the daily/weekly experience as it pertains to how they helped meet the learning objectives. In addition, list the rotation schedule including the dates and times for this section. Below is a suggested template that can be used to detail the discussion(s) about the clinical process.






delivery of care.

2. Develop an understanding of the Patient Centered Care process as outlined by the Joint Commission of Pharmacy Practitioners (JCPP), “Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes.” Using principles of evidence-based practice pharmacists: Collect, Assess, Plan, Implement, and Follow-up: Monitor and Evaluate












TRANSITIONS OF CARE

This experience is designed for students to gain experience to know the importance of transitions of care services such as medication reconciliation and meds to beds as it relates to the spectrum of services that patients receive in a health care system. The activities includes direct patient interaction, patient chart review, reconciling outside pharmacy records with records, patient interviewing, and documenting consult notes in the electronic medical record (EMR). The rotation also will provide an opportunity to orient the students to a hospital environment including the opportunity to work with a diverse array of patients and health care personnel. In addition to a record of the rotation schedule, students are expected to create a self-reflection journal that, in detail, lists and explains the daily/weekly experience as it pertains to how they helped meet the learning objectives. Students are also exposed to the disease states and treatment plans and therefore, it is also expected for students to include what they learned in terms of pharmacotherapy.





delivery of care.


2. Develop an understanding of the Patient Centered Care process as outlined by the Joint Commission of Pharmacy Practitioners (JCPP), “Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes.” Using principles of evidence-based practice pharmacists: Collect, Assess, Plan, Implement, and Follow-up: Monitor and Evaluate












LONGITUDUNAL QUALITY ASSURANCE PROJECT

This rotation is designed to provide students the opportunity to understand how to complete a longitudinal project e.g. continuous quality improvement (CQI) or Quality Assurance (QA) project. Sites may approach this section in a variety of ways i.e. attaching individual students or a team of students to clinical services and project leads or residents. In addition to a record of the rotation schedule for this section, students are expected to create a self-reflection journal that, in detail, lists and explains the daily/weekly experience as it pertains to how it developed their understanding of the process below.





delivery of care.







PHAR 760 - IPPE 3 Introduction to Hospital Pharmacy Self-Reflection

SELF-REFLECTION

The Closing Self-Reflective Statement should address the following questions regarding all the sections i.e. Students need to compose separate statements for sections 1, 2, and 3.

1. What learning objective did you find most interesting and useful? 2. What did you learn about yourself in terms of your knowledge base and skill level? 3. How will you apply the lessons from this experience in the future as you progress through the

curriculum and also after graduation? This should be submitted with the final packet, as a typed summary. No hand written submissions will be accepted.


STUDENT EVALUATION OF SITE AND PRECEPTOR This evaluation must be completed at the end of the course and submitted with your portfolio. Enter your information on this cover sheet. Do not enter information that can identify you on the evaluation page. Please write legibly and include all information. IMPORTANT NOTE: Entering incomplete information can result in a missing grade, i.e., just your preceptor’s first name or just the name of your site. Example: write “Fred Meyer – Store 303, Eugene” or “Samaritan Health Services Inpatient Pharmacy, Albany” instead of just “Fred Meyer” or just “Samaritan Health Services”. These evaluations are used to assess the quality of your rotation experiences and are used by the College of Pharmacy to improve those experiences. Written comments are required. Keep in mind that your assessment of your sites and preceptors help the College to maintain and improve the program for your colleagues who come after you. Student Name: ___________________________________________________________________________ Student’s Signature: ________________________________________________ Date: _________________

This evaluation should be turned in with the final portfolio. If questions or concerns arise during this experience,

please contact Juancho Ramirez, Pharm.D.


STUDENT EVALUATION OF SITE AND PRECEPTOR Preceptor: _____________________________________ Site: _____________________________________

0 1 2 3 4 5

N/A

Strongly Disagree

Disagree Neutral Agree Strongly Agree

SECTION I. Rotation Site Evaluation: The site provided…. 1. Opportunities to develop a good understanding of foundational skills and 0 1 2 3 4 5 perspectives common to this practice setting. 2. Opportunities to practice basic patient care skills common to this practice 0 1 2 3 4 5 setting. 3. Opportunities to interact with other members of the health care team. 0 1 2 3 4 5 4. Opportunities to apply knowledge and skills acquired in the Pharm.D. 0 1 2 3 4 5 coursework. 5. Opportunities to gain skills that have not yet been covered in the 0 1 2 3 4 5 Pharm.D. coursework. 6. Adequate opportunities to complete the requirements of the orientation 0 1 2 3 4 5 rotation. Comment on strengths or weaknesses of the site, specifically activities or opportunities unique to this rotation site: SECTION II. Preceptor Evaluation: The preceptor as an instructor provided or demonstrated…. 7. Orientation to the rotation site, personnel and policies 0 1 2 3 4 5 8. Sufficient instruction time and adequate accessibility 0 1 2 3 4 5 9. Open and consistent communication 0 1 2 3 4 5 10. Enthusiastic and understanding demeanor 0 1 2 3 4 5 11. Strong knowledge base 0 1 2 3 4 5 12. Professionalism in all activities 0 1 2 3 4 5 Comment on preceptor’s strengths and areas for improvement: 13. This rotation expanded my knowledge, skills and confidence 0 1 2 3 4 5 14. I am satisfied with my accomplishments at this rotation 0 1 2 3 4 5

TO INCLUDE ADDITIONAL COMMENTARY ON YOUR ROTATION EXPERIENCE

PLEASE ATTACH A SEPARATE SHEET OF PAPER.

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