5/19/14 – 6/13/14 Session A or 6/16/14 – 7/18/14 Session B
Transcription
5/19/14 – 6/13/14 Session A or 6/16/14 – 7/18/14 Session B
INTRODUCTORY PHARMACY PRACTICE EXPERIENCES (IPPE-II INSTITUTIONAL) PHAR 4339 5/19/14 – 6/13/14 Session A or 6/16/14 – 7/18/14 Session B or 7/21/14 – 8/15/14 Session C St. John Fisher College of Pharmacy Introductory Pharmacy Practice Experience - Institutional PHAR 4339 (3 credit hours) This Introductory Pharmacy Practice Experience (IPPE) rotation is the second of four introductory rotations offered at the Wegmans School of Pharmacy. The focus of this rotation will provide the student with knowledge and experience in the operational aspects of institutional pharmacy and also introduce them to some clinical aspects of pharmacy practice. This is a 160 hour rotation. Please review the course manual thoroughly. As a professional, the student will be responsible for the content contained within. The Wegmans School of Pharmacy would like to thank the members of the Inpatient Pharmacy Advisory Committee (IPAC) who volunteer their time to meet regularly with the Office of Experiential Education. Their input has been invaluable for the creation and continued improvement of the experiential education program. Accessory The student will create a portfolio (MyFolio) in E*Value which will contain site requirement forms, resume/CV, intern permit, HIPAA training forms, and immunization documentation. Confidentiality Patient information is private and we are entrusted with it. The patients trust us because we are health care professionals. Therefore, confidentiality is the foundation for the establishment of trust between patients and health care providers. The students are expected to not discuss any patient information that they have encountered at their rotation sites outside of their learning environment. Any infraction will result in immediate dismissal from the site and a failing grade will be given for the rotation. The student will be reported to the Student Progress Committee. IPPE-II_Manual 2 Letter to the Preceptor Thank you for contributing your time and effort in our educational endeavor. We are preparing a generation of professionals who will lead our profession into the future. Preceptorship is an opportunity to shape the future of pharmacy. PHAR 4339 is a four week rotation in which each student will complete at site a minimum of five, eight hour days each week (total of 160 hours). The student will spend the majority of time assisting in the operational aspects of the pharmacy - the process for getting the medication to the patient in an accurate and timely fashion. The student will also complete homework and tasks which will enhance the learning experience. The homework and tasks must be approved by the preceptor and if not acceptable will be repeated until completed to the preceptor’s satisfaction. Finally, the student will keep a reflection journal that will be reviewed and discussed with their preceptor. The students will upload all documents to E*Value Coursework (Learning Modules) for review by the preceptor. Preceptors should review the student’s documents in E*Value and discuss their growth and educational plans in regards to the pharmacy profession. The preceptors will also verify completion of homework assignments and tasks and assess student performance in E*Value. Preceptors will be notified electronically when their student has submitted assignments/tasks and when formative and final assessments are due. Expectations of Preceptor: 1. Introduce student to site/staff and review rotation schedule. 2. Explain your expectations to student: start times, procedure for turning in homework, procedure for completing tasks, assignment of presentation topic, and assessment procedure. 3. On the first or second day set dates when students will complete required activities. 4. Set dates and time for the formative assessments (week 2) and final assessment (week 4). 5. Coach and mentor student to achieve mastery of “activity list” starting with day two. 6. Coach and mentor student regarding homework – give practical examples to reinforce learning. 7. Review student’s written homework and provide feedback to the student. 8. Identify and resolve student difficulties early. a. For serious issues such as repetitive tardiness or unexcused absences document the issue and notify the Experiential Education Office as soon as possible. b. The E*Value Concern Card is a feature available to send our office a message regarding any student issues you would like us to be aware of. You can complete a Concern Card in E*Value by clicking on Evaluations/On-The-Fly. 9. Discuss career options with the student (locally at current site and other sites in general). 10. Motivate, motivate, motivate, and motivate the student some more! Share your pharmacy practice challenges and how you handle these difficult situations. 11. Attend development presentations at school as the preferred method of preceptor training. In lieu of attending presentations review materials are available on the Pharmacist’s Letter Website at http://www.pharmacistsletter.com. For groups, an onsite presentation can be scheduled to offer preceptor development sessions, contact the Experiential Education Office for more details. Should you have any questions, please contact: Ms. Andrea DiGiorgio Experiential Education Coordinator Wegmans School of Pharmacy St. John Fisher College 3690 East Avenue Rochester, NY 14618 Phone: (585) 385-7249 Email: [email protected] IPPE-II_Manual 3 IPPE-II Overview 1. HOMEWORK: All assigned homework should be discussed with the preceptor prior to the student completing the assignment. Once the homework is completed the student will upload it to Coursework in E*Value. The document uploaded to Coursework should be one document encompassing all of the individual topics for each week. The preceptor may request a printed copy to review with the student. The preceptor will point out its strengths and weaknesses, and comment on each assignment. If not acceptable the student must re-do the assignment using the “onthe-fly” feature in Coursework until approved by the preceptor in E*Value Coursework. Homework can be completed in a sequence that is preferable to the preceptor. 2. ACTIVITIES/TASKS: The student must complete and have their preceptor verify (in E*Value) as acceptable all required activities/tasks in order for the student to pass the rotation. For each task the student will upload a brief description of the activity performed. The activity may be repeated until the student masters the activity. Activities/tasks can be completed in a sequence that is preferable to the preceptor. 3. JOURNAL REFLECTION: At the end of each rotation week the student will create and submit a journal reflection document (see example later in manual) in Coursework which includes at least two new error prevention strategies in bullet form. The student will then reflect and write about how they might use these concepts/tasks to benefit patient care and prevent errors. The reflection piece should not be long; it should be concise so it will be easy for you to review later. The preceptor will review the document in Coursework, comment and indicate whether or not the reflection is acceptable. 4. ERROR PREVENTION ANALYSIS PAPER: Beginning week four, the student and preceptor will select three practical error prevention techniques identified from the previous three weeks. The student will then write one paragraph (for each error prevention technique) describing the pros and cons of implementing these three strategies. The document must be submitted through Coursework for review and approval by the preceptor. 5. MEDICATION PASSES: Each student will witness at least one patient medication pass and create a document containing a brief description of and reflection on the process. The Medication Pass Verification Form (see back of manual) may be used to document and reflect upon this event. Either the medication nurse or a pharmacist may sign the document verifying that the medication pass was observed. Each student will then upload the completed document into Coursework. 6. FORMATIVE AND FINAL ASSESSMENTS: During weeks 2 and 4 of the rotation, both the student and preceptor will complete an assessment of the student independently using E*Value. For each evaluation period, the forms should be printed and the student and preceptor should compare the student’s self-assessment with the preceptor’s assessment and discuss the differences and similarities. A strategy for enhancing the students learning for the remainder of the rotation should be discussed at the end of week 2. For students at risk for failure during a formative assessment a written plan of action for improvement should be composed by IPPE-II_Manual 4 the preceptor and student, signed by the student and preceptor and a copy sent to the Assistant Director of Experiential Education. 7. PRECEPTOR SUMMARY GRADING FORM: During the final week of the rotation the preceptor will complete the summary grading sheet which includes indicating if the student passed or failed the rotation. NOTE: Documents should be verified by preceptor in E*Value when indicated. Student is responsible to make sure preceptor completes all requirements of the rotation. Clerkship/Rotation Policies & Regulations The student must share the clerkship manual with their preceptor during their first day of rotation. The student is responsible for reading the content of the clerkship manual and is expected to follow the policies and regulations as stated. Any infringements may lead to automatic dismissal from the site and failure of the rotation. I. Pre-requisite The student must successfully complete all other required courses in the first and second professional years at the Wegmans School of pharmacy, and possess a valid intern permit. II. Health records Students should have all site required health records up to date (physical examination, immunization, PPD or CXR) before starting rotation. These requirements will vary by site. Copies of these records must be in the Wellness Center and it is highly recommended that they be uploaded to MyFolio for better access by the student when needed. Failure to adhere to this policy may result in the delay of completing your rotation. III. Professional insurance St. John Fisher College arranges liability insurance for students each year. IV. 1. 2. 3. 4. 5. 6. 7. Site Selection A site assignment is tentative and does NOT guarantee that a student will attend that site. Student is responsible for ALL expenses associated with attending site. Students may NOT have a first degree relative as a preceptor. Students may NOT receive academic credit for working at a site where they are currently employed. Students will NOT accept any remuneration from the site while on rotation. For IPPE-I, IPPE-II, APPE Institutional, or APPE Community, students may NOT select a rotation site at which they are currently employed. The Assistant Director of Experiential Education or assigned preceptor can refuse a student assignment if she/he feels there may be a conflict of interest. IPPE-II_Manual 5 8. 9. 10. V. For IPPE I and APPE Community Pharmacy a student may not select a site where they have been employed in the past. For IPPE-III, IPPE-IV, APPE Ambulatory Care, APPE Acute General Medicine or APPE Electives, a student may NOT select a site where their potential preceptor would have a dual role as a preceptor and a “boss” or ”job reviewer”. If the assigned preceptor does not have such a role, then the student can perform a rotation in an institution where they are currently employed. Students who feel that they may not meet the above guidelines should contact the Director of Experiential Education and the prospective preceptor before selecting the site. E*Value and Coursework Portfolio The student is responsible for maintaining and uploading all required documents to E*Value and Coursework. This system will be used for verifying compliance and assessing student performance. VI. Grading Grading will be Satisfactory (Pass) or Unsatisfactory (Fail). Failure of any portion of the course will mandate repeating the entire course. VII. Evaluations The preceptor will evaluate the student throughout the rotation, formal and informal feedback is encouraged. Preceptor evaluation of the student should be used to encourage student improvement in specific areas where the student is not performing well. The student must evaluate the preceptor, the course, and the site. Failure to adhere to this policy may result in an incomplete grade or failure. Failure may result if required documents are not completed and received by the Experiential Education Office by their due date. VIII. Weather conditions All students should follow the weather advisory from SJFC regarding cancellation or delay of classes on campus. However, the students who cannot travel to their sites due to hazardous weather conditions should immediately notify their preceptors and the Experiential Education Office at (585) 385-7249. Attendance policy still applies regarding make up days and missing days. IX. Dismissal from sites All students are representing Wegmans School of Pharmacy and the Pharmacy profession during their presence at the rotation site. Therefore, professionalism and the highest standards are expected from students during their training at the sites. The Department of Pharmacy Practice and the site reserve the right to dismiss any student who does not uphold a professional attitude during the clerkship time. Any student caught under the influence of any substance of abuse/addiction, or caught stealing from the site will be dismissed automatically and fail the rotation. The student will then be reported to the Student Progress Committee and if necessary, the WSOP Student Honor Committee. X. Academic Honesty & Plagiarism IPPE-II_Manual 6 St. John Fisher College has a firm policy concerning academic dishonesty that includes, but is not limited to, cheating, plagiarism, or any other action that misrepresents academic work as being one’s own. Students are expected to demonstrate academic honesty in all coursework, whether completed in-class or not, individually, or as part of a group project. Violations of academic honesty include, but are not limited to, cheating and plagiarism. All students are expected to be familiar with the details of the Policy on Academic Honesty, which are found in the current Student Handbook. XI. Professionalism As consistent with the expectations of a professional and practice environment, professional behavior and attitudes are expected for all students enrolled in this course. Examples of professional behavior include, but are not limited to, appropriate demeanor, grooming, punctuality, and civility. XII. Personal Appearance As a representative of the School of Pharmacy, a student’s personal appearance is an extension of the School and will, to some degree, determine how customers, patients, and colleagues view the student, the program, and the profession of pharmacy. Conservatism and discretion are key determinants of professional attire. Business casual is the minimum requirement for appropriate attire for students during the three didactic years of the Pharmacy program. The following guidelines for attire are provided to assist the Pharmacy Doctoral Candidate to what is deemed as acceptable. The WSoP Dress Code shall be in effect from 8:00 AM until 5:00 PM Monday through Friday and covers the WSoP building and atrium. Students are also expected to adhere to the code when serving as a representative of the program. Hair: Hair should be clean and neatly groomed. Hair may not be dyed any unnatural hair colors. Males shall have short hair (above the shoulders) and it shall be neatly combed. At times and at the discretion of the course instructor, (lab, etc), it may be necessary for females with longer hair to have it pulled back. Hair ornaments shall be moderate and in good taste. Nails: Nails must be neatly manicured (not chipped) and kept at a length that will not interfere with the duties of a pharmacist (e.g., dispensing prescription, compounding in lab, making IVs). If polish is used, it must be conservative in color. Skin: No body piercings (other than earrings) or tattoos are allowed to be visible. Permissible Jewelry: Females and males are allowed no more than two earrings per ear. Earrings should be of a conservative nature (not large, no gauges or stretchers, etc.). Shirts: Revealing clothing (e.g., tank tops, spaghetti straps, halter tops, midriffs, tube tops, swim tops) is not permitted, and proper undergarments shall be worn. For men sweaters are acceptable. If shirts are worn they should have a collar and should be tucked in. For women, blouses should not be low cut or tight fitting. Hoodies and sweatshirts may not be worn in the building during the hours that the dress code is in effect. IPPE-II_Manual 7 Skirts/Dresses: Skirt length shall be no shorter than one inch above the knee (when standing) and may not be tight fitting. Split skirts are permitted, provided they are not tight fitting and fall within the skirt guidelines. Pants/Slacks: Pants shall not be tight fitting. Denim of any color, spandex, leggings, athletic wear, and sweat suits are not permitted. Pants must be worn properly at the hips. Any pants that contain rivets are not considered business casual. No shorts of any kind are allowed in the building during the hours that the dress code is in force. No student shall dress in a way that his/her underwear is partially or totally exposed and proper undergarments shall be worn. Shoes: Shoes must be clean and in good condition. Non-dress open toe casual sandals (flip flops, Birkenstocks, etc) shall not be worn. No athletic shoes or sneakers are permitted. Head Gear: Hats, caps, and other head gear may not be worn in the building during the hours that the Dress Code is in effect. Only headgear worn for bona fide religious purposes is permissible. Should the student be cold in class this code shall not prohibit a student from wearing a jacket during class. A faculty member who sees a student in violation of the student policy and procedures will counsel that student. Continued infractions of the student policy and procedures will result in sanctions appropriate to the policy (such as being sent home for repeated violations of dress code). XIII. Confidentiality & HIPAA Patient information is private and we are entrusted with it. The patients trust us because we are health care professionals. Therefore, confidentiality is the foundation for the establishment of trust between patients and health care providers. The students are expected to not discuss any patient information that they have encountered at their rotation sites outside of their learning environment. The student will also complete and abide by any site specific HIPAA requirements. Any infraction will result in immediate dismissal from the site and a failing grade will be given for the rotation. XIV. Sexual Harassment Sexual harassment is strictly prohibited. Below is the legal definition of sexual harassment, any allegation of sexual harassment by preceptor or student MUST be reported immediately to the Director of Experiential Education and the Director of Human resources. Sexual harassment, by law, is defined as unwelcome sexual advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature when 1) submission to such conduct is made an explicit or implicit term or condition of employment, 2) submission to or rejection of such conduct is used as a basis for employment decisions, or 3) such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance, or educational experience, or creates an intimidating, hostile, or abusive work or educational environment. Sexually harassing conduct may include, but is not limited to, sexually charged or sexually suggestive comments or jokes, sexual advances, requests for sexual favors, sexually suggestive pictures, drawings or emails, or similar conduct of a sexual nature. IPPE-II_Manual 8 XV. Student Complaint Process If the student feels they are being asked to perform an activity that is considered unprofessional conduct, puts patients or the student at risk for harm, or is contrary to the law, policies and/or regulations of the institution, site or college, the student should immediately discuss the concern with their preceptor. If the student is not satisfied with their preceptor’s response the student should immediately contact the Experiential Education Coordinator (Ms. Andrea DiGiorgio) at (585) 385-7249. The Director of Experiential Education or the Assistant Director will then talk with the student and preceptor to discuss possible options. IPPE-II_Manual 9 Preceptor (P) and Student (S) Rotation Reminders: Week 1, Day 1, 2014 Student to complete in advance of rotation start date the Pre-Rotation Self Evaluation. Student and preceptor will review Day 1 of rotation Preceptor to review manual with student. Schedule date and time for Formative assessment with student - Due Week 2 Schedule date and time for Final assessment with student - Due Week 4 Review student homework and activities. Complete time form. Complete Journal Reflection Form. S P P S S P S P P S S Weeks 1 – 4, 2014 Review homework assignment and journal documentation with student. Review, comment, and sign (if acceptable) completed homework and journaling with student. Complete weekly homework and journaling. Verify tasks/activity completion. Complete time form. Complete Formative assessment of student - Due Week 2 Complete Formative self-assessment - Due Week 2 Compare Formative assessments and discuss similarities and differences - Due Week 2 Complete preceptor and site Final assessments on Thursday of week 4 P P S S P P P S P S S Week 4, 2014 Select 3 error prevention strategies from the journal writings, the student will then write a procedure to implement these strategies Upload all completed assignments into E*Value and notify preceptor to review Complete 10 minute presentation Evaluate 10 minute presentation Complete Final student self-assessment. Complete Final assessments of student Compare & discuss preceptor’s Final assessment of student with student’s Final self-assessment. Complete time form and sign. Complete Summary Grade form. Complete Journal Reflections. Upload final copies of all completed homework and journal writings to E*Value P S S S S P P S P P S S IPPE-II_Manual 10 Time Form Student’s Name: ____________________________ Rotation Site: ______________________ Date: _______ Preceptor’s Name (Printed): ________________________ Preceptor’s Signature: ______________________________ It is the student’s responsibility to have this form completed by the preceptor. Students must complete a minimum of 8 hours each day Monday – Friday. 2014 Hours Preceptor’s Preceptor’s comments signature Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10 Day 11 Day 12 Day 13 Day 14 Day 15 Day 16 Day 17 Day 18 Day 19 Day 20 Total hours (Should be ≥ 160 hours) This is a form that must be maintained by the student and uploaded to Coursework in E*Value. IPPE-II_Manual 11 WEEKLY HOMEWORK AND READING ASSIGNMENTS: The preceptor will review each topic with the student so the student understands the concept thoroughly. Homework can be completed in a sequence that is preferable to the preceptor. Below is a suggested sequence to encourage timely completion of homework assignments. The student will submit the completed homework to his/her preceptor through Coursework. Homework should be completed at home unless allowed specifically by the preceptor to be done at site. Homework must be completed and accepted by preceptor. TOPICS – WEEK 1 Orientation to site and introduction to site team. - Include ancillary members of the healthcare team that interact with the pharmacy department - Give an overview of the profession of pharmacy to the student and describe current pharmacy issues of importance State the drug information reference your preceptor prefers and why. Review a medical record in the institution (electronic or paper). - Briefly describe the various sections of the medical record and what type of material is contained in each section. Briefly describe the function of other healthcare workers, including the following: Physicians, Nurses, OT/PT, Nutritionists, Respiratory Therapists, and Lab Personnel. According to your preceptor, define medication reconciliation. - Describe how your site is performing medication reconciliation. - How could this process be improved? Review some medical administration records (MAR’s) and answer the following: - Describe the purpose of the MAR - How are the medications organized on a MAR such as routine medications, prn medications or others? - What does a “prn” order mean? - List examples of prn orders - What are the standard administration times for a Q.I.D. order versus Q6H at your facility? - What are the common administration times for the following: Q.I.D., T.I.D., B.I.D., Q.D., versus Q6H, Q8H, Q12H, Q24H - How can you tell a medication is given by looking at the MAR? - Who can add information to an MAR? - How can you identify errors reviewing an MAR? - In general terms, describe how paper, pre-printed and electronic MARs are utilized. READ the ASHP Statement on the Pharmacy and Therapeutics Committee: http://www.ashp.org/DocLibrary/BestPractices/FormStPTCommFormSyst.aspx - Describe the membership of the P&T committee as recommended by ASHP - Briefly describe the functions of the P&T committee as recommended by ASHP - If possible, attend a P&T committee meeting IPPE-II_Manual 12 TOPICS – WEEK 2 READ the ASHP Guidelines on Medication use Evaluation: http://www.ashp.org/DocLibrary/BestPractices/FormGdlMedUseEval.aspx - Describe the purpose/benefits of the MUE process from the perspective of the physician/provider, patient, and pharmacist. READ The ASHP Guidelines on Adverse Drug Reaction Monitoring and Reporting: http://www.ashp.org/DocLibrary/BestPractices/MedMisGdlADR.aspx - Describe your site’s process for identifying and reporting ADR’s - What are the challenges to improving the system currently in place? - List the criteria that mandate reporting ADR’s to the FDA listed in box B2 located at: http://www.fda.gov/Safety/MedWatch/HowToReport/default.htm - Review the FDA’s ADR voluntary reporting form (3500) at http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/U CM163919.pdf - Complete the form from a real case or a fictitious example submitted by your preceptor. READ The ASHP Statement on the Pharmacist’s Role in Substance Abuse Prevention, Education and Assistance. http://www.ashp.org/DocLibrary/BestPractices/SpecificStSubstance.aspx - Describe the process for tracking/auditing controlled substances in the institution. - How are CII’s, CIII’s, CIV’s, and CV’s inventoried and tracked in the pharmacy and on the nursing units? IPPE-II_Manual 13 TOPICS – WEEK 3 READ The ASHP Discussion Guide for Compounding Sterile Preparations: http://www.ashp.org/s_ashp/docs/files/HACC_797guide.pdf - After discussing with your preceptor, describe in general terms, the process of how USP 797 is being implemented at your site. - Describe your sites challenges for implementing USP 797. - Describe how your site monitors compliance of aseptic technique for the compounding of sterile preparations. - Describe the difference between a sterile product and a sterile preparation. READ The ASHP Guidelines on The Pharmacy and Therapeutics Committee and the Formulary System. http://www.ashp.org/DocLibrary/BestPractices/FormGdlPTCommFormSyst.aspx - Describe the advantage(s) and disadvantage(s) of a formulary system from the perspective of the institution, patient, and physician/provider. - Describe how an institutions use of a formulary may affect patients on discharge. Why is there potential for patients to receive duplicate therapy? - According to your preceptor, describe what it means to have a drug on restricted status? READ the ASHP Statement on Unit Dose Drug Distribution: http://www.ashp.org/DocLibrary/BestPractices/DistribStUnitDose.aspx READ the ASHP Bulletin on Single Unit and Unit Dose Packages of Drug: http://www.ashp.org/DocLibrary/BestPractices/DistribTABUnitDose.aspx - Briefly describe what a unit dose system is. - What are the advantages/disadvantages of a unit dose system? (Think in terms of error prevention.) - Calculate an expiration date for a medication to be prepared in a unit dose package. - Describe the process for determining the shelf quantity of commonly used medication. IPPE-II_Manual 14 TOPICS – WEEK 4 READ the ASHP Guidelines on Handling Hazardous Drugs http://www.ashp.org/s_ashp/docs/files/BP07/Prep_Gdl_HazDrugs.pdf Chemotherapy: - At your site, describe how chemotherapeutic agents are handled differently (ordered, stored, doses calculated, compounded, and transported to patient care areas) as compared to non-chemotherapeutic agents? - How is the chemo hood different from the other hoods and why is it different? MSDS: - What is a material safety data sheet (MSDS)? - Where are they stored at your rotation site? Review the following: http://www.ismp.org/Tools/highalertmedications.pdf from ISMP’s High Alert Medication List (print and review this form with your preceptor). Ask your preceptor to select a medication that is on the sites formulary and is also listed on the High Alert medication list or is in a class on the list. - Review a drug information resource on the medication. Describe why you think the medication is on the High Alert Medication List. - State what special Precautions the institution is taking to prevent a medication misadventure with this medication. Review ISMP’s Error Prone Abbreviation List http://www.ismp.org/Tools/errorproneabbreviations.pdf - Compare ISMP’s “Error Prone Abbreviation List” to your sites banned abbreviation list. Do you agree with your sites banned list? Why or why not? Offer suggestions for improvement. Review ISMP’s list of Confused Drug Names http://www.ismp.org/tools/confuseddrugnames.pdf Review sites sound alike-look alike (SALA) medication list. Describe the error prevention techniques utilized by the site to prevent errors. Suggest a new technique and ask you preceptor to evaluate its practicality. IPPE-II_Manual 15 Rotation Task/Activities: Please be advised that the tasks below do not need to be completed in the order stated, this is a template that the preceptor may use for guidance. Once tasks/activities are completed by the student, the preceptor will verify acceptable completion in E*Value Coursework. If necessary, students will be given several opportunities to complete each task at an acceptable level. Complete task 1 by Friday of Week 1 1. Process orders to ensure accurate and timely delivery of medication to the patient - enter or verify medication information into computer system - print label - select medication (or describe process) - fill medication order (or robot) - label - complete safety checking Complete tasks 2, 3 and 4 prior to Friday of Week 2 2. Perform at least 5 interventions while processing orders. Be sure to document using sites procedures (only need to document once). Describe to preceptor the patient benefits of the interventions. 3. Provide simple drug information (verbal and written) to healthcare workers or patients on 5 different medications - student may use medication safety guides from site or the web at: http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm - use drug information sources at the site such as USPDI or Facts and Comparisons Complete tasks 5, 6 and 7 by Friday of Week 3 4. Read The ASHP Guidelines on Preventing Medication Errors in Hospitals: http://www.ashp.org/s_ashp/docs/files/MedMis_Gdl_Hosp.pdf 5. Review the ISMP Medication Errors Reporting Program (MERP): https://www.ismp.org/orderforms/reporterrortoISMP.asp -Use the ISMP website to report an actual error assigned by your preceptor. 6. Compound simple sterile preparations - Student will perform calculations required and compound at least 10 sterile products using aseptic technique. FINAL TASK: 7. On site 10-minute presentation on topic assigned by preceptor. Preceptor will use the Presentation Evaluation Rubric in E*Value to assess the student. IPPE-II_Manual 16 Journal Reflection: Pharmacy professionals are committed to lifelong learning, often this is called independent learning. The result is for the student to take accountability and responsibility for their own learning. This is a skill that should be nurtured in the students early years of college and will help the student tremendously throughout their career. One tool to assist the student is keeping a journal. Immediately at the end of each rotation week the student will create a journal reflection document and list in bullet form at least two new error prevention strategies. The following is an example: Journal Reflection Date: Error prevention strategies: 1._________________________________________________________________ 2._________________________________________________________________ Reflections: The student will then reflect and write about how they might use these concepts/tasks to benefit patient care and prevent errors. The reflection piece does not have to be long; in fact it should be concise so it will be easy for you to review later. At the beginning of the next rotation week the student will bring a printed copy to site for discussion with their preceptor. Once the preceptor approves the reflection the student will upload the completed reflection paper into E*Value and notify their preceptor that the document is available for verification. The course coordinator will review these on a regular basis so please complete and upload your entries into E*Value in a timely manner. IPPE-II_Manual 17 10 Minute Presentation By the end of the rotation the student will compose and present a brief paper on a topic assigned by the preceptor. Some suggested topics are below (preceptor may also suggest a topic relevant to the practice site). Pharmaceutical Phenytoin vs free Phenytoin Basics of sterile preparation Any new technology used in pharmacy Overview of any herbal medication New vaccine issues Brief review of new drug (unfamiliar to staff) Patient controlled analgesia Review of teratogenicity scale Compatibility of nebulized solutions Treatment of hiccups Significant side effect of a medication or drug/lab interaction or nutrient/drug interaction - CYP 450 - Daptomycin and INR - Ciprofloxacin and tube feedings Peds related Diaper rash care Lice treatment Otitis guidelines Medication administration options in peds Psych med use in peds (black box warning) Holliday-Segar Method of calculating fluids Lead poisoning treatments APGAR scores Autism overview General medical Disease state focusing on specific area diagnosis of pneumonia genetics behind CF treatment of thrombocytopenia treatment of heparin induced thrombocytopenia causes of hyponatremia or hypernatremia INR/coagulation labs Review RBC indices Urinalysis CSF fluid Review procedure in layman’s terms CABG Placement of coronary stent Benefits of PICC line -Placement of coronary stent -Benefits of PICC line Shunts Different types of IV lines Overview of BLS, ACLS or PALS IO lines Different types of enteral tubes Glasgow Coma Scale Medication extravasation care Chemo medication extravasation care Altitude sickness A copy of your presentation must be uploaded into Coursework in E*Value. IPPE-II_Manual 18 Presentations will be cited following the style adopted by the National Library of Medicine and used in Index Medicus with the exception that only the first three authors (last name and two initials, if available) are listed. Examples of this style follow. Note that “Letter,” “Editorial,” “News,” or “Abstract” is added at the end of references to these types of paper. References should be listed at the end of the presentation, and at the preceptor’s discretion may also be listed at the bottom of an individual slide where the information is presented. (a) Standard journal article, including electronic journal article (list all authors when three or fewer; when four or more, list only first three and add “et al.”*): 1. Driscoll DF, Bhargava N, Li L et al. Physicochemical stability of total nutrient admixtures. Am J Health-Syst Pharm. 1995; 52: 623-34. (b) Article from journal paginated by issue: 2. Smith DL. The effect of patient noncompliance on health care costs. Med Interface. 1993; 6(4):74-6,78,84. (c) Letter, editorial, or abstract: 3. Stiles ML, Allen LV Jr, Prince S et al. Stability of ranitidine hydrochloride during simulated home care use. Am J Hosp Pharm. 1994; 51: 1706-7. Letter. (d) Book—personal author(s): 4. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. 5th ed. Baltimore: Williams & Wilkins; 1998. (e) Chapter or article in a book: 5. Jackson EK. Diuretics. In: Hardman JG, Limbird LE, Molinoff PB et al., eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill; 1996:685-713. (f) Editor, compiler, or chair as author of book: 6. Barone MA, ed. The Harriet Lane handbook: a manual for pediatric house officers. 14th ed. St. Louis: Mosby-Year Book; 1996. (g) Government agency publication: 7. National Institute on Alcohol Abuse and Alcoholism. Eighth special report to the U.S. Congress on alcohol and health. Washington, DC: U.S. Department of Health and Human Services, 1993; NIH publication no. 93-3699. (h) Package insert: 8. Zofran package insert. Research Triangle Park, NC: Glaxo Wellcome; 1996 Oct. (i) Paper presented at a meeting: 9. Saltiel E, Nishimura LY, Shane R. Pharmacoeconomic analysis of enoxaparin in orthopedic patients. Paper presented at ASHP Annual Meeting. Reno, NV; 1994 Jun 7. (Note: Give date paper was presented, not range of dates of meeting.) IPPE-II_Manual 19 (j) Electronic sources: 10. Martindale: The extra pharmacopeia [CD-ROM]. Reynolds JEF, ed. Denver: Micromedex; 1988. 11. Food and Drug Administration. Use of investigational products when subjects enter a second institution. IRB operations and clinical investigation information sheet. www.fda.gov/oc/ oha/useofinv.html (accessed 1997 Aug 25). 12. Harrison CL, Schmidt PQ, Jones JD. Aspirin compared with acetaminophen for relief of headache. Online J Ther [serial online]. 1992 Jan 2; Doc no. 1. IPPE-II_Manual 20 Presentation Evaluation Form IPPE II (Preceptor to complete on-line in E*Value) Student:_______________________________ Site:____________________________Topic:__________________Date:___________ 1 Improvement needed; below expectations 2 Meets expectations 3 Exceeds expectations Organization Topic was relevant to practice Logical information sequence Appropriate continuity of presentation Appropriate balance of emphasis Appropriate utilization of time allotted 123 123 123 123 123 Comments and Suggestions for Improvement ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Visual Aids/Handouts Well organized handouts presented to audience Clear and legible Complemented the presentation; not used to read directly References in correct format and complete 123 123 123 123 Comments and Suggestions for Improvement ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Verbal Presentation Delivery Clear, audible speech (rate was easy to understand) No distracting mannerisms Eye contact with audience Ability to handle questions Clear expectation/articulation of concepts Minimum use of space fillers (e.g., umm, yea) 123 123 123 123 123 123 Comments and Suggestions for Improvement ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Total Score___________ Note: student must attain a passing score of ≥30 points to pass the presentation. If student fails the presentation the student will repeat until acceptable by the preceptor. Signature of evaluator___________________________________________________ IPPE-II_Manual 21 Formative and Final Assessments Complete using E*Value Week 2 (Formative) Week 4 (Final) The formative and final assessments of professionalism and learning outcomes will help the student to recognize their strengths and also their weaknesses which require changes and improvements. An honest assessment will help the student in their learning endeavor. The formative assessment must be completed at least once at mid-rotation. The student must also complete a self-assessment at this time. The preceptor and student should then discuss and compare the student’s self-assessment and the preceptor’s assessment of the student. Please answer statements in E*Value using the following scale: Verbal Language PROFESSIONALISM AND COMMUNICATION ASSESSMENT -1Needs Attention Negative attributes Include these examples -2Meets Standards Positive attributes include most of these examples -3Exemplary Positive attributes include all these examples plus “meets standards” Inappropriate vocabulary used for audience Grammar impedes understanding Vocabulary is appropriate for audience (peer, faculty, patient, doctor) Makes significant contributions to the conversation Vocabulary always appropriate for the audience (peer, faculty, patient, doctor, etc…) May be inaudible, demanding tone, disrespectful tone, inappropriate volume for situation (example: too loud for confidentiality) Verbal presentations (if any) suggests lack of preparation Demonstrates confident tone without arrogance Respectful Verbal presentations (if any) flow fairly smoothly – suggesting good preparation Demonstrates empathy Adjusts style and tone for specific situation and/or audience Verbal presentations (if any) are smooth and rehearsed Appears distracted Inappropriate use of technology (uses phone at inappropriate times) Closed posture, staring Inappropriate distance Usually shows active engagement (examples: nodding, leaning in, appropriate eye contact, posture) Demonstrates empathy Always demonstrates active engagement in conversation (examples: nodding, leaning in, appropriate eye contact, posture, etc…) Delivery & Tone Verbal Body Language Non-Verbal IPPE-II_Manual 22 Listening Instructions need to be repeated Interrupts inappropriately Does not ask appropriate questions Struggles comprehending verbal instructions Written Email Errors in spelling, grammar, etc… Inappropriate for audience- ex: demanding Lack appropriate level of formality ex: excessive abbreviations. Text-style writing Charting/ Recording/ Documentation Not addressing legal requirements Lacks clarity or is not concise Plagiarism and/or inaccuracy Documentation does not suggest content knowledge Writing is illegible Appearance Punctuality/ Attendance/ Accountability Professionalism Responds to verbal instructions Demonstrates understanding of information heard Demonstrates engagement by asking appropriate questions. Emails are timely Respectful tone Few if any spelling or grammatical errors Appropriate formality Addresses all legal requirements Usually clear, concise Includes proper citations Good content knowledge shown Accurate Inconsistency in following dress code Sloppy, unkempt appearance Lack of CLEAN lab coat Often late for class, meetings, rotations, appointments Often late with assignments Acts irresponsible or immature at events/meetings/ro tation sites Does not carry fair share of group work Makes excuses Verifies understanding of information heard. Makes significant contributions to conversation Demonstrates engagement by asking in-depth questions Consistently on time for class, meetings, rotation, etc… Assignments consistently on time Diligent Consistently acts responsible with groups, a meetings and/or at site Always prepared for group work Accepts group’s decisions Timely & proactive emails Respectful tone No spelling errors No grammatical errors Adjust level of formality for audience Addresses ALL legal requirements Always clear, concise Includes proper citations Documentation suggests high level of content knowledge Dress is consistent with Student Dress Code Dress is always situation appropriate (ex: CLEAN lab coat) Always punctual and often early for appointments and/or assignments. Always acts responsible and appropriate with all groups /events/meetings Ability to work independently Can lead group work Works toward common goals IPPE-II_Manual 23 Attitude Character Exhibiting any of these behaviors: negative attitude, cocky, defensive, aggressive, arrogant, indifferent, blaming of others Lacking good work ethic Dishonest Culturally insensitive Illegal or immoral actions Does not accept responsibility Generally positive and appropriately confident attitude Accepts feedback openly Good work ethic Willing to help others if asked Trustworthy Appreciates diversity Exhibits empathy & compassion Always positive and projecting appropriate confidence Accepts and acts on feedback Good work ethic Proactively helps others Fair & just with customers, preceptors, colleagues Models cultural sensitivity, empathy, compassion IPPE-II_Manual 24 Formative and Final Assessments Complete using E*Value Week 2 (Formative) Week 4 (Final) Please answer statements in E*Value using the following scale: 1 2 3 Needs Attention Meets Standards Exemplary The student requires significant guidance and reminders to meet basic criteria, may need additional training outside this rotation. The student requires moderate prompting to meet MOST complex criteria and minimal guidance to meet basic criteria. The student meets all basic criteria. The student requires limited prompting to meet MOST complex criteria. The student meets ALL basic criteria. Learning Outcomes TAKES THE INITIATIVE to learn what they have identified they don’t know versus misleading others with incorrect information. PROMOTES error prevention by identifying critical points in the dispensing process where errors may occur. FORMULATES complete, accurate, and evidence-based responses (oral or written) to drug information questions from patients or other healthcare providers. EFFECTIVELY utilizes pharmacy reference materials to find needed information. DEMONSTRATES ability to work in compliance of HIPAA regulations. CAN STATE the functions of the Pharmacy and Therapeutics committee including procedures for formulary and therapeutic substitution. DISTINGUISHES between record keeping requirements of CII’s, C III-V’s and non-controls. CAN STATE procedures for processing written and verbal orders. CAN APPLY the pharmacy law and regulations to the operations of a pharmacy. CAN DESCRIBE the various sections of a medical record. CAN COMPOUND sterile products in a hood. CAN DESCRIBE how chemotherapeutic/biologic agents are handled differently from nonchemotherapeutic/biologic agents. ENSURES that the information on and the preparation of the medication order is accurate and complete for centralized or decentralized systems. CAN DESCRIBE the function and state the safety advantages of a unit dose system. UNDERSTANDS common sig abbreviations; accurately interprets written orders. IPPE-II_Manual 25 IPPE II Optional Challenge Assignments The following are suggested optional assignments designed to further challenge the advanced student. All required tasks must be completed before the preceptor assigns their student an optional challenge. It is up to the preceptor’s discretion to decide if the student has enough experience and has demonstrated mastery of the assigned tasks. Upon completion and preceptor approval of any challenge assignments, the student will complete an “on-the-fly” optional challenge assignment form in E*Value. The number of challenge assignments the student may complete while on this rotation is determined between the student and preceptor. The following is a list of potential assignments; however, the preceptor may decide to assign the student an assignment of their own design that is not included on the list below. 1. Complete a reference sheet for the pharmacist identifying critical counseling points for the drugs and/or devices used to treat any of the disease states listed below. The reference sheet could include items such as mechanism of action, dosing, timing of administration, side effects, drug interactions, warnings, and precautions. a. Hypertension b. Diabetes c. Asthma d. Coronary artery disease e. Congestive heart failure f. Head Lice g. Athlete’s foot h. Hypercholesterolemia i. Osteoporosis j. Hypothyroidism k. Peptic ulcer disease l. Acne m. Influenza 2. Assign the student a drug information question commensurate with their level of education with a focus on the selection and use of resources to answer the question. 3. 4. 5. 6. Complete a complex compounding assignment. Outline the process at your site for a drug product shortage. Outline a plan for inventory management at your rotation site. Outline the process for ordering pharmacy inventory at your site (from wholesaler or other supplier). 7. Create staffing schedule for your pharmacy (include man hours for pharmacists, technicians, etc.) for a 2-week period during rotation. Include assessment of workload to justify staffing. 8. Outline process for proper disposal of expired stock medications (legend vs. control) including hazardous substances. 9. Describe the process of reporting a medication error at your rotation site. 10. Identify five (5) medications used at your rotation site that are not stored at room temperature and five (5) systemic medications administered by a non-oral route of administration (identify route and common indication). IPPE-II_Manual 26 11. Outline and discuss the differences in responsibilities/liabilities between pharmacists and technicians in the processing of a prescription. What attitudes/behaviors may contribute to unsafe dispensing practices? 12. Identify 5 patients at your site who are on more than twelve (12) medications. Identify any potential duplication in therapy or potential drug-drug interactions. 13. Select a recent news article concerning a health care issue related to your site. Outline and discuss the impact this issue may have on the profession of pharmacy or how this article may affect the provision healthcare of your patients. 14. Discuss with your preceptor an ethical dilemma (observed or theoretical) and what procedure or resources your site would utilize to resolve it. 15. Practice dialogue with your preceptor regarding how to handle an angry patient or provider. 16. Participate in the preparation for or reporting to a credentialing body (i.e. The Joint Commission) 17. Participate in the assessment of or utilization of Computerized Physician Order Entry (CPOE). 18. Observe another healthcare practitioners during their daily activities (i.e. NP, Anesthesiologist, RT, OT, Nutritionist). IPPE-II_Manual 27 Student Pre-Rotation Self Evaluation Purpose: The purpose of this form is to give the preceptor an idea of how much experience and knowledge the student has pertaining to the assigned rotation. This will help the preceptor in her/his teaching methods especially in the beginning of the rotation. Please note this form does NOT exempt students from any of the basic requirements of the manual. Requirement: This form is to be completed by the student prior to the start of the rotation approximately 1 month prior to the start of the rotation. Student Self Evaluation Criteria 1. I have worked or volunteered in a community/institutional/neither/both (select one) _____________ pharmacy. 2. I have worked or volunteered in a community or institutional pharmacy performing functions as a pharmacy technician for ________ hours. 3. I have read the homework assignments in the manual and feel confident I could complete ______% of them today. a. Please list the homework assignments you feel you could complete prior to the start of the rotation: 4. I have read the tasks required of me and have already completed________% of them independently. a. Please list tasks you have successfully completed independently: Student signature_________________________ Date________________ IPPE-II_Manual 28 PRECEPTOR SUMMARY GRADING SHEET (Complete in E*Value Week 4) 1. Student completed a minimum of 160 rotation hours with no unexcused absences: Satisfactory = Student Completed Unsatisfactory = Student did NOT complete 2. Student completed assigned homework to preceptor’s satisfaction: Satisfactory = Student Completed Unsatisfactory = Student did NOT complete 3. Student completed ALL task activities at an acceptable level: Satisfactory = Student Completed Unsatisfactory = Student did NOT complete 4. Student completed Journaling requirements of course: Satisfactory = Student Completed Unsatisfactory = Student did NOT complete 5. Student completed the error prevention analysis paper that is acceptable to the preceptor: Satisfactory = Student Completed Unsatisfactory = Student did NOT complete 6. Student compared their Formative self-assessments with preceptor’s Formative assessment of the student midway through the rotation. Student compared their Final self-assessment with the preceptor’s Final assessment of the student at the end of the rotation. Satisfactory = Student Completed Unsatisfactory = Student did NOT complete 7. Student received a score of ≥ 30 on presentation evaluation: Satisfactory= Score ≥ 30 Unsatisfactory = Score < 30 8. Student’s average on the preceptor’s final assessment of professionalism and learning outcomes was: Satisfactory = ≥ 2.0 Unsatisfactory = < 2.0 9. Student reviewed course manual with preceptor during the first week of the rotation: Satisfactory = Yes Unsatisfactory = No To pass PHAR 4339 the student MUST receive a Satisfactory from their preceptor for ALL the criteria listed above. IPPE-II_Manual 29 Final Student Evaluation of Preceptor (Complete in E*Value Week 4) Please answer the following statements: Criteria The evaluation methods and criteria were clarified with me early in the rotation My preceptor exemplifies the characteristics of a professional My preceptor gave me adequate feedback on a regular basis My preceptor’s feedback helped me improve My preceptor (or designee) was readily available My preceptor asked questions that caused me to explore issues and answer questions My preceptor answered my questions clearly My preceptor prompted me to work independently as needed My preceptor displayed dedication to teaching/education Overall my preceptor is an effective educator, coach or mentor Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N What did the preceptor do that was most effective in supporting your learning needs? ______________________________________________________________________ ______________________________________________________________________ ________________ What would you suggest for changes? ______________________________________________________________________ ______________________________________________________________________ ________________ Additional Comments: (not mandatory) ______________________________________________________________________ ______________________________________________________________________ ________________ IPPE-II_Manual 30 Final Student Evaluation of Experiential Site (Complete in E*Value Week 4) Please answer the following statements: Criteria Exposure to the practice of pharmacy at the site meet your expectations The site provides an environment conducive to your learning Y/N Y/N Strengths of the site: ______________________________________________________________________ ______________________________________________________________________ ________________ Weaknesses of the site: ______________________________________________________________________ ______________________________________________________________________ ________________ Suggestions for improvement: ______________________________________________________________________ ______________________________________________________________________ ________________ IPPE-II_Manual 31 EXPERIENTIAL EDUCATION ABSENCE REQUEST FORM St. John Fisher College 3690 East Avenue Rochester, NY 14618 Phone: 585-385-7249 Fax: 585-385-5295 Except for emergency, this form MUST be submitted to the Experiential Education Office 10 days prior to your requested days. Student name _____________________________________________ Date _______________ Rotation type and dates ________________________________________________________ Site name and address _________________________________________________________ Preceptor name and phone number _______________________________________________ Dates requested off for current rotation___________ Total days requested off to date________ (include all IPPE and APPE rotations) Reason for requested days off - be specific (e.g., illness, funeral, etc – days to be made up in the future). Any excused/unexcused non-emergency absence NOT documented on this form may result in failure of the rotation: _________________________________________________________________________ _________________________________________________________________________ C:\Documents and Settings\robrocta\My Documents\Manuals\2006\SJFC\IPPE-EE\EE com. __________________________________________________________ (continue on back) and inst..doc Preceptor approved makeup dates and times: NOTE: Make up time must be in a minimum of 4 hour blocks Date Start Time End Time Total Hours _____________________________________________________________________________ Date Start Time End Time Total Hours . Preceptor’s signature________________________________ Date ________________ Assistant Director of Experiential Education________________________________Date___ IPPE-II_Manual 32 Sample Action Plan IPPE-II Action Plan for: STUDENT NAME Date: Student X received an overall average of 2.5 for the formative preceptor assessment of student at week 5. Student X and I discussed the problem of repetitively showing up late for rotation (6:30AM instead of 6AM as expected). The student stated that child care was the issue but now realizes the importance of showing up on time and will make alternate child care arrangements. The student has agreed to be on time for the remainder of the rotation. I reminded the student that any future violations of rotation policies and regulations will result in failure of the rotation. Student Signature Preceptor Signature cc: Assistant Director of Experiential Education IPPE-II_Manual 33 MEDICATION PASS VERIFICATION FORM PHARMACY STUDENT:____________ __________________________________________ WITNESS:___________________________________________________________________ MEDICATIONS OBSERVED: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ REFLECTION (Note any unique challenges or observations regarding the observed medication administration. Include your thoughts on what could be altered, if any, to benefit the patient): IPPE-II_Manual 34