phrm 771 community ippe checklist.pdf

PRECEPTOR CHECKLIST/ SIGN-OFF PHRM 771 Community IPPE

Student Name _________________________________________________________________

Supervising Preceptor Name(s) ___________________________________________________

Location ______________________________________________________________________ INSTRUCTIONS

The following table outlines the primary learning goals and activities for the Community IPPE. Each student should successfully complete all items on the checklist by the end of the community IPPE. The student should maintain the checklist and the preceptor should review the checklist at the beginning of the rotation and regularly thereafter (at least weekly). When a student successfully completes an item on the checklist, the preceptor should initial and date the item.

DO NOT wait until the last week of the rotation to begin having items checked off. 1. Activities beyond discussion and observation must be documented by the student. For those

activities that do not have a designated form, the student should record the assignment results using a word-processing program.

2. All documentation of assignment completion must accompany the completed check list to earn full credit for the rotation.

Student to submit a hard copy of completed checklist and the supporting documentation to the Office of Experiential Education no later than August 17th 2015 (or January 25th 2016 for winter schedule).

Teera SujithamrakElaine Lucero

Smith's Pharmacy #496 3701 Constitution NE Albuquerque, NM 87110

Community IPPE Checklist

Objective 1.1

Describe the scope of the practice and the functions, roles and accountabilities of its personnel as they relate to pharmacy services and practice management. (Competency 4.2)

Student Preceptor Date

Observe and discuss the following with the preceptor (ideally during week #1): x Number, roles and accountabilities of (functions performed and skills needed by) pharmacists,

technicians and other personnel x Reporting relationships within the site and company x Services offered by the practice x Workload (e.g. numbers of prescriptions filled per day, impact of third party plans) and work processes

Objective 1.2 Relate the characteristics of the patient base and population of the surrounding community to the provision of and need for pharmacist-provided services. (Competency 6.2)


Discuss with the preceptor aspects of the patient-centered pharmacist-patient relationship (ideally during week #1) x Appropriate sharing of power and responsibility between the pharmacist, patient and caregivers x Importance of open and honest communication between pharmacist and patient x Influence of age, cultural sensitivity, health literacy and respect for the patients individuality, emotional

needs, values, and life issues in achieving an effective pharmacist-patient relationship, both in gathering information and in achieving patient adherence to prescribed therapy and/or prevention and health promotion strategies

x Relationship of the community pharmacy approach to the establishment of the pharmacist-patient relationship, continuity of care, and health promotion and disease prevention

Observe and discuss with the preceptor community demographics and the patient base at this site, including age range, ethnicities, level of education, predominant occupations, socio-economic status, and predominant disease states (ideally during week #1 or #2)

Objective 2.1 Describe and apply legal regulations and workflow, policies, and procedures used to ensure the provision of safe and effective drug products. (Activities below may be completed at any time during rotation) (Competency 7.1 & 4.1)


Review and discuss with the preceptor the legal requirements for dispensing prescription medications, including those for controlled substances

Review and discuss with the preceptor the legal and ethical principles governing the maintenance and communication of patient information/ medical records.

Outline the legally required components of NM Board of Pharmacy regulations for patient counseling. Observe and describe how these components are utilized at practice site. Discuss key points of patient counseling.


Observe pharmacists and pharmacy technicians through their daily activities then review and discuss with the preceptor the policies and workflow processes used in the practice to x order and manage inventory of medications x store medications x verify prescription authenticity and accuracy x to maximize efficiencies and minimize medication-related errors when dispensing prescriptions

Identify five (5) medications used in the practice that are NOT stored at room temperature and five (5) medications given by a non-oral route of administration. List the specific storage requirements for the 5 medications not stored at room temperature and describe why these are necessary. For 5 medications not taken by mouth, identify the route of administration and reason(s) why the medication is administered by a non-oral route as well as proper patient counseling for those medications. Record results for inclusion with this report.

Discuss with preceptor the policies and procedures (workflow, checks and balances) used to ensure provision of appropriate, safe and effective drug products to patients. Include in your discussion how the responsibilities and liabilities differ for pharmacists and technicians in the medication use system as well as the attitudes or behaviors that can contribute to unsafe practices.

Objective 2.2 Participate in the appropriate acquisition, storage and inventory management of prescription and non-prescription medications. (Activities below may be completed at any time during rotation) (Competency 4.1)


Participate in the process of ordering medications from a wholesaler or other supplier. Where possible, this should include completion of forms necessary to acquire controlled substances.

Participate in the process of checking in and storing products delivered to the practice site. Fill out a DEA 222 form Follow companys protocol to perform inventory on CII substances. Review how to document discrepancies in controlled substances. Discuss with preceptor how to handle employee theft of controlled substances or any medication.

Objective 2.3 Process and dispense prescription medications in accordance with legal regulations and policies and procedures of the practice. (Activities below may be completed at any time during rotation) (Competency 1.5)


Follow at least five(5) new and five(5) refill prescriptions from intake through the steps necessary to appropriately dispense that prescription. Where possible, these should include at least one each of the following

controlled substance prescription compounded prescription receive prescription phoned in by physicians office request for clarifying information and/or prescription refill approval from a physicians office


Perform calculations necessary to compound, dispense a prescription, or deliver a medication dose for a minimum of five(5) prescriptions

Where available, demonstrate appropriate compounding technique. We recognize that some sites do not provide this service.

Check prescriptions filled by pharmacy technicians on at least five(5) occasions

Objective 3.1 Conduct Patient Interviews (Activities below may be completed at any time during rotation) (Competency 1.1)


Interview a minimum of two patients to obtain patient specific information necessary for the appropriate dispensing and use of medications. One interview should be with a patient filling a new prescription and a second to assess compliance with and effectiveness and safety of a current medication at the time of refill.

Conduct appropriate patient and physical assessment to assess need for or response to drug therapy (e.g. observation of patient appearance / behavior, pulse, blood pressure) for a minimum of two patients (may be the same patients for whom interview is conducted).

Objective 3.2 Identify and Resolve Drug Related Problems

1 (Activities below may be completed at any time during rotation) (Competency 3.3)


Discuss with the preceptor ways in which data are systematically collected and analyzed to identify and address drug-related problems

Discuss with the preceptor how automated alerts for drug interactions or duplication of therapy are handled in the practice.

With the preceptor, communicate with patients and/or review of patient medication records to identify a minimum of five(5) actual or potential drug- related problems

1 DRPs may include compliance issue (over or underuse); adverse drug reaction (actual or potential); drug selection problem (no drug for identified condition, drug with no identified condition, inappropriate/ suboptimal drug selection); drug regimen problem (inappropriate dose, dosage form or route of administration); drug-drug, drug-disease, or drug-food interaction (actual or potential).

Objective 3.3 Evaluate and respond to drug information inquiries (Ideally completed during week #3 but must be completed by last day of rotation). (Competency 5.1)


Clarify, research and respond to a minimum of 2 drug information questions including the identification of appropriate references. With preceptor guidance, identify two drug information questions; one from a patient and one from a health care provider and x outline an appropriate search strategy for each x identify appropriate resources x evaluate literature resources x prepare and submit a written response using the DI documentation form


Objective 4.1 Provide patient counseling for the use of prescription medications and related drug delivery or self-monitoring devices (Note: if you dont see a patient like this, talk to your preceptor about a preceptor-led demonstration. activities below may be completed at any time during rotation). (Competency 1.5)


Provide prescription medication use counseling, consistent with NM Board of Pharmacy. Requirements, for a minimum of 5 patients

Teach patients to use drug delivery or self-monitoring devices, including (where possible) but not limited to x subcutaneous injections (e.g. measuring, mixing, and injecting insulin products) x metered-dose and dry powder inhalers x blood glucose meters x peak flow meters

Objective 4.2 Consult with Patients Regarding Non-prescription Product Selection and Use (Activities below may be completed at any time during rotation) (Competency 1.5)


Walk the OTC drug aisles and review OTC products. Conduct triage and provide self-care recommendations for a minimum of 4 patients. Document your interactions using the Self-Care Documentation Form and provide copies to your preceptor for review.

Objective 5.0 Document pharmacists activities, interactions and interventions with patients. (Competency 3.3)


Use inventory / information management tools to document the acquisition and distribution of prescription and non-prescription medications and devices at least once.

Use prescription processing / dispensing software system to maintain accurate of patient information and dispensing records for a minimum of five (5) patient encounters.

Adjudicate third-party payment claims for a minimum of five (5) prescriptions or patient care services. Identify and document a minimum of five actual or potential drug-related problems identified through review of patient medication records and any corrective actions taken.

Observe patient-pharmacist self-care (OTC) communications, interventions and recommendations for a minimum of one (1) patient.

Observe patient-pharmacist MTM communications, interventions and recommendations for a minimum of one (1) patient.


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Objective 6.0 Promote public health and disease prevention (activities below may be completed at any time during rotation) (Competency 2.3)


Assigned Reading Read Using Health Observances to Promote Wellness in Community Pharmacies (J Am Pharm Assoc. 2003, 43:61-68) at http://japha.org/article.aspx?articleid=1035903 Discuss with preceptor opportunities to promote patients health through education and screenings as well as obstacles that may be encountered. Discuss with preceptor your plans for a future event (community outreach or education offering) that can be incorporated into community pharmacy.

Discuss with the preceptor the current efforts of the practice to promote population-based health maintenance and disease prevention.

Identify and research at least five (5) community resources/agencies in your community/area with which pharmacists might interact. For each agency, provide contact information, a brief summary of what they do and how they help patients.

Objective 7.0 Demonstrate mature and professional attitudes, habits and behaviors (activities below may be completed at any time during rotation) (Competency 7.3)


Assigned Reading Review the professionalism white paper (Pharmacotherapy 2009;29(6):749756) Development of Student Professionalism (HSLIC electronic journals) and print a copy for your preceptor. Discuss with preceptor opportunities to promote professionalism at your practice site as well as obstacles that may be encountered.

Review the preceptor sign-off / checklist with preceptor on the first day of the rotation and weekly thereafter. Make sure all items are checked off by the last day of the rotation.

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Drug Information Documentation Form

State the question received: 1. Identify requestor

2. Why is the question being asked?

3. Formulate clear and specific drug information question(s).

4. Classify drug information request by selecting all that apply. Adverse effect Availability Compatibility/stability Cost analysis Dose/dosage/administration Drug identification Drug interaction

Drug compatibility/stability Drug therapy Patient Education Pregnancy/lactation Pharmacy practice Pharmacology Other _____________

5. Describe your strategy for conducting a systematic strategy and cite references used. 6. Explain your process of resource evaluation and analysis. Provide a concise substantiated

conclusion from the resources used. 7. Provide response to the question.

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Drug Information Instructions: These instructions are a guide to completing the Drug Information Worksheet. Responses should be concise with sufficient detail to show the thoroughness of the search and appropriateness of the final response to the requestor. Additional guidance can be found in Access Pharmacy Database Drug Information: A Guide for Pharmacists The worksheet should not exceed 2 pages in length. 1. Obtain information on the requestor. The individual professional credentials (physician, pharmacist,

nurse, physician assistant, dentist, or lay person- patient/caregiver) suggest educational experience and knowledge. This can be used to determine the appropriate level to formulate and deliver the response to the question(s).

2. Determine why the question is being asked. What information is sought? Is it a specific patient or a

general question? Is the question prospective or retrospective? Is the question for general information or to reach a clinical decision? This information is helpful in formulating the question(s) to be addressed.

3. The question must be carefully focused to address the specific information needed to address the

particular situation. All pertinent/relevant factors must be included patient, clinical situation etc.

Examples: Not Focused: What is the dose of amoxicillin? There is not enough information here to answer a clinical question, or address a specific patient needs.

Focused: What is the dose and frequency of amoxicillin before a dental procedure for bacterial endocarditis prophylaxis in an 18 year old male? The question addresses a specific scenario and allows the response to be focused.

4. Classifying the question allows for selection of the appropriate resource. Selecting the right

reference focuses the search strategy and increases likelihood of locating the correct response. See list of suggested references for guidance.

5. List the resource(s) that you selected for the search based on the probability of locating the requested

information. These should be prioritized based on your knowledge of what information is most likely to be found in a particular reference. Alternatively, you may have selected resources based on ease of access or your comfort in use. If so, state such. Provide your search strategy this can be done via cut and paste of the URL or typed out [e.g. PubMed: pediatric + ear infection]

Describe how you conducted a systematic search. A logical progression is to begin with the information located within the tertiary literature and then move to secondary/primary to fine tune information. If you use secondary literature to access the primary literature, briefly list your search terms. The description should include the confirming reference(s) used to format the response.

When applicable, the use of non-standard references may be used provided they are critically analyzed for credibility. Use of such resources must be explained including the critical analysis. These may include websites or non-referee journal publications.

Cite your references using AMA style as found at http://www.docstyles.com/amaguide.htm . All references used in the final answer should be listed. Include any confirming information as well as the original article/reference.

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6. Evaluate and analyze the findings and confirm with other references for appropriateness, accuracy

and reliability. Is the reference current and supported by other references? In instances where conflicting information is found, provide an evaluation and analysis of how you selected the best reference to be used for this specific question.

7. Synthesize your findings in to a single comprehensive conclusion. Response should show

thoughtfulness and applicability to the question asked. Response should explain why one reference was selected over another when appropriate.

Prepare a concise (less than 100 words) response to the requestor. Begin the response by answering the question. Provide more details as needed. Compose the response at the comprehension level of the requestor. References should be incorporated into the final response.

Helpful Hints for Answering Drug Information Questions It is acceptable to begin with a tertiary resource for background data. If you begin with a tertiary reference, review any cited primary literature. The presented may not fully represent the entire primary reference. Many questions will require a literature search even if you find an answer in a tertiary reference. When doing a literature search, be sure to review older data if available. Just because the information is older does not mean that it is not relevant or useful. x Any resource information should be double checked against another reference to establish credibility.

A review of cited primary literature is often effective in establishing a credible response. x When using clinical guidelines, verify that the guidelines are supported by a professional organization. x Confirm that the guidelines selected are the most recent AND are those most appropriate for this

specific question. When guidelines conflict, perform an evaluation to determine the best answer. x Both safety and efficacy data are important when reviewing a drug therapy. If your

reference(s) do not address these, comment within your final response. Consider adding common side effects/uses or populations in whom the drug should not be used.

x Always answer the question in the first sentence of the written response. x The final response should be complete such that the person asking the question could treat a

patient immediately with the information you provide. Dosage information and/or a brief summary of the efficacy/safety data should be provided.

Self-Care Documentation Form

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Patient Information: Initials: __________ Male Female Pregnant Breastfeeding Patient Age: < 2 years 217 years 18-64 years t65 years Describe chief complaint:

Area of Chief Complaint: Allergy Cold Constipation Cough Dermatology Diarrhea

Headache Heartburn Fever Ophthalmic Otic Tobacco cessation Other __________________

Patient Assessment Suggested questions to focus chief complaint: a. Symptoms: What are the main and associated symptoms? b. Characteristics: What is the situation like? Is it changing? c. History: What has been tried so far? Have you had this before? d. Onset: When did it start? e. Location: Where is the problem located? f. Aggravating Factors: What makes it worse? g. Remitting Factors: What makes it better? h. Medications: Are you taking any prescription or non prescription drugs? Herbal products, vitamins

or dietary supplements? i. Allergies: Do you have any allergies to food or medication? If so, what are they? j. Coexisting conditions: Do you have any other medical conditions or health problems? Patient Analysis 1. List the issues identified. 2. Assessment of current medication therapy (if applicable) 3. Assessment of current medical condition. 4. Treatment goals: Patient is a self-care candidate Refer patient to _________________ due to _______________________________________.

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Possible Self-Care Strategies Possible General care measures: Possible non-prescription medication: (list all options and justifications) Recommendations to Patient General care measures recommended: Non-prescription medications recommended. (Include name, strength, route, frequency & duration) Patient education (i.e., medication administration technique, adverse effects, expectations, monitoring). Student Name: ____________________________________________ Date: ___________________

Reviewed by Pharmacist: _________________________________ Date: ___________________

Retain copy in work book.


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phrm 771 community ippe checklist.pdf

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