THE FLORIDA AGRICULTURAL AND MECHANICAL UNIVERSITY COLLEGE OF PHARMACY AND PHARMACEUTICAL SCIENCES COURSE PLAN CLINICAL CLERKSHIP

Transcription

1 THE FLORIDA AGRICULTURAL AND MECHANICAL UNIVERSITY COLLEGE OF PHARMACY AND PHARMACEUTICAL SCIENCES COURSE PLAN CLINICAL CLERKSHIP **The cardinal rule of rotations is THE MORE INTEREST YOU SHOW IN LEARNING, THE MORE POSITIVE YOUR FEEDBACK.** Department/Division: Pharmacy Practice Course Title: Internal Medicine I & II Course Number: PHA Course Coordinator: Patty Ghazvini, PharmD., CGP. Office Location: New Pharmacy Building, #349 Office Telephone: (850) Office Hours: BY Appointment patty.ghazvini@famu.edu Course Description: Internal Medicine: This course involves study of organ systems with emphasis on diseases, diagnosis, and nonsurgical treatment of those diseases. Patients are treated by a team including the pharmacy and medical interns, medical residents, clinical pharmacists and the attending physicians. The students will attend rounds with the medical team on a daily basis and will be presented with actual clinical situations. This rotation will allow the students to perform chart reviews and enables them to suggest treatments and follow-up care for the patients. Common clinical tasks include: looking at the history, lab values, home and hospital medications, nursing notes, progress reports, etc. This rotation will also help them develop a pharmaceutical plan to improve patient s quality of life. ACADEMIC LEARNING COMPACT 1. Critical Thinking: Graduating seniors will demonstrate the ability to critically think, analyze, and solve problems to make judgment and pharmacy decisions. 2. Communication and Interpersonal Skills: Graduates will demonstrate the ability to communicate verbally and in writing with patients, caregivers, and other healthcare practitioners. 3. Content Knowledge: Graduates will demonstrate an understanding of knowledge, concepts and skills necessary to become a pharmacist. 4. Ethics: The graduate shall provide high quality pharmaceutical care utilizing ethical and moral standards. 5. NAPLEX Pass Rates: Graduates will pass the NAPLEX on the first attempt.

2 GOALS OF THE CURRICULUM It is the Goal of the curriculum to prepare the graduate with the following professional and general abilities 1 : COMPETENCIES 1. Provide patient-centered and population-based pharmaceutical care in a professional and competent manner; 2. Manage and use resources in a health care system in accordance with legal, social, economic, and professional guidelines; 3. Promote health improvement within the community and in various health venues; 4. Communicate with patients, care givers, other health care professionals, and the community at-large; 5. Employ life-long learning techniques to maintain competence in a dynamic profession. 1. Pharmaceutical Care Plan Development The student shall develop pharmaceutical care plans that maximize the patient s response to drug therapy and prevent or resolve drug-related problems in order to ensure positive outcomes. The student shall appropriately document the implementation of and assess the outcomes related to the care plan. The care plan should identify and prioritize patient s problems, delineate monitoring parameters, and include educational information (e.g. nutrition, lifestyle) intended to promote general health and prevent or minimize disease progression. a. Develop a traditional pharmacist-patient relationship b. Determine the pharmacist s role in the patient s care c. Identify and prioritize patient problems d. Collect and interpret relevant data (drug information/literature) i. Interpret drug, disease, and patient information to determine if and how a patient s undesirable signs and symptoms are caused directly by a drug which the patient is taking or has recently taken ii. Interpret drug, disease, and patient information to determine if and how a patient s undesirable signs and symptoms could be more appropriately treated with drug therapy or by halting drug therapy 1. Determine if the patient has an unrecognized disease which requires treatment 2. Determine if the patient is experiencing side effects which require additional drug therapy 3. Determine whether patient requires preventive drug therapy 4. Determine whether the patient requires additional drug therapy to augment or potentiate primary drug therapy e. Correctly identify, satisfactorily solve, and effectively prevent the drug-related problems from the eight categories which most commonly occur and are most likely to cause the greatest harm i. Take or receive agent for no medically valid indication ii. Need pharmacotherapy but is not receiving it iii. Take or receive incorrect medication

3 iv. Take or receive inappropriate therapeutic dose drug v. Recommend appropriate dose vi. Take or receive a drug inappropriately vii. Experience an adverse reaction viii. Experience a drug interaction 2. Pharmacotherapy Evaluation and Decisions The student shall assess and monitor the patients drug therapy, including consideration of economic status, pathophysiology and the chemical, pharmaceutical, pharmacokinetic, pharmacological and pharmacogenomic characteristics of the administered therapy. The student shall make pharmacotherapy decisions and support those decisions based upon evidence in primary, secondary or tertiary literature and knowledge of biomedical, pharmaceutical, administrative and clinical sciences. The student shall recommend patient use of prescription and nonprescription medications, as well as non-drug therapy, when appropriate. a. Identify drug products by their generic, trade, and/or common name b. Identify the postulated sites and mechanisms of action of pharmacotherapeutic agents. c. Evaluate drug therapy for the presence of pharmacotherapeutic duplications and interactions d. Identify indications, contraindications, warnings, and precautions associated with a drug product s active and inactive ingredients 3. Medication Preparation, Distribution, and Administration The student shall compound and/or dispense drug products consistent with patient needs and in congruence with federal and state laws. The student shall demonstrate the ability to accurately interpret a prescription, select the appropriate dosage form and route of administration, and appropriately package and label the medication. The student shall demonstrate the ability to educate patients regarding the administration of medications, when appropriate. a. Accurately interpret a prescription i. Demonstrate knowledge of the components of a prescription ii. Calculate the quantity of medication to be compounded or dispensed; reduce and enlarge formulation quantities and calculate the quantity or ingredient needed to compound the amount of preparation iii. Locate any drug interactions which may be imbedded in a series of prescriptions or in the patient s profile b. Select and dispense the medication i. Determine whether a particular drug dosage form is commercially available, and whether it is available on a nonprescription basis ii. Attach appropriate warning labels iii. Identify and describe techniques and procedures related to drug preparation, compounding, and quality assurance iv. Identify and use equipment necessary to prepare and extemporaneously compound medications v. Information included on the label shall be correct 4. Critical Thinking Skills: The student shall acquire, comprehend, apply, analyze, synthesize, and evaluate information. The student shall employ and integrate these skills to identify, resolve and prevent problems and make appropriate decisions and recommendations. a. Acquire, evaluate, and make inferences from oral, written and visual aids b. Acquire and evaluate relevant information, analyze arguments, synthesize facts, and information, and offer logical approaches, leading to an informed decision c. Identify and solve problems reflectively by conceiving alternatives and evaluating competing views or courses of action

4 5. Communication The student shall read, write, speak, listen, and use multimedia technology to communicate effectively. The student shall counsel and educate patients, care givers, and other health care practitioners. The student shall also collaborate with other health care practitioners, community service or heath care agencies, policy makers, patients, and family members to effectively develop interpersonal and interprofessional relationships. a. Develop nonverbal, verbal, written and graphic communication skills to communicate effectively with patients, care-givers, or family b. Develop nonverbal, verbal, written and graphic communication skills to communicate effectively with health-care providers c. Apply communication skills in interpersonal relationships to improve the clinical, economical, and humanistic outcomes of patients d. Use communications skills in educating and counseling patients i. Set the stage ii. Establish rapport iii. Elicit information from the patient, care-givers, or family iv. Provide information to the patient, care-givers, or family v. Organize the encounter vi. Encourage patient participation vii. Demonstrate sensitivity to and adjustment of communication based on contextual or cultural factors, including health literacy, literacy, cognitive impairment, etc. viii. Conclude the encounter 6. Ethics The student shall practice pharmacy in a professional, moral, and ethical manner. The student shall identify, analyze, resolve and prevent ethical dilemmas within the context of their professional and personal judgment. 7. Professionalism, Service, and Leadership The student shall provide service and leadership to the profession and the community, with special effort directed toward indigent areas and in communities with health disparities. The student shall demonstrate leadership skills that will enable them to mentor other students and supervise pharmacy staff. The student shall dress professionally and demonstrate professional attitudes, behaviors, and skills. a. Display professional attitudes when engaging patients, health-care professionals, colleagues, and care-givers b. Dress professionally when engaging patients, health-care professionals, colleagues, and care givers c. Communicate professionally when engaging patients, health-care professionals, colleagues, and care-givers

5 Goal 1: Learning Objectives After the completion of this rotation, the students should be able to: 1. Demonstrate the ability to communicate both verbally and non-verbally in order to function as a productive member of a multidisciplinary health-care team. 2. Discuss physiology, pathophysiology, and pharmacotherapeutics and pharmacokinetic management of acute chronic diseases commonly encountered in disease states seen in adult internal medicine. 3. Obtain and record patient medication histories, which document previous drug therapy, drug interactions, drug-induced symptoms or diseases, non-compliance, drug misuse or abuse, and allergies or hypersensitivity reactions that may directly affect that patient s drug therapy treatment plan. 4. Use pertinent information gained from the patient and the medical record to: a. Identify all patient problems that lend themselves to treatment with drugs or that may be caused by current drug therapy. b. Identify a rational goal of therapy for each problem. c. Ensure that each problem is being treated with drug(s) of choice for the patient and that exacerbation by drug therapy of other problems that the patient may have is minimized. d. Identify optimal variables for monitoring therapeutic outcomes, including adverse drug effects, and conduct the monitoring process. e. Recommend appropriate alterations in drug therapy when the goal is not reached or adverse effects occur. f. Screen for drug interactions and recommend appropriate changes in the drug regimen. g. Ensure that the patient complies with the therapeutic regimen. h. Evaluate any clinical change for possible drug-related cause. i. Refer pertinent drug and patient information to appropriate health-care provider. 5. Write a formal drug therapy consult note, including recommendations on drug therapy treatment plans and the therapeutic endpoints. 6. Counsel patients regarding appropriate procurement, use and storage of therapeutic agents. 7. Discuss the role of the pharmacist in the management of medical emergencies such as cardiac arrests and acute poisonings. 8. Collaborate with the medical staff in developing, implementing, and conducting drug use review programs. 9. Conduct educational programs on the therapeutic aspects of patient care to healthcare students and professional staff members, using appropriate teaching methods. 10. Evaluate the delivery of pharmaceutical services and offer suggestions for improvement. 11. Work with the nursing staff to insure the safe, correct, and cost-efficient administration of drugs.

6 12. Utilize audiovisual/other equipment used in the enhancement of clinical presentation: a. Provide the pharmacy department a minute presentation relevant to a topic in Internal Medicine. b. Be ready to discuss a current article on any topic of your choice relevant to internal medicine (journal club) Goal 2: Perform competent medical information retrieval processes regarding these disease states: (Disease states may include but are not limited to the following): 1. Infectious disease: a. Respiratory tract infections b. Tuberculosis c. Endocarditis d. Urinary tract infections e. Sexually transmitted diseases f. Meningitis g. Joint and bone infections h. Septic shock i. Infections in immunocompromised hosts j. Skin and soft tissue infections 2. Cardiology: a. Hypertension b. Congestive heart failure c. DVT/PE 3. Gastroentrology: a. Management of nausea, vomiting, diarrhea and constipation b. Peptic ulcer disease c. Hepatic diseases: cirrhosis, hepatitis, drug induced d. Inflammatory bowel disease e. Pancreatitis f. Esophageal reflux 4. Renal: a. Drug-induced b. Acute renal failure c. Chronic renal failure d. Nephrotic syndrome 5. Pulmonary:

7 a. Asthma b. Chronic obstructive pulmonary disease c. Acute respiratory failure d. ARDS 6. Rheumatology: a. Rheumatoid arthritis b. Gout c. Systemic lupus erythematosis 7. Neurology: a. Pain control b. Multiple sclerosis c. Convulsive disorders d. Parkinson s disease e. Stroke f. Myasthenia gravis 8. Psychiatry: a. Depression b. Anxiety c. OCD d. Schizophrenia e. Bipolar 9. Endocrinology: a. Diabetes mellitus Type I and II b. Diabetic ketoacidosis c. Hypothyroidism d. Hyperthyoridism e. Syndrome of inappropriate antidiuretic hormone f. Diabetes insipidus g. Adrenal disorders h. Dyslipidemias

8 The program should also focus on drug literature analysis and associated communication skills. Required Activities: 1. Students presentations 2. Journal club presentations 3. Drug information questions 4. Assignments specified by preceptor 5. Meet regularly with preceptor to discuss patients, topics and readings 6. Rounds with the assigned team Dress Code: Students will be required to dress professionally and wear white lab coats. Name tags (FAMU & TMH) must be worn at all times. Grading: 1. Participation in discussions with preceptor and other health-care providers 2. All students are expected to attend regularly and PUNCTUALLY at all times. 3. Unexcused absences may result in a failing grade. 4. Students will turn in a notebook at the end of the rotation with all the materials from the rotation. 5. Students are expected to complete given assignments and submit them in a timely manner. Late work is NOT accepted. 6. There need to be at least three references each completed assignment. 7. There will be a final examination at the end of rotation. **PLAGIARISM WILL RESULT IN AUTOMATIC FAILURE FROM ROTATIONS AND THE PHARMACY PROGRAM** Distribution of points: A B C D F

9