Post Graduate Year One
Pharmacy Practice Residency
Training Manual
University of Mississippi Medical Center
2500 North State Street
Jackson, Mississippi 39216-4505
Table of Contents
General Information
Pharmacy Practice Residency Program Description
Program Purpose
University Hospitals and Clinics
University of Mississippi Medical Center
History and Description
Pharmacy Services
Organizational Structure
Residency Director
Residency Preceptors
Residency Mentor
Resident Selection Criteria
Resident Salary and Benefits
Policy on Dismissal
Residency Certification
Resident Responsibilities
Policy and Procedures Manual
Licensure
Attendance, Punctuality, and Presentation
Assessment and Residency Training Plan
Individual Assessment Residency Training
Learning Experiences
Collateral Learning Experiences
Resident Teaching Responsibilities
Committee Activities
Practical Experience
Evaluations
Resident Major Scholarly Project
Project Goals
Project Guidelines
Project Time Line
Project Proposal
Membership in Professional Societies
Resident Goals and Objectives
Goals and Objectives for Program
Summative Evaluation
Learning Experiences
Goals and Objectives
Ambulatory Care
Critical Care
Drug Information/ Investigational Studies
Practice Management
Learning Experiences Descriptions
Resident Evaluations
Evaluation Process
Quarterly Evaluations
Learning Experience Evaluations
Self Assessment
Preceptor Assessment of Resident
Assessment of Preceptor and Experience
Learning Experience Evaluation Forms
Ambulatory Care
Major Scholarly Research Project
Practice Management
Preceptor and Experience
Service Component
Summative Evaluation
Appendices
General Information
Residency in Pharmacy Practice
The University of Mississippi Health Care (UMHC) affiliated with the University of Mississippi
Medical Center offers a twelve month post-graduate year one (PGY-1) pharmacy practice
residency and a twelve month post-graduate year (PGY-1) ambulatory care residency
accredited by the American Society of Health- System Pharmacists (ASHP). This program
provides the clinical facilities and individual support needed for the development of competent
practitioners. Building on previous knowledge and skills, the program guides residents to
develop the attitude and competence needed to provide pharmaceutical care. To facilitate this
development, residents are given direct patient care responsibilities under the supervision of
knowledgeable faculty and are held accountable for quality of care and services provided. The
residency runs from 1 July through 30 June of the following year.
The residency is defined as an organized, directed, postgraduate year one training program
that centers on development of the knowledge, skills, attitudes and abilities gained from an
accredited professional pharmacy degree program needed to provide rational medication
therapy. The first year residency program enhances general competencies in managing
medication use systems and supports optimal medication therapy outcomes for patients with a
broad range of diseases. The purpose of the residency is to provide education and training
experiences for the pharmacists in all aspects of contemporary health-system pharmacy
practice. Through various clinical, practice management and pharmaceutical practice training,
the residency instills a philosophy of practice that embraces the concept that pharmacists must
be responsible and accountable for optimal therapy outcomes.
PGY-1 residents acquire substantial problem solving knowledge required for skillful problem
solving, refine their problem solving strategies, strengthen their professional values and
attitudes, and advance the growth of their clinical judgment. The instructional emphasis is on
the progressive development of clinical judgment with further extensive practice, self-reflection,
and shaping the decision making skills fostered by feedback on performance.
The residents will be held responsible and accountable for acquiring the following outcome
competencies as set forth by ASHP:
Managing and improving the medication use process,
Providing evidence- based, patient centered medication therapy management with
interdisciplinary teams,
Exercising leadership and practice management,
Demonstrating project management skills,
Providing medication and practice related education/ training, and
Utilizing medical informatics.
In order to provide training in all aspects of contemporary pharmacy practice, the resident shall
complete organized experiences that provide training and develop competence in the following
practice areas:
Acute Patient Care
Ambulatory Patient Care
Practice Management
Drug Utilization Development
The residency shall provide opportunities to further develop the resident’s competence in the
practice areas cited above while completing various required and elective learning
experiences. These learning experiences shall include the following areas:
PGY-1 Pharmacy Practice
The Program is now designed for Focused Tracks that will allow the resident to tailor
their training during the year. If the residents interests change throughout the year then
this program structure would allow for even more flexibility.
Required Experiences
Hospital and Department Orientation
Adult Medicine 1 –Inpatient Adult Medicine required for all residents
Adult Medicine – 1 month may select any of the following:
Adult Medicine II
Hypertension Clinic
Cardiometabolic Clinic
Family Medicine Clinic
Critical Care – 1 month – may select any of the following
Medicine Intensive Care Unit
Cardiac Care Intensive Care Unit
Surgical/Neurosurgical Intensive Care Unit
Pediatric Intensive Care Unit
Emergency Medicine
Family Medicine or Pediatrics – 1 month may select from one of the following but must
be noted that a Pediatric focus or interest is required during this month
Family Medicine Clinic
Hypertension Clinic
Inpatient Pediatrics
Longitudinal Experiences
Ambulatory Patient Care
Drug Information/ Investigational Services
Practice Management
Service Experience
Major Scholarly Research
Elective Experiences
Additional practice in any required experience
Acute Patient Care in the following specialty areas:
Adult Specialty Care Clinic
Bone Marrow Transplant Unit – not active
Cardiology and Heart Failure Clinic
Adult Internal Medicine
Cardiometabolic Clinic
Anticoagulation
Critical Care (Adult or Pediatrics)
Emergency Medicine
Family Medicine
Hematology/ Oncology
Hypertension Clinic
Infectious Diseases
Introduction to Academia
Nutrition Support
Pain Management-not active
Pediatrics, General
Practice Management (Pharmacy Administration)
Psychiatry
Women’s Health – not active
During each learning experience, the resident works closely with one or more preceptors, who
coordinate resident activities, monitor the resident’s performance and assist in the
development, implementation and progress of the resident’s projects within the area. Upon
completion of the residency program, the pharmacy practice resident should be capable of
functioning as a competent health-system pharmacy practitioner able to assess the total
pharmaceutical care needs of the patients and coordinating the resources of the pharmacy
department to meet the needs of patients and the institution. The resident is awarded a
certificate of residency upon successful completion of the program.
The Mission Statement of the Residency Program at the University of Mississippi
Medical Center is:
The mission of the Residency Programs is to prepare pharmacists in the residency
program for a clinical practice through academic training, participation in health related
research and providing quality patient care. The University of Mississippi Medical Center
(UMMC) will serve as a center for excellence for residency training by meeting the program
and the American Society of Health System Pharmacists, the accrediting body, goals and
objectives.
The Purpose Statement of the Residency Program at the University of Mississippi
Medical Center is:
Pharmacists completing this residency program will effectively manage pharmacotherapeutic
issues in a variety of patient – care environments. They will be responsible for achieving
optimal medication therapy outcomes as a vital member of the health care team. These
pharmacists will be proficient in educating other health care professionals, patients, and the
community on medication related topics. They will demonstrate professional maturity by
following a personal philosophy of practice and use self-assessment when measuring their
performance. In demonstrating a commitment to the profession, they will show leadership by
proactively seeking the advancement of pharmacy practice.
The Residency Outcomes of the program are that the resident:
1.
2.
3.
4.
5.
6.
7.
Function as a member of the health care team in multiple environments.
Educate others.
Develop self-assessment skills to manage their own practice.
Become confident, competent, and versatile, and serve as a role model for others.
Demonstrate commitment to the profession of pharmacy.
Acquire Pharmacy Practice Management skills.
Become an effective communicator.
The additional outcome competencies of the program include
Managing and improving the medication use process,
Providing evidence- based, patient centered medication therapy management with
interdisciplinary teams,
Exercising leadership and practice management,
Demonstrating project management skills,
Providing medication and practice related education/ training, and
Utilizing medical informatics.
The University of Mississippi Medical Center
University of Mississippi Health Care
History and Description
The University of Mississippi Medical Center in Jackson is the health sciences campus of the
University of Mississippi. The Medical Center opened in 1955, but its beginnings date to 1903 when a
two-year medical school was established on the parent campus in Oxford. In that era, certificate
graduates went out of state to complete their doctor of medicine degrees.
Finally, in 1950, the Mississippi Legislature -- by a
one-vote margin -- enacted a law to create a fouryear medical school. On July 1, 1955, the state's
new University Medical Center, or UMC as it's
commonly called, opened in Jackson, initially as a
four-year medical school with medical and
graduate students, interns and residents. As it had
in Oxford, the School of Medicine offered both
medical and graduate degree programs. The
campus included a teaching hospital and a library.
The Oxford campus' nursing department moved to
the Medical Center in 1956 and it was granted
school status in 1958. The School of Health
Related Professions (SHRP) was added in 1971 and began offering baccalaureate curricula in 1973. The
School of Dentistry was authorized in 1973, and its first students were admitted in 1975.The graduate
program was elevated to school status in 2001 and designated the School of Graduate Studies in the
Health Sciences.
The Medical Center functions as a separately funded, semi-autonomous unit responsible to the
Chancellor of the University of Mississippi and, through him, to the constitutional Board of Trustees of
State Institutions of Higher Learning, which governs all eight state institutions of higher learning in
Mississippi. The Medical Center's chief executive officer is the Vice Chancellor for Health Affairs.
Purpose
The University of Mississippi Medical Center unites the interrelated activities of education in the health
sciences and accepts responsibility for teaching, research, service and leadership in this field. Its
programs embrace training for physicians, dentists, nurses, and related members of the health team;
graduate medical education; graduate dental education; graduate study in the health sciences; and the
delivery of health care in the teaching hospitals and clinics. The Medical Center offers equal opportunity
in all its programs and services regardless of race, sex, color, religion, marital status, sexual orientation,
age, national origin, disability or veteran status.
The parent campus, the University of Mississippi chartered in 1844, has five areas of focus in its current
Statement of Purpose. One of these is health. "The University will continue to provide the professional
education of those who deliver and administer human health services and those who perform research
aimed at improving the efficiency, the effectiveness, quality, and availability of health care. . . ."
Within this framework, the Medical Center's principal and continuing purpose is to accomplish the
interrelated goals of health professional education for Mississippi: to teach in a superior manner the art
and science of health care to students of exceptional promise and talent; to provide high quality treatment
for all patients using the disciplines and specialties of modern health care; to lead the way to discoveries
which will raise the health level of Mississippians and, indeed, all mankind; to foster dedication to life-long
learning; to respond to community needs through continuing education and outreach programs that
extend beyond the campus; and to recruit and retain the caliber of faculty necessary to meet these goals.
The Medical Center fosters and protects an intellectual, emotional and challenging learning environment
conducive to educational excellence in the health sciences, productive scientific investigation and
exemplary patient care and moves toward the ultimate goals of improved health and well-being for the
citizens of Mississippi, the region, the nation and the world.
Mississippi's population is culturally diverse. Most Mississippians trace their ancestral roots to the British
Isles, the continent of Europe or the continent of Africa. The state also has many citizens of American
Indian, Asian or Pacific Islander and Hispanic descent. In policy and practice, the institution encourages
and actively recruits applicants from all segments of the state's population. The Medical Center is
committed to maintaining an educational environment that fosters respect for and sensitivity to individual
differences; promotes personal and professional development; and gives all students the opportunity to
succeed, regardless of ethnicity, gender or socioeconomic status.
The Medical Center graduates at all levels are expected to possess and to demonstrate the skills and
knowledge necessary to practice their disciplines as competent health professionals. The Medical Center
regularly uses appropriate external and internal measurement tools to assess the institution's
effectiveness in training health professionals for Mississippi and to evaluate its programs for patient care,
research, continuing education and outreach.
The expeditious growth of the Medical Center into a major academic health sciences
center reflects the deep commitment of the State of Mississippi, the Board of
Trustees of State Institutions of Higher Learning and the administration and faculty
of the University of Mississippi Medical Center to the continuing fulfillment of this
statement of purpose.
Physical Facilities
The health sciences campus occupies a 168-acre tract of University-owned land in the heart of Jackson.
The original eight-story building is now the nucleus of a major academic health sciences complex.
Schools of Medicine, Nursing, Dentistry and Health Related Professions (SHRP) all have their own
buildings on campus. The School of Pharmacy will begin construction of a stand alone building serving
the needs of the students and faculty and to aid with integration within the Health System’s Campus.
Between 1988 and the mid-1990s, five construction projects were completed: the University Medical
Pavilion; the Ronald McDonald House, a hotel-like accommodation for families of pediatric patients; the
Mississippi Children’s Cancer Clinic, which houses all outpatient treatment facilities for pediatric
hematology and oncology patients; a state-of-the-art laundry; and the Arthur C. Guyton Laboratory
Research Building.
From 1997 to 1999, six new buildings and two parking garages opened as part of a $211 million campus
construction program -- the largest expansion package in the history of higher education in the state at
the time. Funding came from self-generated revenue, private donations, and the Mississippi Legislature.
The new Blair E. Batson Hospital for Children opened in 1997. A new imaging center opened the same
year, housing state-of-the-art radiology facilities, including an interventional MRI. In 1999, four major new
buildings opened: the Winfred L. Wiser Hospital for Women & Infants, the School of Health Related
Professions, the expanded Christine L. Oglevee Building housing the School of Nursing, and the Norman
C. Nelson Student Union.
A second construction phase has been completed. It included the Wallace Conerly Hospital for Critical
Care, already occupied, a new 256-bed adult hospital opened November 2006, a two-story expansion of
the children’s hospital which has been completed, a classroom addition and an expansion to the Arthur C.
Guyton Research Complex which have been completed. With the completion of
the adult hospital, all of the Medical Center’s original hospital beds will have been
replaced. A second expansion of the Arthur Guyton Research complex is now
complete and expansion construction at the Pavilion which houses the private
medical clinics has now been completed. The dedication of the Eli Manning
Children’s Clinic was held on 26 June 2009. This distinguishes the $1 million
dollar clinic that has opened on the 2nd floor of the old hospital. In July 2010, the
University Physicians opened private clinics at Grants Ferry and Mirror Lake. The
Clinics at the Medical Mall as of 1 July 2010 became Federally Qualified Health
Care Clinics to provide much needed service to the underserved of the state of
Mississippi population. UMHC is undertaking the development of corridors for
areas of excellence. The Academic Corridor will house the 2 story School of Pharmacy building; the
planned new construction for a nursing school, medical and dental schools. The Health Care Corridor
houses the newly constructed hospital and all patient care areas. The Research Corridor has plans to
expand on campus in the future. The Cancer Institute at the Jackson Medical Mall provides state of the
art care for patients with cancer.
Medical Care
The University of Mississippi Health Care System is the teaching hospitals for all Medical Center
education programs and a 722-bed diagnostic and treatment referral center for the entire state. The
hospital medical staffs are appointed from the Schools of Medicine and Dentistry. Inpatients total about
27,000 annually with more than 418,000 outpatient and emergency visits every year.
On the Medical Center campus, the University of Mississippi Health Care System includes the University
Hospital, Winfred L. Wiser Hospital for Women & Infants, Blair E. Batson Hospital for Children, Wallace A.
Conerly Acute Care Tower and, for the faculty private practice, the University Medical Pavilion. One mile
west of campus, the Jackson Medical Mall houses the hospital's specialty care clinics, the ambulatory
specialty clinics, the Jackson Heart Study offices and the Cancer Treatment Center. Family Medicine and
Hypertension Clinics as well as other specialty Adult and Pediatric Clinics are located in close proximity to
the UMMC campus. The Medical Center also owns and operates the 84-bed University Hospital -Holmes County in Lexington, Mississippi and has recently acquired a portion of the Specialty Select Long
Term Care Center in north Jackson for patient services including Cardiology, Gastroenterology, to name
a few.
The University is the only hospital in the state designated as a level 1 trauma center. Specialized hospital
services include: an interventional MRI; the only level 3 neonatal intensive care unit (NICU) in the state;
separate medical, surgical, cardiac, neuroscience and pediatric ICUs; a heart station for diagnosis and
treatment of heart disease; a heart failure clinic; heart, kidney, cornea and bone marrow transplant
programs (with plans for expansion of transplantation service); a comprehensive stroke unit; state-of-theart radiological imaging systems; a sleep disorders laboratory; an in vitro fertilization program; and
telemedicine program and special pharmaceutical services.
The Sonny V. Montgomery Department of Veterans Affairs Medical Center, adjacent to the campus, is the
Medical Center's principal teaching affiliate. Students and residents also gain clinical experience at
community hospitals throughout the state.
The Mississippi Methodist Hospital and Rehabilitation Center and the McBryde Rehabilitation Center for
the Blind are on the Medical Center campus.
The Department of Pharmacy Services
The Department of Pharmacy Services provides comprehensive pharmaceutical care as well
as unit dose drug distribution and intravenous admixture services.
Patient Care Area Pharmacists (PCAP) provide pharmaceutical care. The duties of these
pharmacists include patient profile review, therapeutic medication monitoring, adverse
medication event reporting, drug information, order verification and problem resolution. The
institution has recently implemented the Electronic Health Record (HER) EPIC system with
CPOE Computerized Physician Order Entry. Our on-site Drug Information Center handles in
excess of one hundred calls per month and is equipped with journals, texts, CD-ROM IDIS,
and on line data base services. Micromedex™ can be accessed from decentralized
workstations for aid in answering medication information inquires in the patient care areas.
Central Pharmacy services are available twenty-four hours daily. The Central Pharmacy
consists of:
Intravenous admixture area with separate clean rooms for the preparation of large
volume parenterals, minibags, and total parenteral nutrition and a cancer
chemotherapeutic agent area for after hours
Unit Dose area
Purchasing and Inventory Control area with state of the art refrigerated and room
temperature carrousels with bar coding and fingerprint verification.
Satellite Pharmacies exist in the Batson Pediatric Hospital; Acute Care Tower; Bone
Marrow Transplant; Pediatric Cancer Clinic; each with limited hours of operation. The
Neonatal Intensive Care Unit (NICU) satellite is a twenty-four hour operation.
The Department of Pharmacy Practice
The Department of Pharmacy Practice of the University of Mississippi’s School of
Pharmacy is affiliated with the University of Mississippi Medical Center. The Department of
Pharmacy Practice has faculty on both the Oxford campus and the University Medical Center
campus. The Department has developed nationally recognized academic and practice
programs.
The Department is dedicated to promoting active learning. The majority of the courses at the
UMMC campus are taught in a problem-based learning format. We educate competent
problem-solvers who can provide the very highest quality of pharmaceutical care to the
patients they serve.
Our service includes collaborative relationships with Medical Center faculty and private
enterprise within our State. Faculty collaborative efforts result in quality research and more
comprehensive patient care rendered to all Mississippians. We aim to be a role model for
progressive practice to all pharmacists.
Our research efforts focus on developing outcome studies, which will generate data to justify
the value of pharmacist's involvement in pharmaceutical care. We collaborate with our medical
colleagues on clinical research of new drug entities or indications.
Organizational Structure
The organizational chart for the Department of Pharmacy Services is found in Appendix A.
The Residency Program Structure
Residency Director
The Director of the PGY-1 Residency training programs serves at the designation of the
Director of Pharmacy Services and is ultimately responsible for the overall quality of the
residency program. Final evaluations of the resident applicant’s qualifications and approval of
resident candidates and the preceptors rest with the Residency Director. The Residency
Director serves as the supervisor for the residents in all pharmacy residency programs at the
University of Mississippi Medical Center.
The Director is responsible for coordination of resident and preceptor activities in order to
assure an effective and well organized educational and learning experience. These activities
include conduction and coordination of Resident recruitment; scheduling of learning
experiences; Resident and Preceptor evaluations/ assessments; and Resident projects
directed by the Resident Research Coordinator.
Residency Preceptors
Pharmacists shall be appointed by the residency Director to serve as residency preceptors.
These individuals are selected based on their knowledge and skills as pharmacy practitioners
in one or more areas of pharmacy practice. Residency Preceptors shall coordinate and
evaluate the resident’s activities during assigned learning experiences.
Some learning experiences may have more than one preceptor; however, a primary preceptor
is designated for each experience and that person shall assume primary responsibility for
coordination and monitoring of resident functions. Some preceptors may coordinate more than
one training segment. Specific responsibilities of preceptors include:
1. Development of objectives, reading assignments, and required activities
2. Orientation of the residents to the experience and discussion of learning objectives and
requirements
3. Define and explain practice requirements for the experience; the resident’s involvement in
the provision of pharmaceutical care; services provided to the medical staff; hours of service;
meetings to attend; assignments or lectures to present; and other functions required for that
experience
4. Monitor, evaluate, and provide ongoing feedback to the resident on his/ her perceived
progress, with recommendations for improvement; including snapshots as support of ongoing
feedback
5. Maintain availability to assist and guide the resident
6. Evaluate the resident’s performance at the completion of the experience, discuss the
evaluation with the resident, and submit the completed evaluation to the Residency Director in
a timely fashion. All assessments are now completed on the Resi-Trak™, a program managed
by ASHP
7. Assure completion, review, and submission of the resident’s evaluation of the preceptor and
resident’s self assessment to the Residency Director. All assessments are now completed on
the Resi-Trak™.
It is expected that the resident will become accountable and accept responsibility for pursuing
optimal clinical outcomes of patient’s medication therapy during each experience. In order to
encourage the resident to accept such responsibility, the preceptor must carefully determine
the amount of resident supervision required. Hence, the pharmacy preceptor and the resident
must work closely to ensure that this fundamental element of training is met without
compromising patient care through inadequate supervision. The Preceptor shall model the
practice; coach and mentor the resident; and assess resident performance throughout the
learning experience.
It is the responsibility of the resident to review the learning objectives prior to beginning each
learning experience and to discuss the objectives with the primary preceptor. The resident
should seek to clearly understand the requirements and activities of each experience and
understand the expectation of the preceptor.
It is also the responsibility of the resident to complete the assigned readings for the training
segment prior to or during the respective experience. The resident will be asked to report on,
utilize, or discuss many of the assigned readings with the preceptor.
The resident is expected to pace and self-discipline himself/ herself to assure assigned
readings are completed in a timely manner. The preceptor will monitor the resident to assure
that the reading assignments are completed as required.
Resident Mentor
The Resident will select a Residency Mentor by the third week of Orientation. The Mentor
should serve as a role model for pharmacy practice and be a person that the resident can
discuss personal and professional issues. This person can be any pharmacist within the
Department of Pharmacy Services or the School of Pharmacy’s Department of Pharmacy
Practice. This person should be one that the resident develops a rapport and can confide and
seek advice.
Residency Committee
The Residency Committee is comprised of the Residency Program Directors and the
preceptors for the residency programs. This Committee shall meet at least quarterly to discuss
the resident’s progress and assessment of the resident’s performance. The Committee will
convene in the event of special circumstances such as discussion of the residency programs
and changes that may be necessary to improve the programs. If there are any serious
problems identified with a resident, the Committee will convene to discuss the nature and
resolution of any circumstances that arise. This committee will make recommendations for
changes to the program as needed. This committee will also vote on whether the resident will
receive their certificate at the completion of the residency, provided they have completed all
requirements.
Resident Selection Criteria
It is the responsibility of the Residency Director to recruit, interview, and evaluate the residency
candidates. The University of Mississippi Medical Center participates in the residency
matching program coordinated by the American Society of Health-Systems Pharmacists.
All candidates must meet the following criteria:
1. Be a graduate of a college or school of pharmacy accredited by the ACPE and hold the
Doctor of Pharmacy degree or anticipate successful graduation prior to beginning the
residency program.
2. Hold a current pharmacist license in the state of Mississippi or be eligible for licensure in
Mississippi during the first quarter of the residency program
3. Participate in the ASHP Residency Matching Program and PhORCAS electronic application
process.
Candidates are selected by the Resident Selection Committee which consists of faculty
members, pharmacy staff, and residents. The Committee will review and consider the
applicants based on the following criteria:
1. Competence – based upon the candidate’s performance in therapeutics and clinical
clerkships
2. Scholastic achievement – based upon the candidate’s college transcript
3. Verbal communication skills – assessed during the interview process
4. Written communication skills – assessed based on the candidate’s individual
assessment for residency training
5. Extracurricular activities – based upon leadership in organizations, school functions,
and community activities
6. Letters of Reference – any issues will be clarified with the letter writer
7. Enthusiasm, self-motivation, and self-confidence – based on the interview, letters of
reference, and the candidate’s individual assessment for residency training
8. Perceived compatibility with departmental goals and philosophy
The University of Mississippi Medical Center is an Affirmative Action/ Equal Opportunity
Employer and does not discriminate on the basis of age, race, color, sex, pregnancy, religion,
marital status, national origin, disabilities, or status as a disabled or Vietnam-era veteran.
Applicants will be invited for onsite interviews. Assessments of the candidates’ performance as
well as application packet will be completed by each person conducting an interview. That
assessment will be submitted to the Program Director to compile the averages of the results
and provide these to the Selection Committee after the final interview has been completed.
The residency candidates are evaluated according to the above guidelines, all members of the
Selection Committee will vote as to the rank order of the applicants that they would accept as
candidates. The results are reviewed by the Program Director, who will make the final
decisions concerning the rank order for submission.
Resident Salary and Benefits
The resident is a full time salaried employee of the University of Mississippi Health Care and
as such is eligible for full benefits under the compensation and benefit plan of the organization.
As a salaried employee, the resident will not be compensated as an “hourly employee” but will
be paid a residency stipend based on the pay grade assigned to the residency position by the
Human Resources Department. In order to obtain a thorough and complete educational and
learning experience, the resident should demonstrate a commitment to work an undefined
number of hours in order to meet learning segment requirements and pharmaceutical care
responsibilities. The hours expected will be within the ASHP requirement of no more than 80
hours per week including any work outside the institution.
Once the resident has accepted the residency position, a drug screen for employment and a
background check will be conducted as early as possible after the match results. A physical
examination in Employee Health will be scheduled during the orientation period to complete all
requirements for employment.
Salary
The annual salary is consistent with the salary grade for the residency position. The resident is
paid every 2 weeks in keeping with the institutional policy and deposit slips are available
electronically on Employee Self Service located on LINC Lawson.
Vacation
Residents will accrue eighteen working days vacation during the twelve month residency.
Vacation requests must be directed to and approved by the Residency Director and must be
initialed by the preceptor of record to assure they have been notified. Due to the short duration
of the residency program and the concentrated learning process, the residents are encouraged
to limit and reserve vacation time until completion of the residency training program. Vacation
requests may not be made before the ninety day probationary period has ended. Time off that
is needed before the probationary period has concluded will be uncompensated. Be sure to
inform the preceptor in as much advance as possible to assist with scheduling of activities
during learning experiences.
Administrative Leave
Professional educational meetings and educational training will be requested in advance and
are considered Administrative leave. Travel forms must be completed and submitted with the
leave request form per the Travel Reimbursement policy. Be sure to notify preceptors to
provide as much advance notice as possible to arrange activities during learning experiences.
Holidays
Residents are expected to inform preceptors of all dates including holidays that they will not be
present and arrange for holiday and essential vacation absences in as much advance as
possible with the preceptor.
Inclement Weather
In the event that inclement weather occurs and you are scheduled to work as an essential
employee, then you must attempt to report to work. The University will try to assist in
transportation to the University for duty. If an employee leaves early due to inclement weather,
personal leave must be taken. When an employee arrives to work late and is being transported
by the Medical Center’s designated drivers, he/ she will be paid for the entire eight hours. All
other employees will be paid only for the hours worked. An employee who is unable to report
for work the entire day due to inclement weather will be required to take personal leave. If the
employee has no leave, then all hours not present will be uncompensated. Please see the
inclement weather policy for full explanation in the Employee Handbook on the Intranet.
Outside Employment of the Pharmacy Resident
The Pharmacy Resident is not prohibited from procuring a part-time position if needed as long
as this does not affect the resident’s performance; which is that they are unable to complete
assignments when due, affects interactions with colleagues, endangers patient safety or
provides suboptimal patient care services to name a few examples. If any of these or other
deficiencies are noted, the Residency Director will discuss with the Resident the option of
decreasing the numbers of hours of outside work. A letter will be placed in the resident’s file
and if the action is not corrected and the resident has shown no improvement or has not
decreased the outside hours, then the Resident will be brought before the Residency
Committee for review and discussion of action including but not limited to suspension or
termination from the program and employment from University of Mississippi Medical Center.
You must complete the form granting permission to work outside the institution, sign it and
have the Residency Director sign the document.
Leave of Absence
Employees that have completed the initial period of employment may be granted a leave of
absence without pay for further education or other personal reasons at the discretion of the
Department Head and the Residency Director. Employees who take this leave will not accrue
personal or major medical leave and will have to pay for the full amount of their insurance
coverage. This leave of absence will not be greater than 1 month during the residency program
to ensure that the residency requirements are met and may necessitate that the resident
complete the residency program without compensation at a later date. As much advance
notice should be provided the Residency Director and Director of Pharmacy Services as
reasonably possible. A plan for completion of the residency program should be discussed at
the time of the request.
Sick Leave
Absence due to illness or injury is considered as sick leave only after the resident has used
one day of personal leave for such absence due to illness, or leave without pay if the resident
has not accrued personal leave. Residents are expected to contact the Residency Director and
any preceptor/ supervisor to whom they are assigned as early as possible on each day of
illness requiring absence. Illness extending beyond three days requires an original physician’s
excuse/ clearance to return to work.
Travel
Monetary support is sought annually to assist the resident in reimbursement for travel
expenses to the annual ASHP Midyear Clinical Meeting and the annual Regional Residency
Conference and various other state and regional conferences. The amount of support is not
predictable with certainty, being dependent upon budget allocations and outside assistance.
Travel request forms must be completed and submitted within at least 6 weeks for travel out of
state and 8 weeks for travel outside of the country. For travel within the state, at least 4 weeks
must be allowed for submission of paperwork. Original receipts must be kept for all expenses
including meals, taxi, accommodations, registration, and travel. Reimbursements should be
sought as soon as you return from travel but no later than one week. A copy of all documents
submitted should be maintained by you prior to submission of paperwork. Forms necessary for
travel authorization and reimbursement are on the Employee Self Serve located on LINC
Lawson. Please refer to specific documents provided at orientation related to Travel. If at any
time you have a question, contact the Residency Program Director.
Death of Immediate Family
In the event that you experience a death in your immediate family, you will be provided with 3
days of Major Medical leave. If this occurs during your probationary period (the first 90 days)
and you have not accrued leave then this will be unpaid medical leave. If you have accrued
Major Medical leave then this can be used up to 3 days. Immediate family is defined as
spouse, parent, stepparent, brother, sister, child, stepchild, grandchild, grandparent, son or
daughter-in-law, mother or father in-law, brother in-law or sister in-law. The proper leave forms
must be submitted.
Major Medical Leave
Each month the resident will accrue eight hours of major medical leave for a total of twelve
days over the year. During the 90 day probationary period, this leave is accrued but the
employee is not eligible to take paid major medical leave except in the case of the death of a
family member. This leave may be used for the illness or injury of an employee or member of
the employee’s immediate family only after the employee has used one, eight hour day of
personal leave for such illness or leave without pay if the employee has not accrued personal
leave. All unused major medical leave can be counted as creditable service toward retirement.
For each absence due to illness of four days (combined personal and major medical leave),
major medical leave will be authorized only when the illness is certified by the employee’s
private physician. This leave may be used intermittently to cover regular scheduled visits to a
doctor’s office or hospital for the continuing treatment of a chronic disease as certified in
advance by doctors of medicine, osteopathy, dental medicine, podiatry, or chiropractic. There
is a maximum 12 week allotment for major medical leave absences. When an employee is
injured at work and the employee is eligible for workman’s compensation, earned major
medical and personal leave may be used to cover time lost from work. Employees do not earn
major medical leave while on leave of absence, unpaid temporary disability leave or unpaid
family and medical leave. An original doctor’s statement of fitness to return to work is
mandatory before the employee can return to duty.
Temporary Disability Leave
Full time employees who have successfully completed the probationary period are eligible for
temporary disability leave for their own illness if they are not eligible for family and medical
leave. Employees that are on family and medical leave and require an extension of leave
beyond the 12 weeks during the calendar year will be eligible for temporary disability leave up
to a maximum of nine months. A certified statement from the private physician must be
provided the Residency Director and Department of Pharmacy Director prior to returning to
work. Failure to provide the document will result in non-pay status for the period of time in
question and /or dismissal even though accrued personal and major medical leave exist. Upon
returning from temporary disability leave, the Resident must process through Human
Resources. If a resident is out of the program for an extended period of time, it is necessary
that the resident inform the Residency Director on a weekly to biweekly basis of the status of
the leave and be working on a plan to complete the program based on the performance of the
resident to that point in time.
Family and Medical Leave (FMLA)
Eligible employees are those that have worked for the Medical Center for a combined
total of 12 months or have worked at least 1250 hours during the 12 month period
immediately preceding the taking of leave. This allows eligible employees to take up to 12
weeks of job protected leave during any calendar year for specified family and medical
reasons. Note: PGY-1 pharmacy residents will not be eligible for FMLA leave during the one
year residency. If you need this type of leave please see the Residency Program Director to
determine your options.
The reasons FMLA can be granted are for the following:
Birth of a son or daughter and the care of the newborn
Placement of employee with son or daughter for adoption or foster care
Care for employee’s spouse, son, daughter, or parents with serious illness
Employee’s own serious health condition that makes the employee unable
to perform functions of his/ her job.
A husband and wife who are both employed at UMC may only take a combined total of 12
weeks of leave during any 12 month period for the
Birth of son or daughter and the care for the newborn
Placement of son or daughter for adoption or foster care
Care for parent with serious health condition.
The husband and wife are each allowed 12 weeks to care for their own serious health
condition.
At least 30 days notice is required if possible to complete the necessary paperwork and
provide for scheduling of the work flow during the time off.
The employee must report to Residency Director and Department Head every 2 weeks
regarding the employee’s status and intent to return to work. When the employee returns to
work, they must provide a certificate of ability to return to work. If the employee does not
provide the fitness to return to duty certificate within 1 working day of their return this could
result in termination. All FMLA will be paid up to the amount of time the employee has
accrued. Any time beyond this time will be unpaid.
During the residency, all projects and requirements must be met to complete the residency
program. If this extends beyond the 12 month residency, then the time for completion will be
uncompensated or unpaid. The number of hours required by ASHP for an accredited program,
2000 hours, will have to be completed as well.
Policy on Dismissal
The Pharmacy Resident is a full time professional staff member in an academic curriculum of
the Department of Pharmacy Services who reports directly to the Residency Director and the
Director of Pharmacy Services. The discipline or termination of the resident will be consistent
and in compliance with established policies and procedures of the residency, the department
and the institution. Corrective action is to be made in a progressive, stepwise manner, except
in certain instances of gross misconduct which requires immediate discharge. Corrective
action involves five steps, including:
Oral warning – intradepartmental verbal discussion of misconduct with the
Residency Committee
Written reprimand – documentation of misconduct, formally discussed with
the resident, and place in the resident’s personnel file
Suspension – an order for the resident to absent himself/ herself from
work for one to five days with documentation and discussion of the
incident with the resident; this can be suspension without pay and
must be discussed with Human Resources
Probation – a time designated by the Residency Committee, of not less than 30 days or
more than 90 days, in which the resident can still continue daily activities but is
under review
Termination – an involuntary dismissal of the resident requiring Residency
Director approval in consultation with the Residency Committee and Institutional
Administration Personnel. Involuntary dismissal may occur by either termination
of employment resulting in dismissal from the academic program or dismissal
from the academic program resulting in termination of employment.
Examples of misconduct and steps of corrective action are fully explained in the institutional
policies and procedures manual and are available on the Intranet and in the Department of
Pharmacy Services and Human Resources. Additionally, any action or behavior deemed
unethical or unprofessional will be reviewed by the Residency Committee and will be
addressed at that time with appropriate action taken. If the resident does not obtain a
pharmacists license in the state of Mississippi by the end of the first quarter, he/ she may be
subject to suspension up to termination.
The Resident does not have a property right to his/ her job or academic training and
may be terminated with or without cause.
Suspension without pay can result when the infraction is serious (theft, willful damage to
property or persons, or arrest pending outcome of trial, etc.) and will result in discharge
pending review of the facts.
Resignation
Residents who intend to resign are expected to discuss their plans with the Residency Director
as far in advance as possible. Resignations must be in writing; forms are available in Human
Resources or the Pharmacy Department. Employees paid monthly are expected to give at
least a month’s notice. If circumstances are such that this is not possible in the resident’s case,
then as much advance notice as possible is expected.
Residency Certification
A residency certificate is awarded upon successful completion of the all residency
requirements. This includes but is not limited to submission of all monthly reports, successful
completion of drug monograph and medication use evaluation, completion of two articles for
the Drug Information Newsletter, successful completion of the major residency scholarly
project, completion of all evaluations of learning experiences, successfully completing all
learning experiences as determined by the preceptor and the Residency Director, and
completing all other requirements as set forth in the program. The Resident must also
successfully meet the Competencies for Outcomes Assessment as defined by the residency
program and as stated under the learning experiences goals and objectives. See Appendix B
for Checklist of Required Items for Completion of Residency. The Residency Committee will
address all areas for improvement with the residents as well as their strengths on an at least a
quarterly basis and provide the resident with an assessment of their progress to that point. The
Residency Plan that is developed by the Resident and the program Director will be revised as
often as needed but at least quarterly. The Residency Committee will vote during the last
quarter on the successful completion of the program by the resident and the awarding of the
certificate. If remediation is necessary at any time, if this is not completed prior to the end of
the scheduled time frame for completion of the residency, the resident will complete the
requirements lacking on an uncompensated basis. The certificate will be awarded when all
requirements have been successfully completed and not before. The maximum time allowed
for completion of the residency after the 30 June deadline is 6 months. If an extension is
required, approval must be requested in writing by the resident and submitted to the Residency
Committee during the last quarter. At the completion of the extension, the Residency
Committee will again reconvene and vote on the successful completion of the residency before
the certificate is awarded.
Performance Appraisals
The residents will have their employment performance appraised for the institution based on
the resident’s job description at 90 days and annually in January through March of each year.
The residents’ academic progress will be assessed by the preceptor and a self assessment for
each learning experience completed within 10 days after the concentrated or monthly
experience or at least quarterly for longitudinal experiences with the preceptor of record.
Snapshots will be completed at the time or directly following the activity being evaluated as
directed in the Assessment section of the manual. Problems with a resident’s performance will
be brought the attention of the Program Director immediately and documentation of such
problems will be made and addressed with the resident. The assessments will be submitted to
the program Director for immediate review from Resi-Trak™. Each quarter the Progress to
Date Assessment will be printed and placed in the resident notebook. Assessment with
continual feedback is vital to the resident’s success in each experience and the overall
successful completion of the program.
Resident progress through the program and successful completion of the program will be
evaluated based on the qualities of the resident, meeting the Competencies for Outcomes
Assessment, learning experience evaluations and the achieved time line for completion of
program requirements on at least a quarterly basis by the Residency Committee.
At any time, a resident receives any assessment or evaluation rating identifying less than
satisfactory progression, the resident performance will be discussed by the Residency
Committee. The action taken will be determined by the Committee but can include up to
immediately placing the resident on academic probation of not less than 30 days or
more than 90 days. During this period of time, weekly reports of progress are required
and will be submitted to the Residency Director. Assessments of learning experiences
during this time as well as the reports will be used to evaluate the resident performance and
determine the future course of action. At the end of the probationary period, actions may
include the following: continued probationary period; full removal from probation; or termination
and academic dismissal from the program.
Resident Responsibilities
Policy and Procedures Manual
A copy of the Department of Pharmacy Services Policies and Procedures Manual is available
to the resident through the Intranet on the Departmental web page. Residents are expected to
become familiar with this manual and be knowledgeable of all departmental policies and
procedures. The Distribution section should be completed prior to beginning the service
component of the learning experiences.
Attendance, Punctuality, and Presentation
The resident is expected to be present for all assigned activities. Punctuality is essential and
tardiness is not expected or tolerated. Any unusual situations or circumstances which cause
the resident to be absent, or require the resident to be late in attending activities or functions,
or require the resident to leave early, should be communicated to the preceptor and the
Residency Director. The resident is expected to act and present himself/ herself in a
responsible and professional manner at all times. Presentation of the resident should be
consistent with the Departmental dress code as published in the policy and procedures
manual. Wearing of scrub suits is permitted during the service component and during
experiences that are permitted by the preceptor.
Assessment and Plan for Residency Training
Individual Assessment for Residency Training
In an attempt to determine the resident’s strengths and areas for improvement, an assessment
of each resident is conducted during orientation. The assessment includes an Assessment of
Residency Experience that the resident completes and submits prior to Orientation. The
assessment continues during orientation with a written examination of questions derived from
those submitted by preceptors to assess areas of strength and improvement as well as serve
to introduce information they should be familiar with throughout the orientation period as well
as during learning experiences. These documents will be utilized in providing a specific
orientation for the resident and to assist in developing the resident plan for training. See
Appendix D.
Residency Plan for Training
The resident plan for training shall relate to practice skills required in contemporary pharmacy
practice and shall describe abilities to attain during the residency training. The Residency
Director in consultation with the resident will develop the plan for training including scheduling
of learning experiences based on the assessments and the goals of the program as well as the
individual goals of the resident. The plan should be completed by the middle of the second
month of training.
The relative emphasis in specific areas of training may vary according to each resident’s
individualized plan. The training plan will be modified on a continual basis in order to meet the
needs of the resident, reflect the progress of the resident and to incorporate areas of continued
improvement. Each preceptor will review the plan prior to and at the completion of the learning
experience, utilizing the plan as a basis for planned activities during the learning experience.
The plan shall be modified as needed but at least quarterly to reflect the quarterly review to
ensure the resident competencies are being met.
Training Learning Experiences
In order to develop the resident’s ability to provide quality pharmaceutical care, the resident
shall receive training and develop competence in each of the following areas of pharmacy
practice for the PGY-1 Pharmacy Practice Resident:
Acute Patient Care
Ambulatory Patient Care
Drug Information / Drug Utilization Development
Practice Management.
To obtain competence in each of the above areas, the resident shall complete learning
experiences in various areas of pharmacy practice. The content or direction of specific training
segments will be developed to meet the individual resident’s needs as determined by the
resident plan and quarterly evaluations. The Resident will be able to focus their experiences
based on interest but may change at anytime as their interests change as previously
described.
Required learning experiences and the length of time in each experience is:
Hospital and Department Orientation
Adult Medicine
Inpatient Adult Medicine
Critical Care
Ambulatory Care
Family Medicine or Pediatrics
Practice Management
Research Experience
Service Component
6 weeks
4 weeks
4 weeks
4 weeks
Longitudinal
4 Weeks
Longitudinal
4 weeks + Longitudinal
Orientation + Longitudinal
*Longitudinal experiences continue throughout the year.
The length of time to be spent in each elective learning experience shall be determined by the
Residency Director based on needs and interests of the resident. Elective learning
experiences shall include the following:
Additional experiences in any of the required learning experiences
Acute care in the following specialty areas:
Adult Special Care Clinic
Hematology/ Oncology
Ambulatory Care Clinics
Hypertension Clinic
Bone Marrow Transplant
Infectious Diseases
Cardiology
Cardiometabolic Clinic
Critical Care
Nutrition Support
Coagulation Clinic
Pain Management
Emergency Medicine
Pediatrics
Family Medicine
Psychiatry
Women’s Health
Heart Failure Clinic
Academic Experience
Administrative Experience
The resident shall select the elective learning experiences at least 60 days prior to initiation of
that experience. The learning experiences should be discussed with the Residency Director
during the development of the residency plan.
If the resident wishes to pursue practice in an area not listed above as an elective, approval by
the Residency Director is required and is contingent upon preceptor availability. The resident,
upon approval by the Director, may elect to spend additional time in a required area,
depending on the interest or need.
Collateral Training Activities
Several areas of residency training cannot be scheduled for completion during a specific
learning experience or in the form of a traditional learning experience. These activities include
but are not limited to the following:
The resident is responsible for presenting at least four Powerpoint presentations during the
year. The purpose of the presentations is to improve the resident’s public speaking skills,
provide teaching experience, and to build the resident’s self-confidence in making formal
presentations.
Other opportunities in addition to the presentations include medical department rounds,
professional continuing education meetings, departmental educational conferences, Regional
Residency Conference, ASHP Midyear Clinical Meeting, preparation and presentation of a
Medication Utilization Review (MUE) and Medication Monograph to Pharmacy and
Therapeutics (P&T) Committee.
The resident is responsible for publication of two articles for the Department’s Drug Information
Newsletter, one article for MSHP journal, and an optional publication of their choice. These
activities will enhance their manuscript writing skills.
Residency Teaching Responsibilities
The PowerPoint presentations must be approved by the Residency Director or the preceptor of
record. The presentation should be approximately 45 - 50 minutes with five minutes for
answering questions. The resident is responsible for scheduling the time and date and the
room. The resident is responsible for reproducing copies of the slides for the attendees. The
presentations will be evaluated by the audience. The resident evaluation form will be utilized or
a snapshot by the preceptor can be completed. A copy of the presentation along with the
critiques or snapshots will be placed in the notebook in the appropriate section. The purpose of
the critique is to provide feedback to the resident in a constructive and timely manner. See
Appendix E.
The resident will also participate in instructing pharmacy students and other health care
professionals during various learning experiences. The respective learning experience
preceptor will coordinate this teaching. The resident should discuss teaching responsibilities
with the preceptor at the beginning of each learning experience.
Committee Activities
The resident will participate in a number of departmental and hospital committees in order to
gain an understanding of the objectives and functions of the committee. The resident will be
assigned by the Department Director membership in a standing committee. This appointment
will be for the entire year. The following committees are ones that the resident should attend
when presenting or at least once to observe:
Pharmacy and Therapeutics (P&T) Committee – first meeting and if presenting
Institutional Review Board (IRB) – at least one meeting if can be arranged
Other committees with Preceptor of record
In addition the resident will routinely attend scheduled pharmacy staff meetings. The resident
will be notified of other special meetings to attend which are associated with specific learning
experiences. All agendas or minutes should be maintained and placed in the appropriate area
of the Accomplishments Notebook.
Practical Experience or Service Component
In order for the resident to obtain practical experience in distributive as well as clinical
functions of pharmacy practice and to develop the resident’s philosophy of pharmacy and
competence in meeting the total pharmaceutical care of the patient and to ensure that proper
recommendations can be made, the resident will, as a service component, work as a full-time
pharmacist in the Central Pharmacy or the Pharmacy Patient Care Area (PCAP) one weekend
a month. The resident will have the Friday off prior to the weekend before they are scheduled
to work to ensure that they are within the time limitations for hours worked.
In the event of a disaster or extenuating circumstances, the resident may be utilized to assist in
staffing a particular area. However, efforts are made to minimize the need for removing a
resident from a learning experience to staff areas that have staffing shortages.
Special projects or additional activities and responsibilities may be assigned on a routine or as
needed basis based upon patient and departmental needs.
Evaluations
In order to determine the resident’s perception of the effectiveness of each learning experience
and of the primary preceptor responsible for the experience and to identify unmet objectives
established for each period of learning, to assist the resident in evaluating their own
performance and progress in meeting the overall plan for residency training, the resident shall
complete an evaluation of the learning experience and preceptor and a self-assessment. This
will allow the resident to develop the skills to continually assess their practice and make
adjustments as needed. The resident is responsible for completing the evaluations within ten
days of completing the learning experience. The Residency Director shall review the
evaluation within the next five days. These evaluations will be reviewed by the Residency
Committee to assess progress each quarter and to review and modify the resident plan as
needed. All assessments and evaluations will be conducted via the Resi-Trak™ system a part
of ASHP, the accreditation body.
Membership in Professional Organizations
Residents are required to join as members the American Society of Health-Systems
Pharmacists (ASHP) and are encouraged to become members of state and local pharmacy
associations. One year membership will be provided by the residency program to ASHP.
Additional membership information will be provided by the Residency Director.
Licensure
The resident must provide the Residency Director with a photocopy of his/ her Mississippi
Pharmacist Registration/ License Card. A copy must be placed in the appropriate section of
the notebook and within their personnel file.
If the resident is not licensed as a pharmacist in the state of Mississippi at the beginning of the
residency program, the resident should initiate the process for obtaining a license as soon as
possible. Normally, residents should obtain Mississippi licensure within the first three months
of their residency. If this is not accomplished, the resident may be suspended without pay until
the license is obtained.
Resident Journal Club
All pharmacy residents will participate in a bi-weekly journal club with the time and location to
be established annually. The purpose of the journal club is to ensure that all residents in all
programs are exposed to a variety of literature and to ensure that the residents develop the
skills to review journal articles and evidence based medicine and to ensure that the resident
continues to be a life-long learner. The resident will also participate in journal article review
during various learning experiences. The residents will select one or two articles and distribute
to the preceptors and fellow residents at least one week prior to presentation. The article
should be approved by the Residency Director and should be a recent landmark trial or a
controversial article from a reputable journal. The article does not always have to be the best
article. We can also learn from those articles that are flawed. The resident will lead the
discussion and should prepare a handout with a standard review for participants. Several
formats will be provided during the orientation period. Attendance is mandatory and roll will be
taken. If the resident is unable to attend, he/she must advise the Residency Director. After the
discussion is completed, the resident will email the handout to the Residency Director to
distribute to the staff and preceptors.
Pharmacy Resident Therapeutics Conference
The pharmacy residents will participate in a monthly Resident Therapeutics Conference. Each
assigned resident will prepare a handout related to interesting patients or questions that they
have encountered for discussion with fellow residents and preceptors. The discussions should
focus on medication therapy management (MTM) with essential background or
pathophysiology for understanding. The focus of these conferences is to provide a broader
exposure for all residents and provide experiences that may be useful or limited due to
selection of learning experiences. Preceptors will be available for discussions to provide
valuable clinical expertise. Handouts should be prepared for discussions. Attendance is
mandatory for all residents. The time and location of the meetings will be established annually.
After the discussion, the resident is to email the handout to the Residency Director for
dissemination to the staff and preceptors. With the inclusion of the surrounding area residency
programs we will have a rotating schedule of presentations at each meeting.
Chief Resident
There will be a Chief Resident selected that will serve for six months at a time. The Chief will
be selected by the Residency Director and selected preceptors. The responsibilities of the
Chief will be to ensure that the residents are working together and that they are completing
their tasks as assigned for special projects for all residents, will include scheduling the
presentations of journal club, health fairs, etc. The Chief will coordinate activities of the
residents at health fairs, during pharmacy month, interviewing, and other activities that require
all the residents. This person shall communicate with the Residency Directors and the
Residency Committee.
Resident Scholarly Project
Each resident is required to complete a major scholarly research project directed at enhancing
personal and professional growth. This project may be in the form of original research, a
problem solving exercise, or development, enhancement or evaluation of some aspect of
pharmacy services. It is anticipated and encouraged that the residency project will consist of
one major project.
All projects shall be directed toward useful outcomes and should not merely be an academic
exercise for the sole purpose of satisfying this requirement. The purpose of the project is to
develop the resident’s problem solving skills and to expose the resident to research methods,
while addressing an issue or area in need of study or research, development, or evaluation.
Each resident should select a Research Mentor to serve as the project advisor or investigator
throughout the year. The project selection will be reviewed by the Residency Director and the
Residency Committee.
Residents are encouraged to consider several factors when selecting a project. The project
should be one of personal interest to the resident and of value in the provision of
pharmaceutical care or to the department in provision of services. Finally, the resident project
should be selected with the intent of completing the project in one year and submitting results
for publication in an appropriate professional journal.
Each resident will present his/her research project at a Regional Residency Conference held in
the spring each year. Practice sessions will be held within the department in preparation for the
conference. See guidelines for Research Slides and presentation in the file folder provided
during orientation.
Following completion of the major project, each resident will submit a final manuscript to the
Research Mentor and the Program Director and place a copy in the appropriate section of the
notebook. The manuscript style should follow guidelines and requirements for submission of
manuscripts based on the requirements of a professional journal that your research might be
submitted. Each resident will prepare a final manuscript with report of the project:
1.
Include the final manuscript with statistical information and data collected with
final analysis
2.
A copy of the slides presented at the residency conference
3.
Assessment or evaluation of the Research Mentor and the overall research
experience – can be submitted separately or on the same page
4.
Perform a self assessment and preceptor assessment evaluation on ResiTrak™
5.
One copy of the above is placed in your notebook and one copy is provided to
your Research Mentor and Program Director.
6.
All research data and information must be left with your Research Mentor for
storage for 6 years as mandated by the Institutional Review Board (IRB)
7.
The resident will close out the project with the IRB at the completion of the
project and include the closure letter from the IRB in the final report that is
submitted to the Program Director as well as place one copy in your notebook.
In 2010, the IRB will no longer allow Residents to serve as primary
investigators – so if this continues to remain the case, then the close out letter
will not be necessary. But a letter or email from the Mentor stating that the
research has been completed to their satisfaction will be placed in the
notebook.
The resident should make every effort to complete their project according to the timetable
outlined below. It is imperative that at the outset of the planning for the research project that
the mentor and the resident establish what will be required for completion of the research
project – this is especially important for prospective research since enrollment can be a limiting
factor in completion. This needs to be in writing and a copy submitted to the Program Director
so there is no confusion at the end of the residency. Failure to meet deadlines for the interim
steps should be discussed with the Research Mentor and the Residency Director. If the
resident fails to successfully complete the residency project before the twelve month training
period ends, a short extension not to exceed 6 months may be granted by the Residency
Director, Research Mentor and Residency Committee. If this extension exceeds the original
twelve month period, the time spent completing the residency requirements will be
uncompensated. The residency certificate will be withheld until all requirements,
including the major project, are successfully completed.
Major Scholarly Project Goals
1. To expose the resident firsthand to the mechanics of research methodology.
2. To provide the resident experience in directing and conducting an original project from
beginning to end.
3. To teach a resident how to write and submit a manuscript for presentation at a national
or regional meeting and for publication in a refereed pharmaceutical or medical journal
or prepare a poster for presentation.
4. To promote research that evaluates some aspect of pharmacy practice.
5. To develop new and innovative approaches to managing medication and biological
therapies for improving patient care.
Project Guidelines
1. Complete the CITI training for conducting research on the IRB Website. This should be
completed during the orientation period in Drug Information.
2. Project should focus on practice – related activities and issues.
3. No commitments shall be made without approval from the Residency Committee.
4. If needed, outside funding should be sought and is often available in limited amounts
from pharmaceutical manufacturers or state pharmacy organizations. If outside funding
is not available, departmental research funds may be sought to support proposed
projects.
5. Discuss potential research projects with several preceptors/ pharmacists to assist in
formulating a workable idea.
6. Select one preceptor to serve as the Research Mentor to assist with the project
throughout the residency. Other project associated preceptors may be solicited if
needed.
7. The IRB website will have instructions for electronic submission of all paperwork. Be
sure to select as the Department Head, the Pharmacy Services Director.
8. Prepare a formal proposal using the standard format. Examples are available from
previous residents and will be provided upon request.
9. Projects may commence only after the Residency Committee and the IRB have granted
final approval, if necessary.
10. Discuss with the statistician early during the planning phase to ensure that the
information is collected and entered into the spreadsheet as needed to expedite this
process. Consider a class in Excel spreadsheets if you are not familiar with this
program.
11. A final written manuscript, approved by the Research Mentor shall be submitted to the
Residency Director and a copy placed in the notebook upon completion of the project,
12. A final close out report must be filed electronically with the IRB and receipt of the
closure letter from IRB should be included in the final report, if applicable.
13. All materials related to the research project – written and electronic will be given to the
Mentor to hold on campus for 6 years.
Time Table for Major Scholarly Research
Identify at least 3-4 areas of interest………………………………July
Select Research Mentor…………………………………………….August - early
Project identification and development ………………………….. August - mid
Project Proposal & Revisions ……………………………………. September
IRB review, if needed …………………………………………….....1st of October – at latest
First progress report………………………………………………….Mid December
Biographical data for Research Conference & Abstract…………January
Background Slides and script due for review……………………...January
Second progress report……………………………………………...1st of March
Result and conclusion slides due for review………………………Mid March
Practice presentations……………………………………………….March/ April
Regional Residency Conference……………………………………April/ May
Final Presentation…………………………………………………….May/June
Final Report and Closure…………………………………………….Mid June
Project Proposal and Format
In preparing for the presentation of the major research project proposal, certain information
should be included. The following format is suggested:
1. A cover page including title of project, the resident’s name, and name of Research
Mentor.
2. State the purpose of the project clearly and concisely.
3. A background section that states the reason your project is needed and includes a
concise review of the literature on the topic. A bibliography should be attached.
4. The Methodology section should explain the “how” of your project and should include,
where appropriate the design of your project.
5. An analysis section should address how the results will be analyzed including statistical
treatment to be employed. This section should provide a measurement for the
completion of the project.
6. Finally, include a section on cost and funding to show estimates of the cost of your
project and potential outside funding. Cost should include supplies, materials, services,
and manpower other than the resident’s time.
Learning Experiences
Goals and Objectives
Learning Experiences
The residents will be held responsible and accountable for acquiring the following outcome
competencies as set forth by ASHP:
Managing and improving the medication use process,
Providing evidence- based, patient centered medication therapy management with
interdisciplinary teams,
Exercising leadership and practice management,
Demonstrating project management skills,
Providing medication and practice related education/ training, and
Utilizing medical informatics.
In order to provide training in all aspects of contemporary pharmacy practice, the resident shall
complete organized experiences that provide training and develop competence in the following
practice areas:
Acute Patient Care
Ambulatory Patient Care
Practice Management
Drug Utilization Development
During the year of training, the pharmacy resident will gain experience in contemporary
pharmaceutical care delivery through organized learning experiences and other activities, in
order to develop the resident’s competence to provide pharmaceutical care.
The training system employed by the University of Mississippi Medical Center is the ASHP
Residency Learning System or RLS. This systematic approach to residency training has goals
with specific objectives describing the necessary knowledge, skills, and abilities that a resident
in the PGY-1 residency should attain during the residency program. These goals and
objectives serve as guides for the resident, the preceptor, and any other individuals who may
share responsibility for specific learning experiences, for developing and supervising
experiences, and for evaluating achievement. The goals are broad statements about what a
resident should learn to do. They are not worded so as to be measured but are more “outcome
competencies” desired in the practitioner following completion of the residency. The objectives
specify with precision what the learner will do and are worded in such a way that the
performance can be measured. The goals and objectives include those required by all
programs along with those selected by our program based on strengths of this site. The
competencies are specific skills that the resident should utilize in providing care.
The program has selected the following competencies for outcomes assessment:
1.
2.
3.
4.
5.
6.
7.
Function as a member of the health care team in multiple environments
Provide education to health care providers, patients and the community
Develop self-assessment skills to manage their own practice
Become a confident, competent, versatile, role model for fellow practitioners
Demonstrate a commitment to the profession
Acquire pharmacy practice management skills
Become an effective communicator in both written oral presentations.
The preceptor will utilize the self-assessment and the resident plan in addition to consultation
with the resident in determining the emphasis to be placed on specific objectives. The
objectives should be provided to and reviewed with the resident at the beginning of each
learning experience. The resident and preceptor will review the goals and objectives
throughout the experience to ensure that they are being met. The resident is expected to
successfully meet the objectives before completion of the residency program. The resident is
expected to successfully progress through each learning experience meeting the stated
objectives for that experience. The preceptor and resident will assess the resident’s
performance based on the goals and objectives. Further discussion of assessment will be
provided in the next chapter.
The objectives will be assessed and assigned a value of Needs Improvement or Satisfactory
Progress. The preceptor will mark the appropriate assessment. The assessment of the
previous preceptors will be shared with the upcoming preceptors to identify areas of focus
during the next learning experience. The assessment, residency plan, and quarterly
evaluations, will be shared with upcoming residency preceptors. After three Satisfactory
Progressions have been assessed for a goal, the Residency Director will designate the goal as
Achieved. At this time, achieved goals and objectives can continue to be taught but do not
have to be assessed unless there is a deficiency noted.
Preceptors are encouraged to elaborate in the comments section of the objective assessment
specifying where possible the instrument or mechanism by which the resident demonstrated
accomplishment or completion of stated objective. If the resident has satisfactorily completed
the objective but needs further training to further advance his practice skills, this information
should be included in the comments section.
The assessment of goals and objectives attainment should be by the preceptor and a self
assessment by the resident. The resident will complete a Preceptor and Learning Experience
evaluation at the end of the experience on Resi-Trak™. All the assessments should be
reviewed and signed electronically by both the resident and the preceptor. These will then be
automatically forwarded to the Program Director. The assessments will be completed by the
tenth of the month immediately following the learning experience. During the learning
experience, snapshots or criteria based assessments will be completed close to the event
being evaluated. These will provide real time feedback to the resident of their performance.
During a four week learning experience, at least two snapshots will be completed. During a two
week concentrated experience, at least one snapshot will be completed. During a quarterly
assessed experience, at least two snapshots will be completed.
The assessments will be forwarded to the Residency Director as soon as they are completed
for review and assessment of progress of goals and objectives for achievement. The
Residency Director will provide the next preceptor with the resident’s progress and any
deficiencies that need to be addressed.
During the quarterly evaluation by the Residency Committee, the resident’s progress toward
meeting the goals and objectives and the competencies of the residency program will be
assessed and discussed with the resident.
The program has selected the following goals for completion of the program. The goals are
divided into the area of practice during training:
Practice Management Experience
Outcome R1:
Outcome R3:
Outcome R4:
Outcome R5:
Outcome R6:
Manage and improve the medication-use process.
Exercise leadership and practice management skills.
Demonstrate project management skills.
Provide medication and practice-related education/training.
Utilize medical informatics.
Direct Patient Care Experiences
Outcome R1:
Outcome R2:
Outcome R3:
Outcome R5:
Outcome R6:
Manage and improve the medication-use process.
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Exercise leadership and practice management skills.
Provide medication and practice-related education/training.
Utilize medical informatics.
Drug Information Experiences
Outcome R1:
Outcome R3:
Outcome R4:
Outcome R5:
Outcome R6:
Manage and improve the medication-use process.
Exercise leadership and practice management skills.
Demonstrate project management skills.
Provide medication and practice-related education/training.
Utilize medical informatics.
Service (Staffing)
Outcome R1:
Outcome R2:
Outcome R3:
Outcome R5:
Outcome R6:
Manage and improve the medication-use process.
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Exercise leadership and practice management skills.
Provide medication and practice-related education/training.
Utilize medical informatics.
Major Research Project
Outcome R3:
Outcome R4:
Outcome R6:
Outcome E1:
Exercise leadership and practice management skills.
Demonstrate project management skills.
Utilize medical informatics.
Conduct pharmacy practice research
The Goals and Objectives along with the instructional objectives for the selected goals
are as follows:
Required and Elective Educational Outcomes, Goals, and Objectives Plus
Instructional Objectives
Required By PGY1 Standard
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
OBJ R1.1.1 (Comprehension) Explain the organization’s medication-use system and
its vulnerabilities to adverse drug events (ADEs).
IO
Explain the central concepts of systems theory.
IO
Explain the concept of system error.
IO
Explain the definitions of the various terms associated with adverse drug
events (e.g., medication misadventure, medication error, adverse drug
reaction, error, accident, systems error, individual error, latent error).
IO
State sources of information on the design, implementation, and
maintenance of safe medication-use systems.
IO
From both the pharmacy department perspective and the organization
perspective explain the potential for contribution to the occurrence of
adverse drug events by the use of automation and information technology.
IO
From both the pharmacy department perspective and the organization
perspective explain the role that automation and information technology
play in preventing adverse drug events.
IO
Explain the meaning of the term “culture of safety.”
OBJ R1.1.2 (Analysis) Analyze the structure and process and measure outcomes of
the medication-use system.
IO
Explain methods for analyzing a medication-use system’s structure.
IO
Explain how inputs to the medication-use system such as patients,
staff, and environment make up its structure.
IO
Explain methods for analyzing processes within a medication-use system
(e.g., root cause analysis, failure mode and effect analysis).
IO
Explain how the interactions between clinicians and patients
constitute processes in the medication-use system.
IO
Exercise skill in process-mapping, a type of flowchart depicting the
steps in a process, with identification of responsibility for each step
and the key measures
IO
Exercise skill in cause-and-effect diagramming.
IO
Explain the organization’s policies and procedures for handling a
drug recall.
IO
Explain the role of medication-use evaluation (MUE) in measuring
medication-use processes.
IO
Explain methods for measuring outcomes of the medication-use system.
IO
Generate examples of the outcomes of a medication-use process
which are changes in patients’ health status (e.g. length of stay;
acuity).
IO
Explain the characteristics of a clinically significant ADE.
IO Explain various methods, including decision trees, for
determining the significance of adverse drug events.
IO Explain how to categorize medication errors using the ASHP
Guidelines on Preventing Medication Errors in Hospitals.
IO
Explain how to categorize medication errors using the National
Coordinating Council for Medication Error Reporting and
Prevention's medication error index for categorizing errors.
IO Explain how to categorize medication errors using one’s own
institution’s categorization methodology.
IO
When a clinically significant ADE is identified, report the event following
the organization’s policies and procedures.
IO
Explain the role of the MUE in measuring outcomes of the medication-use
process.
OBJ R1.1.3 (Evaluation) Identify opportunities for improvement in the organization’s
medication-use system by comparing the medication-use system to relevant best
practices.
IO
When a clinically significant ADE is identified, participate in determining
the presence of any similar potential ADEs.
IO
Participate in the pharmacy department’s ongoing process for tracking and
trending ADEs.
IO
Explain how basic safety design principles such as standardization,
simplification, and the employment of human factors training can minimize
the incidence of error in the medication-use process.
IO
Explain safe practices for selecting and securing alternative medications
when shortages occur and for adjusting the formulary and notifying
prescribers.
IO
Explain safe practices for the storage, dispensing, administration, and
security of pharmaceuticals.
IO
Use the results of an MUE to identify opportunities for improvement in the
medication-use process.
IO
Explain how to use information on how to design, implement, and maintain
safe medication-use systems from external sources to identify
opportunities for improvement in the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
OBJ R1.2.1 (Synthesis) Participate in the identification of need for, development of,
implementation of, and evaluation of an evidence-based treatment
guideline/protocol related to individual and population-based patient care.
IO
Define treatment guidelines and protocols.
IO
Explain the indications/rationale for using guidelines and protocols.
IO
Explain guidelines/protocols as they relate to: patient care activities;
provider networks; provider incentives; cost and reimbursement controls;
utilization management; quality measurement; consumer incentives;
accreditation; and benefit analysis (if applicable).
IO
Explain the use of evidence-based medicine in the development of
treatment guidelines/protocols.
IO
Explain the process by which criteria for treatment guidelines/protocols are
developed.
IO
Explain effective strategies for gaining necessary commitment and
approval for use of a treatment guideline/protocol.
IO
Explain the importance of providing outcome information to the
prescriber/provider as support for evaluative decisions on program
continuance or revision.
IO
Explain methods for assessing the effectiveness/impact of guidelines and
protocols.
IO
Explain the importance of assessing the clinical, economic and humanistic
outcomes of treatment guidelines/protocols related to patient care.
OBJ R1.2.2 (Synthesis) Design and implement pilot interventions to change
problematic or potentially problematic aspects of the medication-use system with
the objective of improving quality.
IO
Explain the importance of continually reassessing medication-use policies.
IO
Exercise skill in the revision of a policy or procedure when necessitated by
the implementation of a change in a medication-use process.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
OBJ R1.3.1 (Evaluation) Interpret the appropriateness of a medication order before
preparing or permitting the distribution of the first dose.
IO
State the elements of a complete medication order and the essentials of
legibility and accuracy.
IO
Use effective prescriber education techniques to secure agreement on
modifications to medication orders.
IO
Document modifications to medication orders according to the
organization's policies and procedures.
OBJ R1.3.2 (Application) Follow the organization's policies and procedures to
maintain the accuracy of the patient’s medication profile.
OBJ R1.3.3 (Application) Prepare medication using appropriate techniques and
following the organization's policies and procedures.
IO
Explain standards of practice for the preparation of medications.
IO
Explain the organization's quality assurance standards for the preparation
of medications.
IO
Prepare intravenous admixtures using aseptic technique.
IO
Prepare chemotherapeutic agents observing rules for safe handling of
cytotoxic and hazardous medications.
IO
Appraise admixture solutions for appropriate concentrations, rate,
compatibilities, stability, clarity, coring, and storage IO Formulate
strategies for preparing extemporaneously compounded medications to
produce the desired end products.
IO
Label medication products following the organization’s policies and
procedures.
OBJ R1.3.4 (Application) Dispense medication products following the organization's
policies and procedures.
IO
Compare and contrast the procedures used to dispense medications
across the continuum of care settings.
IO
Follow a systematic procedure for checking the accuracy of medications
dispensed, including correct patient identification, correct medication,
correct dosage form, correct dose, correct number of doses, expiration
dates, and properly repackaged and relabeled medications.
IO
Follow departmental procedures and standards of practice to insure the
integrity of medication dispensed throughout the organization.
IO
Follow appropriate policies and procedures to document patients'
medication refill histories.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
OBJ R1.4.1 (Characterization) Display initiative in preventing, identifying, and
resolving pharmacy-related patient-care problems.
IO
Explain the role of the pharmacist in preventing, identifying, and resolving
pharmacy-related patient-care problems.
IO
IO
IO
IO
IO
Explain the importance of contacting the appropriate parties when a
problem is identified.
Explain the role of assertiveness in presenting pharmacy concerns,
solutions, and interests.
Explain the pharmacist’s obligation for absolute attention to detail in the
preparation/distribution process.
Explain the interdependent relationship between operational tasks and
clinical activities.
Explain the importance of follow-through of medication-use system
activities.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
(When provided as part of the practice of direct patient care, this outcome always involves a
series of integrated, interrelated steps.)
Establish collaborative professional relationships with health care team
members

Place priority on delivery of patient-centered care to patient

Establish collaborative professional pharmacist-patient relationship

Collect and analyze patient information

When necessary make and follow up on patient referrals

Design evidence-based therapeutic regimen

Design evidence-based monitoring plan

Recommend or communicate regimen and monitoring plan

Implement regimen and monitoring plan

Evaluate patient progress and redesign as necessary

Communicate ongoing patient information

Document direct patient care activity
Goal R2.1:
As appropriate, establish collaborative professional relationships with members
of the health care team.
OBJ R2.1.1 (Synthesis) Implement a strategy that effectively establishes cooperative,
collaborative, and communicative working relationships with members of
interdisciplinary health care teams.
IO
Demonstrate knowledge of other team members’ expertise, background,
knowledge, and values in all interdisciplinary team interactions.
IO
Explain the training and expected areas of expertise of the
members of the interdisciplinary with which one works.
IO
For each of the professions with which one interacts on an
interdisciplinary team, explain the profession’s view of its role and
responsibilities in collaborations on patient-centered care.
IO
Exercise skill in the use of individual roles and processes required to work
collaboratively on interdisciplinary teams.
IO
Define a collaborative professional working relationship.
IO
Explain the structures and content of collaborative working
relationships that are possible between the pharmacist and the
physician and between the pharmacist and other health care
professionals.
IO
Explain the limits that are imposed on possible collaborative
relationships by the presence or absence of guidelines, legal and
regulatory requirements, and organizational policies and
procedures.
IO
Exercise skill in the use of group techniques to include communication,
negotiation, delegation, time management, assessment of group
dynamics, and consensus building.
IO
Explain the principles and applications of negotiation as they apply
to interdisciplinary team work.
IO
Explain the principles and applications of delegation as they apply
to interdisciplinary team work.
IO
Explain the principles and applications of time management as they
apply to interdisciplinary team work.
IO
Explain the principles of group dynamics and how they apply to
interdisciplinary team work.
IO
Explain the principles of conflict management and how they apply
to interdisciplinary team work.
IO
Explain a systematic approach to building consensus.
IO
Explain how interdisciplinary team members develop unique
communication patterns (shared language).
IO
Explain the importance of adhering to use of an interdisciplinary
team’s shared language.
IO
Exercise skill in the coordination and integration of pharmacist’s care with
the contributions of other members of the interdisciplinary team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
OBJ R2.2.1 (Organization) Choose and manage daily activities so that they reflect a
priority on the delivery of appropriate patient-centered care to each patient.
IO
Explain the meaning of patient-centered care and the rationale for its use.
IO
Explain methods for prioritizing the delivery of care to patients when time
or resources prohibit the delivery of full direct patient care services to all
patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
OBJ R2.3.1. (Synthesis) Formulate a strategy that effectively establishes a patientcentered pharmacist-patient relationship.
IO
Explain the meaning of the term “patient-centered” and the rationale for its
use.
IO
Explain the appropriate sharing of power and responsibility between the
pharmacist, patient and caregivers in a patient-centered, pharmacistpatient relationship.
IO
Explain why it is important that the pharmacist communicate with the
patient in a shared and fully open manner in a patient-centered,
pharmacist-patient relationship.
IO
Explain the role of demonstrating respect for the patient’s individuality,
emotional needs, values, and life issues in a patient-centered, pharmacistpatient relationship.
Goal R2.4: Collect and analyze patient information.
OBJ R2.4.1 (Analysis) Collect and organize all patient-specific information needed by
the pharmacist to prevent, detect, and resolve medication-related problems and
to make appropriate evidence-based, patient-centered medication therapy
recommendations as part of the interdisciplinary team.
IO
Identify the types of patient-specific information the pharmacist requires to
prevent, detect, and resolve medication-related problems and to make
appropriate evidence-based, patient-centered medication therapy
recommendations as part of the interdisciplinary team.
IO
Explain the role of collecting information regarding the patient’s
culture, emotional needs, preferences, values, and life issues in
formulating evidence-based, patient-centered care decisions.
IO
Explain patient or disease specifics that would require the
pharmacist to collect pharmacogenomic and/or pharmacogenetic
information.
IO
Explain issues surrounding confidentiality of patient information and
the impact of HIPPA regulations on the collection and safeguarding
of patient-specific information.
IO
Explain signs and symptoms, epidemiology, risk factors, pathogenesis,
natural history of disease, pathophysiology, clinical course, etiology, and
treatment of diseases commonly encountered.
IO
Explain the mechanism of action, pharmacokinetics, pharmacodynamics,
pharmacoeconomics, usual regimen (dose, schedule, form, route, and
method of administration), indications, contraindications, interactions,
adverse reactions, and therapeutics of medications in the treatment of
diseases commonly encountered.
IO
Explain current trends and issues in nontraditional therapy.
IO
Use standard patient medical charts, records and/or internal electronic
information databases to collect information that may be pertinent to
prevent, detect, and resolve medication-related problems and to make
informed evidence-based, patient-centered medication therapy
recommendations to an interdisciplinary team.
IO
Integrate effective communication techniques in interviews with patients,
caregivers, health care professionals, or others so that the patient-specific
information needed by the pharmacist for evidence-based, patientcentered care is collected.
IO
When presented with a limited time frame (e.g., ambulatory care
office visit) use an interview strategy that elicits maximum pertinent
information
IO
Explain effective phone techniques to be used to obtain
information for the patient database.
IO
Explain the impact of having discontinuous or fragmented
patient-care information when developing an interview
strategy for patients (e.g., patient seeing multiple caregivers,
last visit 6 months ago).
IO
Distinguish the meaning of non-verbal cues in patient
encounters (e.g., broken sentences in an asthmatic patient,
difficult ambulation in an arthritic patient).
IO
When appropriate, measure patient vital signs and use appropriate
physical assessment skills.
IO
Determine the most reputable and credible source of required patientspecific information.
IO
Record required patient-specific information in a manner that facilitates
detecting and resolving medication-related problems and making
appropriate evidence-based, patient-centered medication therapy
recommendations to an interdisciplinary team.
IO
In a setting where none exists, create an effective organizational system
for recording patient-specific data.
OBJ R2.4.2 (Analysis) Determine the presence of any of the following medication
therapy problems in a patient's current medication therapy:
1. Medication used with no medical indication
2. Patient has medical conditions for which there is no medication prescribed
3. Medication prescribed inappropriately for a particular medical condition
4. Immunization regimen is incomplete
5. Current medication therapy regimen contains something inappropriate
(dose, dosage form, duration, schedule, route of administration, method of
administration)
6. There is therapeutic duplication
7. Medication to which the patient is allergic has been prescribed
8. There are adverse drug or device-related events or potential for such
events
9. There are clinically significant drug-drug, drug-disease, drug-nutrient, or
drug-laboratory test interactions or potential for such interactions
10. Medical therapy has been interfered with by social, recreational,
nonprescription, or nontraditional drug use by the patient or others
11. Patient not receiving full benefit of prescribed medication therapy
12. There are problems arising from the financial impact of medication therapy
on the patient
13. Patient lacks understanding of medication therapy
14. Patient not adhering to medication regimen
IO
Explain psychological, cultural, and economic factors that influence patient
compliance with prescribed medications.
IO
Explain factors to consider when comparing the benefits and risks of an
alternative medication therapy.
IO
Explain factors to consider when trying determining the likelihood that a
reaction is occurring because of a medication.
IO
Assess criteria for assessing the severity of an adverse drug reaction.
IO
Explain acceptable approaches to the therapeutic management of an
adverse drug reaction.
IO)
Explain mechanisms of determining therapeutic consequence resulting
from defective medications or drug products (e.g., exacerbation of asthma
due to a defective inhaler).
IO
Use a functional format to list patients' pharmacotherapy problems.
IO
Prioritize patients' pharmacotherapy problems.
OBJ R2.4.3 (Analysis) Using an organized collection of patient-specific information,
summarize patients’ health care needs.
Goal R2.5: When necessary, make and follow up on patient referrals.
OBJ R2.5.1 (Evaluation) When presented with a patient with health care needs that
cannot be met by the pharmacist, make a referral to the appropriate health care
provider based on the patient’s acuity and the presenting problem.
IO
Explain the organization’s process for making a patient referral.
IO
Explain the information needed to make an appropriate referral.
IO
Explain a systematic process for assessing the acuity of a patient’s illness.
OBJ R2.5.2 (Synthesis) Devise a plan for follow-up for a referred patient.
IO
Explain the importance of following up on patients who are referred to
other health care providers.
IO
Explain the importance of integrating follow-up information into the longterm management plan.
Goal R2.6: Design evidence-based therapeutic regimens.
OBJ R2.6.1 (Synthesis) Specify therapeutic goals for a patient incorporating the
principles of evidence-based medicine that integrate patient-specific data,
disease and medication-specific information, ethics, and quality-of-life
considerations.
IO
Explain the use of evidence-based consensus statements and guidelines
in the setting of patient-specific therapeutic goals.
IO
Explain how culture influences patients’ perceptions of desirable
outcomes.
IO
Explain the importance of the patient's perception of desirable outcomes
when setting therapeutic goals for a patient with functional limitations.
IO
Explain the impact of quality-of-life issues on making decisions about
therapeutic goals.
IO
Explain ethical issues that may need consideration when setting
therapeutic goals.
IO
Compare and contrast the realistic limits of treatment outcomes among
the various care settings.
IO
Explain how a patient's age or mental status might affect the setting of
therapeutic goals.
IO
Explain how goals of others on the interdisciplinary team influence the
specification and prioritization of therapeutic goals.
IO
Explain unique aspects of the patient’s role in the ambulatory care setting
in determining his/her therapeutic goals.
OBJ R2.6.2 (Synthesis) Design a patient-centered regimen that meets the evidencebased therapeutic goals established for a patient; integrates patient-specific
information, disease and drug information, ethical issues and quality-of-life
issues; and considers pharmacoeconomic principles. .
IO
Explain the use of evidence-based consensus statements and guidelines
in the design of patient-specific therapeutic regimens.
IO
Accurately interpret best evidence for use in the design of a patientcentered regimen for a specific patient.
IO
Explain where and how to find the best possible sources of evidence for a
specific patient case.
IO
Explain how to conduct a search for relevant answers to a specific clinical
question, including searches of resources that evaluate or appraise the
evidence for its validity and usefulness with respect to a particular patient
or population.
IO
Explain how to integrate seemingly applicable findings of best evidence
with clinical judgment to arrive at an optimal evidence-based regimen for a
specific patient.
Explain how culture influences patients’ perception of disease and how
this affects responses to various symptoms, diseases, and treatments.
IO
Explain how patient-specific pharmacogenomics and pharmacogenetics
may influence the design of patients’ medication regimens.
IO
Explain additional concerns with compliance, cost, and route of
administration when making decisions on medication regimens.
Goal R2.7: Design evidence-based monitoring plans.
OBJ R2.7.1 (Synthesis) Design a patient-centered, evidenced-based monitoring plan
for a therapeutic regimen that effectively evaluates achievement of the patientspecific goals.
IO
Explain the use of evidence-based consensus statements and guidelines
in the design of patient-specific monitoring plans.
IO
Explain cultural and social issues that should be considered when
designing a monitoring plan.
IO
Explain the importance of considering what is feasible and useful when
designing a monitoring plan.
IO
Compare and contrast various methods for monitoring patient adherence
(e.g., refill rates, questioning, return demonstration).
IO
Determine monitoring parameters that will measure achievement of goals
for a therapeutic regimen.
IO
State customary drug-specific monitoring parameters for medical
regimens commonly prescribed.
IO
Explain the relationship between what are normal value ranges for
parameters and the influence on those ranges by a given disease
state.
IO
Identify the most reliable sources of data for measuring the selected
parameters.
IO
Define a desirable value range for each selected parameter, taking into
account patient-specific information.
IO
Explain factors that should influence the frequency and timing of
parameter measurements in monitoring plans.
IO
Explain effective approaches to assuring patient return for follow-up visits
in the ambulatory setting.
IO
Identify the most appropriate person to collect monitoring data (e.g., family
member, nurse, patient).
Goal R2.8: Recommend or communicate regimens and monitoring plans.
OBJ R2.8.1 (Application) Recommend or communicate a patient-centered, evidencebased therapeutic regimen and corresponding monitoring plan to other members
of the interdisciplinary team and patients in a way that is systematic, logical,
accurate, timely, and secures consensus from the team and patient.
IO
Explain the right of patients to refuse a treatment.
IO
Explain the importance of explicitly citing the use of best evidence when
recommending or communicating a patient’s regimen and monitoring plan.
IO
Explain what would be a pharmacist’s responsible professional behavior in
the circumstance that a patient refuses a proposed treatment.
IO
Differentiate between circumstances where documenting in the chart is
sufficient and when communication to team members requires immediacy.
Goal R2.9: Implement regimens and monitoring plans.
OBJ R2.9.1 (Application) When appropriate, initiate the patient-centered, evidencebased therapeutic regimen and monitoring plan for a patient according to the
organization's policies and procedures.
IO
IO
Explain the requirements for a situation in which it is appropriate for the
pharmacist to initiate a medication-therapy regimen.
IO
Explain the organization’s policies and procedures for ordering tests.
OBJ R2.9.2 (Application) Use effective patient education techniques to provide
counseling to patients and caregivers, including information on medication
therapy, adverse effects, compliance, appropriate use, handling, and medication
administration.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
OBJ R2.10.1 (Evaluation) Accurately assess the patient’s progress toward the
therapeutic goal(s).
IO
Gather data as specified in a monitoring plan.
IO
Explain factors that may contribute to the unreliability of monitoring
results (e.g., patient-specific factors, timing of monitoring tests,
equipment errors, and outpatient versus inpatient monitoring.)
IO
Determine reasons for a patient’s progress or lack of progress toward the
stated health care goal.
IO
Explain the importance of the analysis of trends over time in monitoring
parameter measurements.
IO
Accurately assess the effectiveness of a patient-specific education
program.
IO
Explain methods for assessing the effects of patient-specific
education.
OBJ R2.10.2 (Synthesis) Redesign a patient-centered, evidence-based therapeutic
plan as necessary based on evaluation of monitoring data and therapeutic
outcomes.
Goal R2.11: Communicate ongoing patient information.
OBJ R2.11.1 (Application) When given a patient who is transitioning from one health
care setting to another, communicate pertinent pharmacotherapeutic information
to the receiving health care professionals.
OBJ R2.11.2 (Application) Ensure that accurate and timely medication-specific
information regarding a specific patient reaches those who need it at the
appropriate time.
IO
Explain the importance of effective communication of modifications of the
therapeutic plan to the patient and members of the interdisciplinary team.
IO
Determine instances in which there is urgency in communicating the
results of monitoring to the interdisciplinary team.
Goal R2.12: Document direct patient care activities appropriately.
OBJ R2.12.1 (Analysis) Appropriately select direct patient-care activities for
documentation.
OBJ R2.12.2 (Application) Use effective communication practices when documenting a
direct patient-care activity.
OBJ R2.12.3 (Comprehension) Explain the characteristics of exemplary documentation
systems that may be used in the organization’s environment.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
OBJ R.3.1.1 (Characterization) Practice self-managed continuing professional
development with the goal of improving the quality of one’s own performance
through self-assessment and personal change.
IO
Explain the systematic process by which professionals pursue expertise.
IO
Formulate and adhere to an integrated system for staying current
with, arranging, and storing pertinent practice-related literature.
State the literature pertinent to one’s area of practice.
State sources of information outside of pharmacy that contain ideas
and/or information that may be effectively applied to one’s practice.
IO
Explain the importance of storing practice-related information in an
organized manner.
IO
Explain the components of an effective self-assessment system.
OBJ R3.1.2 (Characterization) Demonstrate pride in and commitment to the
profession through appearance, personal conduct, and association membership.
IO
Explain guidelines for professional dress and its importance.
IO
Explain strategies for maintaining personal self-control and professional
decorum.
IO
Explain the local, state, and national organizations and the activities of
each that are essential to the developing pharmacy professional.
IO
Explain why it is important to publish in the professional literature.
IO
Explain why it is important to become actively involved in the leadership of
professional associations.
OBJ R3.1.3 (Characterization) Act ethically in the conduct of all job-related activities.
IO
Explain ethical/conflict of interest issues in business relationships.
IO
Explain the system of ethical reasoning (consequentialist or
nonconsequentialist) employed in arriving at a particular ethical decision.
IO
Explain systems of ethical reasoning.
IO
Explain ethical principles embodied in the American Pharmacists
Association’s Code of Ethics for Pharmacists.
IO
Explain rules for attribution of sources of published work when preparing
written documents or presentations.
Goal R3.2: Contribute to departmental leadership and management activities.
OBJ R3.2.1 (Synthesis) Participate in the pharmacy department's planning processes.
IO
Explain the principles and application of various approaches to pharmacy
department planning, including the development of a departmental
strategic plan.
IO
Explain the necessary relationship between the organization's and the
department's vision, mission, and plans.
OBJ R3.2.2 (Comprehension) Explain the effect of accreditation, legal, regulatory, and
safety requirements on practice.
IO
State current regulatory and safety requirements.
IO
Explain the importance of these regulations and safety requirements.
IO
Explain how the regulations and safety requirements affect practice.
IO
State the process by which the regulations and safety requirements are
implemented.
IO
State the agencies responsible for regulating accreditation, legal,
regulatory, and safety requirements.
OBJ R3.2.3 (Comprehension) Explain the principles of financial management of a
pharmacy department.
IO
Explain the purposes of and how to access multiple sources of
reimbursement.
IO
Explain the data elements of a productivity matrix (e.g., clinical activities,
budgets, FTE justification).
IO
Explain the implications for pharmacy reimbursement of the current health
care environment (regulatory issues, manpower shortages, Medicare
Modernization Act, quality mandates).
IO
Explain sources of revenue for the pharmacy and health system.
IO
IO
OBJ R3.2.4 (Synthesis) Prioritize the work load, organize the work flow, and check the
accuracy of the work of pharmacy technical and clerical personnel or others.
IO
Explain the principles of work delegation.
IO
Explain systematic approaches to organizing and keeping track of the
work of multiple participants in a given work activity.
IO
Explain the importance of routine checks on accuracy of the work of
pharmacy technical and clerical personnel or others under one’s
supervision.
Goal R3.3: Exercise practice leadership.
OBJ R3.3.1 (Synthesis) Use knowledge of an organization's political and
decision-making structure to influence accomplishing a practice area goal.
IO
Explain the importance of networking in achieving practice area and other
professional goals.
OBJ R3.3.2 (Comprehension) Explain various leadership philosophies that effectively
support direct patient care and pharmacy practice excellence.
OBJ R3.3.3 (Application) Use group participation skills when leading or working as a
member of a committee or informal work group.
IO
Explain effective strategies for leading a meeting.
IO
Explain the role of delegation for task accomplishment in effective
leadership.
OBJ R3.3.4 (Application) Use knowledge of the principles of change management to
achieve organizational, departmental, and/or team goals.
IO
Explain the principles of change management.
Outcome R4:
Demonstrate project management skills.
Goal R4.1: Conduct practice-related investigations using effective project management
skills.
OBJ R4.1.1 (Synthesis) Initiate, design, implement, and write up a practice-related
investigation which, at all steps in the process, reflects the skillful application of
project management skills.
IO
Explain the types of resident investigations that will meet residency
program project requirements and timeframe.
IO
Explain the elements of a project proposal.
IO
When given a particular proposed residency project, explain how to
identify those key stakeholders who must approve that project.
IO
When given a particular approved residency project, explain how to
identify those individuals who will be affected by the conduct of the project
and strategies for gaining their cooperation.
IO
When given a particular approved residency project, explain how to
determine a timeline with suitable milestones that will result in project
completion by an agreed upon date.
IO
Explain strategies for keeping one’s work on a project at a pace that
matches with the timeline plan.
IO
When given a particular approved residency project, explain methods for
organizing and maintaining project materials and documentation of the
project’s ongoing implementation.
IO
When given a particular residency project ready for presentation, explain
the type of manuscript style appropriate to the project and criteria to be
met when using that style.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
OBJ R5.1.1 (Application) Use effective educational techniques in the design of all
educational activities.
IO
Design instruction that meets the individual learner’s needs.
IO
When given a particular patient data base, therapeutic regimen,
and monitoring plan, explain the educational needs of the patient
for successful implementation of the therapeutic regimen and
monitoring plan.
IO
Explain the concept of learning styles and its influence on the
design of instruction.
IO
Explain the importance of considering the learner’s reading level
when designing patient education.
IO
Write appropriately worded educational objectives.
IO
Design instruction to reflect the specified objectives for education or
training.
IO
Explain the match between instructional delivery systems (e.g.,
demonstration, written materials, videotapes) and specific types of
learning commonly required of patients.
IO
Design instruction that employs strategies, methods, and techniques
congruent with the objectives for education or training.
IO
Explain effective teaching approaches for the various types of
learning required of patients (e.g., imparting information, teaching
psychomotor skills, inculcation of new attitudes).
OBJ R5.1.2 (Synthesis) Design an assessment strategy that appropriately measures
the specified objectives for education or training and fits the learning situation.
IO
Explain appropriate assessment techniques for assessing the learning
outcomes of pharmacist-provided educational or training programs.
OBJ R5.1.3 (Application) Use skill in the four preceptor roles employed in practicebased teaching (direct instruction, modeling, coaching, and facilitation).
IO
Explain the stages of learning that are associated with each of the
preceptor roles.
OBJ R5.1.4 (Application) Use skill in case-based teaching.
OBJ R5.1.5 (Application) Use public speaking skills to speak effectively in large and
small group situations.
IO
Explain techniques that can be used to enhance audience interest.
IO
Explain techniques that can be used to enhance audience understanding
of one's topic.
IO
Explain speaker habits that distract the audience.
OBJ R5.1.6 (Application) Use knowledge of audio-visual aids and handouts to
enhance the effectiveness of communications.
IO
Use a systematic and educationally sound method for determining when it
is appropriate to use handouts or visual aids and for selecting the
appropriate aid.
IO
Explain accepted conventions for the design of visual aids and handouts.
IO
Exercise skill in the operation of audio-visual equipment.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
OBJ R6.1.1 (Comprehension) Explain security and patient protections such as access
control, data security, data encryption, HIPAA privacy regulations, as well as
ethical and legal issues related to the use of information technology in pharmacy
practice.
OBJ R6.1.2 (Application) Exercise skill in basic use of databases and data analysis
software.
IO
Explain the principles and uses of databases in the management of large
volumes of data
IO
Perform statistical analysis of data for the purposes of evaluating the
significance of data
OBJ R6.1.3 (Evaluation) Successfully make decisions using electronic data and
information from internal information databases, external online databases, and
the Internet.
IO
Explain the type of data collected, transmitted and stored by information
systems.
IO
Explain the impact on the quality of decision-making facilitated by
information systems by the validity, reliability, and consistency of data put
into the system.
IO
Explain the use and risks of decision support tools.
IO
Explain the sources, the benefits and potential risks of patient’s drug and
medical information on the Internet
Electives
Outcome E1:
Conduct pharmacy practice research.
Goal E1.1: Design, execute, and report results of investigations of pharmacy practice-related
issues.
OBJ E1.1.1 (Analysis) Identify potential practice-related issues that need to be
studied.
OBJ E1.1.2 (Application) Use a systematic procedure for performing a comprehensive
literature search.
OBJ E1.1.3 (Analysis) Draw appropriate conclusions based on a summary of a
comprehensive literature search.
OBJ E1.1.4 (Synthesis) Generate a research question(s) to be answered by an
investigation.
OBJ E1.1.5 (Synthesis) Develop specific aims and design study methods that will
answer the question(s) identified.
IO Explain the ethics of research on human subjects and the role of the IRB.
OBJ E1.1.6 (Application) Use a systematic procedure to collect and analyze data.
OBJ E1.1.7 (Evaluation) Draw valid conclusions through evaluation of the data.
OBJ E1.1.8 (Synthesis) Use effective communication skills to report orally and in
writing the results and recommendations of an investigation into a pharmacy
practice-related issue.
Goal E1.2
Participate in clinical, humanistic and economic outcomes analyses.
OBJ E1.2.1 (Evaluation) Contribute to a prospective clinical, humanistic and/or
economic outcomes analysis.
IO
IO
IO
Explain the principles and methodology of basic pharmacoeconomic analyses.
Explain the purpose of a prospective clinical, humanistic or economic outcomes
analysis.
Explain study designs appropriate for a prospective clinical, humanistic and
economic outcomes analysis.
IO
IO
IO
IO
IO
Explain the technique and application of modeling.
Explain the types of data that must be collected in a prospective clinical,
humanistic and economic outcomes analysis.
Explain possible reliable sources of data for a clinical, humanistic and economic
outcomes analysis.
Explain methods for analyzing data in a prospective clinical, humanistic and
economic outcomes analysis.
Explain how results of a prospective clinical, humanistic and economic outcomes
analysis can be applied to internal business decisions and modifications to a
customer's formulary or benefit design.
OBJ E1.2.2 (Evaluation) Contribute to a retrospective clinical, humanistic, and/or
economic outcomes analysis.
IO
IO
IO
IO
IO
IO
IO
Explain the purpose of a retrospective clinical, humanistic or economic outcomes
analysis.
Explain study designs appropriate for a retrospective clinical, humanistic and
economic outcomes analysis.
Explain the types of data that must be collected in a retrospective clinical,
humanistic and economic outcomes analysis.
IO
Explain the content and utilization of reports and audits produced by the
pharmacy department.
Explain possible reliable sources of data for a retrospective clinical, humanistic
and economic outcomes analysis.
Explain methods for analyzing data in a retrospective clinical, humanistic and
economic outcomes analysis.
Explain the impact of limitations of retrospective data on the interpretation of
results.
Explain how results of a retrospective clinical, humanistic and economic
outcomes analysis can be applied to internal business decisions and
modifications to a customer's formulary or benefit design.
Learning Experience
Descriptions
Contents
Introduction to Academics
Dr. Jay Pitcock
Dr. Katie McClendon
Bone Marrow Transplant
Adult Cardiology/CICU
Anticoagulation Clinic
Anticoagulation Clinic- Veterans Affairs Hospital
Ambulatory Care Clinics-Veterans Affairs Hospital
Cardiometabolic Clinic
Critical Care- MICU
Critical Care- SICU
Inpatient Diabetes
Drug Information and Investigational Studies
Emergency Medicine
Family Medicine Clinic
Heart Failure Disease Management
Hypertension Clinic
Infectious Diseases
Inpatient Adult Internal Medicine
Inpatient Adult Internal Medicine II
Inpatient VA Adult Internal Medicine
Nephrology/Renal Transplant
Nutrition Support
General Oncology Experience
Orientation
Pain Management
General Pediatrics
Pediatric Inpatient Hematology/Oncology
General Pediatric/Pediatric Critical Care
Practice Management
Adult Psychiatry
Renal Failure/ Dialysis
Major Research
Service (Staffing)
Adult Special Care
Special Interest
Women’s Health
Introduction To Academics Experience
PRIMARY PRECEPTOR: Jay Pitcock, Pharm.D., BCPS
Clinical Assistant Professor, Department Pharmacy Practice
Work Phone: 601-984-2794
Fax: 601-984-2751
Email: jpitcock@umc.edu
CO-PRECEPTORS:
Katie McClendon, Pharm.D., BCPS
Danny Riche, Pharm.D., BCPS
Other faculty may provide discussion on an as needed basis
PURPOSE:
To gain understanding and increased exposure to the 3 main
elements involved with serving in an academic setting: teaching,
research, and service. To gain experience in balancing the day-today schedule of those 3 areas of academia. To have increased
exposure to classroom instruction and precepting of pharmacy
students. To develop and improve teaching skills.
PRACTICE SITE:
University of Mississippi School of Pharmacy
Department of Pharmacy Practice
AREAS OF EMPHASIS
This is an elective rotation that will be tailored to the resident’s individualized residency
goals; however, the overall purpose of this rotation is outline below. In addition to oneon-one discussions about the following areas of academia, the resident will also obtain as
much practical hands-on experience as possible in each area.
Overall Academia
1. Discuss professionalism and ethics involved with being a faculty member (R3.1.2, R3.1.3)
2. Review different types and associations that one can have within a school of pharmacy
(R3.1.2, R3.1.3)
3. Discuss requirements for advancement within an academic setting with regards to self
assessment and assessment of fellow faculty members (R3.1.1, R3.2.1)
4. Discuss future of pharmacy relating to academia and direction the profession of pharmacy
is heading (R3.1.1, R3.2.1, R3.3.1)
5. To understand the role and balance of being a teacher, researcher, and mentor for both
students and other faculty (R3.1.1, R3.2.4, R3.3.1)
6. Discuss responsibilities and obligations of a full time faculty member as it relates to the 3
areas of practice described below (R3.1.2)
Teaching
1. To understand the philosophy behind different methods of teaching (i.e. passive vs. active
learning) (R5.1.1)
2. Develop a case to be used for teaching in an active learning environment (i.e. PBL)
(R5.1.1, R5.1.2)
3. Learn what is involved in course and lecture development for a didactic based system
(R5.1.1, R5.1.3)
Introduction to Academics Experience- Pitcock Continued
4.
5.
6.
7.
Review and practice syllabus development and writing (R5.1.1, R5.1.2)
Participate in test development, and if applicable administration and grading (R5.1.2)
Discuss evaluation and assessment of student performance (R5.1.2)
Gain experience in precepting students with different levels of experience, if available (i.e.
P3 vs. P4 students) (R5.1.1, R5.1.3)
8. Participate in the PBL series at the University of Mississippi School of Pharmacy (R5.1.3,
R5.1.4, R5.1.5, R5.1.6)
Research
1. Learn about the different types of research done in an academic setting (R4.1.1)
2. Review the steps involved in development and completion of a research project. This would
include, but not limited to, generation of ideas, literature searches, IRB approvals, seeking
of funding, recruitment of patients, performing the study, & writing of results. (R4.1.1)
3. Review the different types of funding available (R4.1.1)
4. Obtain an overview of how to apply for a grant and how to manage a grant that is awarded.
(R4.1.1)
Service
1. Review all the different aspects of academia that fall into the category of service (R3.1.1)
2. Learn what it takes to balance a clinical practice with the rest of your academic obligations
(R3.1.1, R3.2.1)
3. Understand the types of committees that function in the School of Pharmacy at both a
department and school-wide level (R3.3.3, R3.3.4)
4. Discuss involvement in professional organizations at the local, state, and national levels
(R3.1.2)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Outcome R3:
Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R4:
Demonstrate project management skills
Goal 4.1:
Conduct practice-related investigations using effective project management
skills.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Introduction to Academics Experience – Pitcock Continued
ACTIVITIES AND RESPONSIBILITIES:
The activities and responsibilities will be tailored to each resident’s expectations and level of
future involvement in academia (i.e full-time vs. adjunct faculty position). The core group of
activities expected of all residents is listed below.
1. Attend discussions with various faculty members on topics involved with academia.
(R3.1.1, R3.1.2, R3.1.3, R3.2.1, R3.2.4, R3.3.1, R3.3.3, R3.3.4)
2. Develop a syllabus for a clinical rotation and/or didactic lecture class (R5.1.1, R5.1.2,
R5.1.3)
3. Research and write a minicase and/or progressive disclosure case (along with test
material) for an ambulatory care topic to be used in the PBL course series (R5.1.1, R5.1.2,
R5.1.3)
4. Research, prepare, and give a 30 minute PowerPoint lecture (with applicable hand-out
material) on an ambulatory care therapeutics topic that could be used in a didactic type
lecture series (R5.1.2, R5.1.4, R5.1.5, R5.1.6)
5. Actively serve as a preceptor and role model for pharmacy student(s) which includes
schedule development, facilitating case discussions, guiding clinical activities, and
assessment (R5.1.3, R5.1.4, R5.1.5, R5.1.6)
6. Participate in the committee meetings, question development, proctoring, and grading of
the Problem-Solving Exam and Knowledge and Comprehension exams with the University
of Mississippi School of Pharmacy, as applicable (R5.1.2, R3.3.3, 3.3.4)
7. Participate in the PBL process at the University of Mississippi School of Pharmacy (R5.1.3,
R5.1.4, R5.1.5, R5.1.6)
8. Attend other meetings associated with the University of Mississippi School of Pharmacy, as
applicable (R3.3.3, R3.3.4)
9. Complete assigned projects prior to end of rotation (R3.1.1, R3.2.4)
10. Continue other research activities that fall outside the rotation as required by the residency
(R4.1.1)
REQUIRED READING
Will be discussed with resident the first day of the rotation
Resident Progression Objectives
Week
Week 1
Objective(s)
1) Resident should decide upon subject matter of their progressive
disclosure and/or minicase.
2) Resident should decide on topic for their student discussion
and/or grand rounds presentation.
3) Resident should sit in on PBL sessions.
Week 2
1) Resident should increase participation in the group PBL process
through interactions with students in group.
Week 3
1. Resident should write test questions related to their case topic to
assess student learning.
Week 4
1. Resident should effectively lead a discussion to an audience using
teaching strategies that include active learning
2. Resident should have final draft of all material related to their
progressive disclosure and/or minicase completed.
3. Resident should lead PBL session, as well as assess student
performance in PBL.
Introduction To Academics Experience
PRIMARY PRECEPTOR: Katie McClendon, Pharm.D., BCPS
Clinical Assistant Professor, Department Pharmacy Practice
Work Phone: 601-984-2794
Pager: 601-929-3806
Fax: 601-984-2751
Email: jpitcock@umc.edu
CO-PRECEPTORS:
Jay Pitcock, Pharm.D., BCPS
Danny Riche, Pharm.D., BCPS
Leigh Ann Ross, Pharm.D., BCPS, CDE
Gary Theilman, Pharm.D.
Note: additional faculty members will be involved in the learning experience.
PURPOSE:
To gain understanding and increased exposure to the 3 main
elements involved with serving in an academic setting: teaching,
scholarly activity, and service. To gain experience in balancing the
day-to-day schedule of those 3 areas of academia. To have
increased exposure to classroom instruction and precepting of
pharmacy students. To develop and improve teaching skills. To
develop skills in evaluation and feedback of students in both
classroom and experiential settings. This is an elective learning
experience.
PRACTICE SITE:
University of Mississippi School of Pharmacy
Department of Pharmacy Practice
Thad Cochran Medical Mall
University of Mississippi Medical Center Office Annex
University of Mississippi Medical Center
Jackson, Mississippi
AREAS OF EMPHASIS
This is an elective rotation that will be tailored to the resident’s individualized residency
goals; however, the overall purpose of this rotation is outline below. In addition to oneon-one discussions about the following areas of academia, the resident will also obtain as
much practical hands-on experience as possible in each area.
Overall Academia
1. Discuss professionalism and ethics involved with being a faculty member (R3.1.2,
R3.1.3)
2. Review different types and associations that one can have within a school of pharmacy
(R3.1.2, R3.1.3)
3. Discuss requirements for advancement within an academic setting with regards to self
assessment and assessment of fellow faculty members (R3.1.1, R3.2.1)
4. Discuss future of pharmacy relating to academia and direction the profession of
pharmacy is heading (R3.1.1, R3.2.1, R3.3.1)
Introduction to Academics Experience - McClendon Continued
AREAS OF EMPHASIS
1. To understand the role and balance of being a teacher, researcher, and mentor for both
students and other faculty (R3.1.1, R3.2.4, R3.3.1)
2. Discuss responsibilities and obligations of a full time faculty member as it relates to the
3 areas of practice described below (R3.1.2)
Teaching
3. To understand the philosophy behind different methods of teaching (i.e. passive vs.
active learning) (R5.1.1)
4. Develop a case to be used for teaching in an active learning environment (i.e. PBL)
(R5.1.1, R5.1.2)
5. Learn what is involved in course and lecture development for a didactic based system
(R5.1.1, R5.1.3)
6. Review and practice syllabus development and writing (R5.1.1, R5.1.2)
7. Participate in test development, administration, and grading (R5.1.2)
8. Discuss evaluation and assessment of student performance (R5.1.2)
9. Gain experience in precepting students with different levels of experience (i.e. P3 vs. P4
students) (R5.1.1, R5.1.3)
10. Participate in the PBL series at the University of Mississippi School of Pharmacy
(R5.1.3, R5.1.4, R5.1.5, R5.1.6)
Scholarly activity
11. Learn about the different types of research done in an academic setting (R4.1.1, E1.1)
12. Review the steps involved in development and completion of a research project. This
would include, but not limited to, generation of ideas, literature searches, IRB approvals,
seeking of funding, recruitment of patients, performing the study, & writing of results.
(R4.1.1, E1.1)
13. Review the different types of funding available (R4.1.1, E1.1)
14. Obtain an overview of how to apply for a grant and how to manage a grant that is
awarded. (R4.1.1, E1.1)
Service
15. Review all the different aspects of academia that fall into the category of service
(R3.1.1)
16. Learn what it takes to balance a clinical practice with the rest of your academic
obligations (R3.1.1, R3.2.1)
17. Discuss the management of activities reflecting priority of patient-centered care, along
with balancing other academic time expectations (R2.2.1)
18. Discuss how to establish and manage a pharmacy clinical services, with a focus on
protocol development, implementation, reimbursement, and maintenance issues
(R2.1.1)
19. Discuss collaborative practice agreements and disease state management with a focus
on the emergence of medication therapy management and its impact on pharmacy
(R1.2.1, R2.1.1)
20. Recommending pharmacological management taking into consideration drug
interactions, side effects, and disease state management based on evidence based
medicine. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R 2.9.2, R2.10.1, R2.10.2, R2.11.1
R2.11.2)
Introduction to Academics Experience – McClendon Continued
AREAS OF EMPHASIS
21. Communication with health care providers and patient education techniques. (R2.8.1,
R2.11.1, R2.11.2)
22. Understand the types of committees that function in the School of Pharmacy at both a
department and school-wide level (R3.3.3, R3.3.4)
23. Discuss involvement in professional organizations at the local, state, and national levels
(R3.1.2)
24. Drug literature evaluation as pertains to academic literature. (R6.1.1, R6.1.2)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3:
Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R4:
Demonstrate project management skills
Goal 4.1:
Conduct practice-related investigations using effective project management
skills.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Outcome E1:
Conduct pharmacy practice research
Goal E1.1: Design, execute, and report results of investigation of pharmacy practice-related
issues.
Introduction to Academics Experience - McClendon Continued
ACTIVITIES AND RESPONSIBILITIES:
The activities and responsibilities will be tailored to each resident’s expectations and
level of future involvement in academia (i.e full-time vs. adjunct faculty position). The
core group of activities expected of all residents is listed below.
2. Attend discussions with various faculty members on topics involved with academia.
(R3.1.1, R3.1.2, R3.1.3, R3.2.1, R3.2.4, R3.3.1, R3.3.3, R3.3.4)
3. Maintain a clinical presence in the Anticoagulation and Asthma Clinics (see
Anticoagulation/Asthma Experience description for more detail involving the clinical
activities and responsibilities) (R1.2.1, R2.1.1, R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R
2.9.2, R2.10.1, R2.10.2, R2.11.1 R2.11.2)
4. Develop a syllabus for a clinical rotation and/or didactic lecture class (R5.1.1, R5.1.2,
R5.1.3)
5. Research and write a minicase (along with test material) for a topic to be used in the
PBL course series (R5.1.1, R5.1.2, R5.1.3)
6. Research, prepare, and give a 30 minute PowerPoint lecture (with applicable hand-out
material) on a therapeutics topic that could be used in a didactic type lecture series
(R5.1.2, R5.1.4, R5.1.5, R5.1.6)
7. Actively serve as a preceptor and role model for pharmacy student(s) which includes
schedule development, facilitating case discussions, guiding clinical activities, and
assessment (R5.1.3, R5.1.4, R5.1.5, R5.1.6)
8. Participate in the committee meetings, question development, proctoring, and grading of
the Problem-Solving Exam and Knowledge and Comprehension exams with the
University of Mississippi School of Pharmacy, as applicable (R5.1.2, R3.3.3, 3.3.4)
9. Participate in the PBL process at the University of Mississippi School of Pharmacy
(R5.1.3, R5.1.4, R5.1.5, R5.1.6)
10. Attend other meetings associated with the University of Mississippi School of Pharmacy,
as applicable (R3.3.3, R3.3.4)
11. Complete assigned projects prior to end of rotation (R3.1.1, R3.2.4)
12. Continue other research activities that fall outside the rotation as required by the
residency (R4.1.1, E1.1)
REQUIRED READING
Buchel TL, Edwards FD. Characteristics of Effective Clinical Teachers. Fam Med. 2005; 37:
30-35.
Clegg VL, Cashin WE. Improving multiple-choice tests. iDEA Paper no. 16. (will provide)
Dobbie AE, Tysinger JW, Freeman J. Strategies for efficient office precepting. Fam Med. 2005;
37: 239-41.
Dobbie AE, Tysinger JW. Evidence-based stategies that help office-based teacher give
effective feedback. Fam Med. 2005; 37: 617-619.
Langlois J, Thach S. Teaching and learning styles in the clinical setting. Fam Med. 2001; 33:
344-346.
Monaghan MS, Jones RM, et al. Designing an assessment for an abilities-based curriculum.
Am J Pharm Educ. 2005; 69: 118-125.
Ross LA, Crabtree BL, Theilman GD, Ross BS, Cleary JD, Byrd HJ. Implementation and
refinement of a problem-based learning model: a ten-year experience. Am J Pharm Educ.
2007; 71: 17.
And others may be assigned.
Resident Progression Objectives
Week
Week 1
Week 4
Objective(s)
4) Complete at least one of the Week 4 objectives
2) lead discussion with students
3) present effectively to an audience using teaching strategies that
include active learning
4) write test questions to assess learning
5) lead PBL session and assess student performance in PBL
BONE MARROW TRANSPLANT UNIT EXPERIENCE
PRECEPTOR:
Justin Harrison, PharmD
Oncology/Hematology
Work: 601-815-1550
FAX: 601-815-1697
Pager:
Email: mharrison@umc.edu
PURPOSE:
To gain clinical experience and to develop an understanding of the
pharmacists role in the management of the patient receiving a bone
marrow transplant. To gain a working knowledge of chemotherapy
regimens, chemotherapy preparation, and consequential side effects of
patients receiving chemotherapy. The resident will be given the
opportunity to provide meaningful interaction and assistance to physicians,
residents and nurses as an integral part of the health care team. This is an
elective learning experience.
PRACTICE SITE:
University of Mississippi Medical Center, Bone Marrow Transplant Center
COMPETENCY BASED LEARNING OBJECTIVES:
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Bone Marrow Transplant Unit Experience
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
AREAS OF EMPHASIS
1. Sequence at least 2 BMT protocols, autologous and
allogeneic, the conditioning regimens, prophylactic antibiotics,
immunosuppressant therapy (R1.2.1, R2)
2. Learn to interpret lab values pertaining to the bone marrow patient. (R2.2.1, 2.4.1 –
2.11)
3. Develop an understanding of dosing regimens and obtaining serum levels that
involve immunosuppressive therapy. (R2.2.1, 2.4.1 – 2.11)
4. Learn the monitoring parameters associated with patients receiving chemotherapy
regimens and bone marrow transplants. (R2.2.1, 2.4.1 – 2.11)
5. Become familiar with antibiotic regimens and appropriateness. (R2.2.1, 2.4.1 – 2.11)
6. Serve as a resource to rotating residents, physicians and nurses in the
BMT unit. (R2.1.1, 2.2.1, 2.4.1 – 2.11, R6)
7. Recognize the differences and similarities in the pediatric BMT patient
and the adult BMT patient. (R2.2.1, 2.4.1 – 2.11)
8. Develop an understanding of the side effects and possible complications associated
with the BMT patient. (R1.1.1, 1.1.3, R2, R6)
9. Study the different types of hematologic cancers (R2, R6)
ACTIVITIES AND RESPONSIBILITIES:
1. Participate in daily sit down rounds. (R2.1.1, 2.2.3)
2. Assist in preparation of chemotherapy agents. (R1.3 – 1.4)
3. Assist in large and small volume intravenous medications for patients in
the BMT unit. (R1.3 – 1.4)
4. Assist medical residents in protocol implementation of the BMT patient. (R1.2.1)
5. Monitor immunosuppressant levels and recommend adjustments as warranted. (R2)
6. Review profiles of all patients on the Hematology service for appropriateness of
therapy. (R2)
7. Monitor antibiotics and levels as needed, making recommendations for dosage and
drug changes as required. (R2)
8. Provide inservice to nursing staff on BMT medications.(R5)
9. Participate in proper order entry of chemotherapy medications. (R1.3)
10. Provide assistance with drug stabilities and compatibilities. (R1.3, R6)
SUGGESTED LITERATURE
1. ASHP Oncology Handbook
2. Oncology Pocket Guide
Adult Cardiology / CICU Experience
Preceptor:
INACTIVE
Cardiac Intensive Care Unit Pharmacist
Phone: 601-815-1572
Pager: 601-952-5020
Fax: 601-815-1937
Email:
Practice Site:
Cardiac Intensive Care Unit
University of Mississippi Health Care
Purpose
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To gain knowledge and clinical skills to optimally manage patients with cardiovascular
diseases in the acute and critically ill setting
To gain knowledge and clinical experience in the treatment of heart failure, including acute
decompensated heart failure chronic heart failure, myocardial infarction, various
arrhythmias, cardiomyopathies, and post-op cardiothoracic surgery patients including heart
transplant patients.
The resident will also develop and improve problem-solving and communication skills by
educating and interacting with pharmacists, medical, pharmacy, and nursing students,
medical and pharmacy residents, and nurse practioners.
The resident will have opportunities to develop effective patient education techniques with
medications such as beta-blockers, warfarin, Lovenox, and amiodarone.
The resident will also participate as an active member of a collaborative health care team
both in the cardiac intensive care unit as well as on the cardiology floor.
Areas of Emphasis
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Limited physical assessment of the patient while on rounds with health care providers
(R2.4.1)
Understanding of acute care pharmacology and monitoring therapeutic effect (R2.7.1)
Effective communication and interaction with health care providers. (R2.8.1,2.11.1,2.11.2)
Evaluation of primary literature and application of evidence-based medicine to patientspecific situations. (R2.6.1, R2.6.2, R2.8, R2.10, R2.11)
Preparing a patient-specific pharmacologic and monitoring plan that adheres to the
principles outlined in evidence-based practice guidelines. (R12.6.1, R2.6.2, R2.8, R2.10,
R2.11)
Effective time management skills. (R2.2.1, R3.1, R3.2.4)
Understanding the anatomy and physiology of the heart. (R2.4.1)
Understanding the pathophysiology of various cardiovascular diseases and the surgical
interventions, (i.e cardiac catheterization, coronary-artery bypass graft, ICD, pacemaker
placement, and valve repair) performed to correct the condition. (R2.4.1, R2.4.2)
Management of cardiac patients primarily in the critical care setting, but also in the stepdown unit (R2 in all of it entirety)
Management of hypertension and hypertensive urgencies/emergencies
Management of ischemic heart disease (R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8, R2.9.1,2,
R2.10.1,2, R2.12)
Adult Cardiology Experience continued
Areas of Emphasis continued
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Management of acute coronary syndrome (R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8, R2.9.1,2,
R2.10.1,2, R2.12)
Management of heart failure—acute decompensated and chronic (R2.4.1,2,3, R2.6.1,2,
R2.7.1, R2.8, R2.9.1,2, R2.10.1,2, R2.12)
Management of cardiomyopathy (R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8, R2.9.1,2, R2.10.1,2,
R2.12)
Perioperative and post-operative management of cardiac surgery patients (R2.4.1,2,3,
R2.6.1,2, R2.7.1, R2.8, R2.9.1,2, R2.10.1,2, R2.12)
Identification and management of atrial and ventricular arrhythmias(R2.4.1,2,3, R2.6.1,2,
R2.7.1, R2.8, R2.9.1,2, R2.10.1,2, R2.12)
Management of valvular heart disease and anticoagulation after valve replacement
(R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8, R2.9.1,2, R2.10.1,2, R2.12)
Management of heart transplant and its complications. (R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8,
R2.9.1,2, R2.10.1,2, R2.12)
Management of medications in Code Blue situations (R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8,
R2.9.1,2, R2.10.1,2, R2.12)
Prevention and management of drug-drug, disease, food interactions and related adverse
effects. (R2.4.1,2,3, R2.6.1,2, R2.7.1, R2.8, R2.9.1,2, R2.10.1,2, R2.12)
Monitoring and interpretation of laboratory data related to disease management and
medication safety and effectiveness. (R2.4.2)
Recommendation of appropriate immunizations. (R2.6.1,2)
Effective patient counseling skills. (R2.8, R2.9.1,2, R2.12, R5- in it entirety)
Competency-Based Learning Goals and Corresponding Objectives:
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Adult Cardiology Experience continued
Competency-Based Learning Goals and Corresponding Objectives continued:
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Activities and Responsibilities
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Practice effective communication skills. Interact and become familiar with the role of each
member of the health care team (i.e., physicians, nurses, nurse practitioners, nursing
students, case managers, dieticians, secretaries). (R2.1.1,2.3.1, R5)
Actively incorporate yourself in medical rounds with the cardiology team as the drug
information provider for all therapies---cardiology and non-cardiology. (R2.1.1, 2.3.1, R5)
Practice evidence-based medicine by reviewing primary literature and the most current
evidence-based practice guidelines. (R1.2.1, R6)
Prepare for detailed topic discussions on various cardiovascular diseases as well as on
specific drug information on weekly basis. (R2.4,1,2,3, R6)
Obtain complete patient assessment by including the following information: reason for
admission, medical history, social/family history, review of systems, physical examination,
home medications, adherence to therapy (if any), need for medication assistance, and
current diagnosis and treatment. (R2, R6)
Discussion/patient presentation with preceptor daily (R2- in all its entirety)
Contact community pharmacies to obtain home medication list if necessary. (R2, R5)
Monitor patient profiles for appropriateness of therapy, complete therapeutic management,
potential drug-drug/food/disease interactions, and adverse drug effects. This includes daily
lab review to ensure patient safety, therapeutic response to therapy, and to identify needed
changes in therapy. (R2.4.1,2, R2.8)
Make clinical recommendations for initiation and modification of pharmacotherapy based on
all relevant considerations. (R2.8,.1, R2.9.1,2, R2.10, R2.11, R2.12)
Gain an understanding/experience of dosage forms which can be used when patient is
mechanically ventilated or unable to swallow. (R2.4.2)
Perform IV to PO dose conversion and vice versa for medications commonly used in the
acute setting, i.e digoxin, steroids, beta-blockers, ace-inhibitors, etc. (R2.4.2)
Serve as drug information resource for intravenous compatibility questions that may arise.
(R2.4.2)
Recommend the most cost effective yet appropriate medication regimens for indigent
patients. (R2- all, R3.2.3)
Educate patients on both pharmacologic and non-pharmacologic recommendations prior to
discharge. (R2.11, R5)
Adult Cardiology Experience continued
Activities and Responsibilities continued
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Recommend immunizations based on patient risk factors prior to discharge. (R1.2.1, R2)
Record documentation of all interventions and care provided to the patients. (R2, 2.12, R5)
Attend daily staffing rounds. Time will be determined daily by team. (R2.1.1, 2.3.1)
Attend morning service snapshot at 8 am. (R2.1.1, 2.3.1)
Assist in teaching medical, nursing, and pharmacy students on rotation. (R5, 5.1.3, R6)
Provide in-services to the nursing staff or medical staff as necessary. (R5, R6)
Be prepared to take consultations as well as solving pharmacokinetic and calculation
problems. (R2, R6, R5)
Present a formal Powerpoint presentation to the clinical pharmacy staff and students near
the end of the rotation. Topic of the presentation should be determined at least two weeks
prior to the date of the presentation. (R3,R4, R5)
Gain an understanding of the medications used in CODE BLUE situations – know
mechanism, dose, side effects, administration and compatibility, how to mix and administer
(R6 all inclusive)
Calculate rates of infusion commonly used in the cardiac ICU such as dopamine,
dobutamine, heparin, lidocaine, amiodarone, etc. (R2.7.1)
Observe surgical procedure (PCI, CABG, heart valve repair/replacement, etc) if interested
(R2)
Become familiar with automated dispensing machines, the useful of the pneumatic tube
system, and become comfortable preparing IV admixtures using aseptic technique. (R1,3 in
its entirety)
Anticoagulation Clinic
PRECEPTORS:
Elizabeth Hood, Pharm.D., CDM, Preceptor of Record
Anticoagulation Clinic Coordinator
Clinical Pharmacy Specialist
Assistant Professor of Pharmacy Practice
Work Phone: 601-984-2776
Pager: 601-929-4008
Fax: 601-815-2751
Email: ehood@umc.edu
Julie George, Pharm.D., BCPS
Adult Asthma Clinic Coordinator
Clinical Pharmacy Specialist
Assistant Professor of Pharmacy Practice
Work Phone: 601-815-4697
Pager: 601-929-0215
Email: jgeorge@umc.edu
Emmy C. Steevens, Pharm.D., CACP
Clinical Pharmacy Specialist
Pager: 601-929-4018
Cell: 601-212-7637
Email: jsteevens@umc.edu
PRACTICE SITE:
University of Mississippi Medical Center
Jackson Medical Mall
PURPOSE: The Adult Asthma/Anticoagulation Clinic Experience is a 4-week rotation offered
at University of Mississippi Health Care at the Jackson Medical Mall. These learning
experiences are elective for our PGY1 Program. The experiences involve the provision of
direct care for patients in the Anticoagulation Clinics. The Anticoagulation Clinics are protocoldriven, pharmacist-run clinics in which the resident interacts independently with patients who
are referred by physicians for management. The resident is responsible for interviewing
patients, making decisions with regard to medication management, and providing appropriate
education to patients and caregivers. Good communication and interpersonal skills are of
paramount importance in this setting. The resident must devise efficient writing skills to
appropriately document all patient encounters.
GOALS
1. To gain clinical experience in chronic disease state management (R1.2.1, R2)
2. To develop effective patient counseling techniques (R2.11, R5)
3. To interact as part of a multidisciplinary team of health care providers (R2.1.1,
2.3.1)
4. To serve as a drug information resource (R6)
5. To further enhance problem-solving abilities (R2)
6. To develop effective written and oral communication skills (R5)
7. To develop effective preceptor skills (R5)
8. To become familiar with the process for establishing pharmacy clinical services,
including protocol development and implementation, reimbursement issues, as
well as overall management (R1.2.1, R2)
Anticoagulation Clinic Experiences
Competency-Based Learning Goals and Corresponding Objectives
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
AREAS OF EMPHASIS
Common disease states, in addition to the ones mentioned above, with which the resident will
be expected to gain facility through literature review, topic discussion, and direct patient care
experience include:
Hypertension, Atrial Fibrillation, Congestive Heart Failure, Chronic Obstructive Pulmonary
Disease, Peptic Ulcer Disease, Gastroesophageal Reflux Disease, Thyroid Disease, Arthritis,
Infectious Disease (HIV/AIDs), Osteoporosis/Hormone Replacement Therapy.
Anticoagulation Clinic Experiences
The resident is expected to understand the pharmacotherapy related to these disease states
as well as other disease states encountered in this setting. The preceptor or designee will be
available to the resident throughout the learning experience for consultation and topic
discussions. Resident learning is predicated not only on the above responsibilities but also on
acceptance of personal responsibility and dedication to direct patient care and team service.
ACTIVITIES AND RESPONSIBILITIES
Competencies
Clinical Skills:
A. Appropriately identify real and potential drug therapy problems. (R2)
B. Construct appropriate patient pharmacotherapy plans. (R1.2.1, R2)
C. Appropriately assess the patient’s status and monitor response to therapy. (R2.7 – 2.11)
D. Apply pharmacokinetic principles to make dosing recommendations. (R2)
E. Describe the pathophysiology, clinical presentation, and appropriate therapies for each
patient. (R2)
F. Collect and analyze patient data in accordance with current standards of practice, including
use of primary literature. (R2)
G. Demonstrate a knowledge of drug classes, mechanisms of action, common adverse
effects, drug-drug, drug-diet, drug-disease interactions, monitoring parameters, and
therapeutic endpoints. (R2, R6)
H. Appropriately document clinical findings and interventions. (R2.12)
I. Demonstrate a working knowledge of non-drug therapies and alternative therapies. (R2)
J. Demonstrate the ability to effectively understand and interpret the medical management of
a patient and communicate the work-up of the patient and an assessment of the drug
therapy decisions in a case presentation. (R1.2.1, R2, R5)
K. Obtain and record a complete medication history. (R2, R5)
L. Obtain and record each patient’s home medications. (R2, R5)
Information Resources:
A. Effectively use drug information resources. (R6)
B. Apply drug literature appropriately in patient care decisions. (R6, R2)
C. Supplement textbook knowledge with primary literature for use in patient care decisions.
(R2, R6, R1.2.1)
Communication Skills:
A. Effectively communicate, verbally and in writing (e.g., consultations progress notes, drug
information responses and other documents), with other health care professionals
(pharmacists, physicians, nurses, etc.) about therapeutic plans, other patient care needs,
and health care issues. (R2.11, R5)
B. Articulate and support drug therapy recommendations. (R1.2.1, R5, R6)
C. Write patient care notes/documents that: (R2.12, R5)
i. Are accurate, logical, yet only pertinent information
ii. Provide complete drug therapy directions (dosage, route, frequency, duration,
monitoring parameters, and time of follow up)
iii. Use correct terminology, spelling, and grammar.
D. Effectively communicate patient and/or medication self-management information to patients
and health professionals. (R2.8.1, 2.11, R5)
E. Deliver appropriate and effective patient counseling skills. (R2.11, R5)
Anticoagulation Clinic Experiences
Professional Ethics and Identity:
The resident shall behave ethically. The resident shall accept the responsibilities embodied in
the principles of pharmaceutical care. (R3.1.3, 3.2.2)
A. Make appropriate ethical and legal decisions.
B. Accept responsibility and provide patient-centered care.
C. Maintain excellence in personal practice.
D. Exhibit a professional demeanor.
E. Conduct direct patient care activities using a consistent approach that reflects the
philosophy of primary care as well as pharmacy practice.
Drug Therapy Assessment:
The resident shall assess the appropriateness of patient's drug therapy, including
consideration of the chemical, pharmaceutical, pharmacokinetic, and pharmacological
characteristics of the administered medications. (R1.2.1, R2)
A. Assess each acute and chronic medical problem. (R1.2.1, R2)
B. Identify the following drug-related problems: (R1.2.1, R2)
i. Drug therapy is needed for untreated indications.
ii. Patient is receiving a drug that has no indication and/or there is therapeutic
duplication.
iii. There is a better choice of drug based on patient/disease characteristics, formulary,
cost, etc.
iv. Drug therapy needs optimization (population and patient-specific pharmacokinetic
and pharmacodynamic data indicate a drug regimen is not optimized).
v. Medication nonadherence.
vi. Drug induced disease/medical conditions.
vii. Socio-behavioral and economic barriers to effective drug therapy.
viii. Adverse drug reactions that are substantiated by laboratory, test, and physical
findings.
ix. Routes of administration that are not the best, safest, and most cost-effective.
x. Drug interactions that are substantiated with pharmacokinetic/dynamic and
compatibility information.
C. Identify and evaluate each drug-related problem. (R1.2.1, R2)
D. Prioritize drug-related problem list. (R1.2.1, R2)
Develop, Implement, and Monitor Drug Therapy Plans:
The resident shall develop a therapeutic plan for the patient, which includes appropriate
monitoring to address any problem identified. (R1.2.1, R2)
A. Establish desired therapeutic outcomes.
B. Consider drug and non-drug therapy alternatives.
C. Develop drug therapy plans that are patient-specific, comprehensive, logical, practical,
consider current evidence-based medicine recommendations, include strategies for
prevention, and include patient education.
D. Establish a plan for therapeutic drug monitoring that includes accurate documentation of
population and patient-specific parameters, dosing history/administration times,
monitoring parameters, and daily SOAP notes/plans.
E. Develop and implement the pharmacotherapeutic plan promptly, efficiently, accurately,
and effectively.
F. Use an effective patient monitoring system (monitoring forms).
G. Monitor the patient and follow up at appropriate intervals.
Anticoagulation Clinic Experiences
H. Revise drug therapy plans on an ongoing basis.
I. Ensure continuity of pharmaceutical care to and from the acute and ambulatory care
patient care settings.
7. Presentations/ Projects:
A. Oral Presentation: The resident will be responsible for one presentation, with topic approval
by the preceptor, and must pertain to drug therapy and disease management in
anticoagulation. This will be presented to the pharmacy staff, residents, and pharmacy
students. (R5)
B. Primary Care Project: During the experience, the resident will be responsible for a project
that pertains to primary care. (R4, E1)
C. Demonstrate appropriately the use of devices commonly encountered in the
primary care setting, including: (R1.3, R5, R6)
Injection Techniques
Blood Pressure Monitors
Coaguchek-XS machine
8. Other Responsibilities:
A.
Perform self-assessments by: corroborating midpoint and final rotation self-assessment
ratings with those of the instructor, performing a self- assessment of each document,
and writing a reflective self-evaluation at the end of the rotation. (R3.1.1)
B.
Demonstrate professional written communication skills by thorough documentation of
patient information in the patient’s record. (R5)
C.
Participate in the billing activities of the Anticoagulation Clinic. (R3.2.3)
D.
Review appropriate literature to prepare for topic discussions. (R5, R6)
E.
Attend and contribute to all topic discussions. (R5, R6)
F.
Record recommendations made and drug information given to all health care
professionals daily. (R2.12, R5)
G.
Conducting administrative activities to ensure continual performance of the clinics in an
efficient manner. (R3.1.3, 3.2.1, 3.2.2, 3.2.3,3.2.4, 3.3.3, 3.3.4)
H.
Reviewing and updating protocols as deemed necessary by the preceptor. (R1.2.1)
I.
Researching and writing functional protocols when applicable to current clinic
requirements. (R1.2.1, R6, R5)
J.
Actively serving as a preceptor for pharmacy student(s) which includes teaching
therapeutic principals, facilitating case discussions, and guiding clinical activities. (R5)
REQUIRED READINGS
Reading assigned daily during rotation.
Progression Outcomes-Anticoagulation Clinic
Week
Week 1
Objective(s)
5) Follow all patients in coordination with preceptor
6) Review Anticoagulation Protocol and protocol development
7) Review warfarin therapy and management
Week 2
6) Follow patients independently of preceptor, with overview
7) Review patient assistant programs for anticoagulants
8) Observe an initial visit interview with a patient
Week 3
1) See an initial visit patient independently of preceptor
2) Review alternative anticoagulants
3) Review bridging techniques for anticoagulated patients
Week 4
1) Review initiating anticoagulant therapy
2) Have a pharmacy student shadow you in clinic
Anticoagulation Clinic – GV Sonny Montgomery Veterans Hospital
PRECEPTOR:
Clinical Pharmacist – Erika Webster, Pharm D, BCPS, CDE
Primary Care Green Anticoagulation Clinic Coordinator
Work Phone:
Pager:
Email: erika.webster@va.gov
PRACTICE SITE:
G.V. (Sonny) Montgomery
Veteran’s Administration Medical Center
Jackson, Mississippi
PURPOSE: The Anticoagulation Clinic Experience is a 4-week rotation offered by the
University of Mississippi Medical Center at the Veteran’s Administration (V.A.) Medical Center.
This learning experience is required for the PGY-1 Ambulatory Care resident. The experience
involves the provision of direct care for patients in the Anticoagulation Clinics at the V.A.
Medical Center. The Anticoagulation Clinic is protocol-driven, pharmacist-run clinic in which
the resident interacts independently with patients who are referred by physicians and nurse
practitioners for management. The resident is responsible for interviewing patients, making
decisions with regard to medication management, and providing appropriate education to
patients and caregivers. Good communication and interpersonal skills are of paramount
importance in this setting. The resident must devise efficient typing skills to appropriately
document all patient encounters with appropriate terminology.
GOALS
1. To gain clinical experience in chronic disease state management (R1.2.1, R2)
2. To develop effective patient counseling techniques (R2.11, R5)
3. To interact as part of a multidisciplinary team of health care providers (R2.1.1,
2.3.1)
4. To serve as a drug information resource (R6)
5. To further enhance problem-solving abilities (R2)
6. To develop effective written and oral communication skills (R5)
7. To develop effective preceptor skills (R5)
8. To become familiar with the process for establishing pharmacy clinical services,
including protocol development and implementation, reimbursement issues, as
well as overall management (R1.2.1, R2)
AREAS OF EMPHASIS
Common disease states, in addition to the one mentioned above, with which the resident will
be expected to gain facility through literature review, topic discussion, and direct patient care
experience include:
Hyperlipidemia, Hypertension, Atrial Fibrillation, Congestive Heart Failure, Chronic Obstructive
Pulmonary Disease, Peptic Ulcer Disease, Gastroesophageal Reflux Disease, Epilepsy,
Thyroid Disease, Arthritis, Infectious Diseases, Benign Prostatic Hyperplasia, Influenza
Immunizations and Smoking Cessation.
Anticoagulation Clinic Experience – VA Hospital
AREAS OF EMPHASIS
The resident is expected to understand the pharmacotherapy related to these disease states
as well as other disease states encountered in this setting. The preceptor or designee will be
available to the resident throughout the learning experience for consultation and topic
discussions. Resident learning is predicated not only on the above responsibilities but also on
acceptance of personal responsibility and dedication to direct patient care and team service.
ACTIVITIES AND RESPONSIBILITIES
Competencies
1. Clinical Skills
A. Appropriately identify real and potential drug therapy problems. (R2)
B. Construct appropriate patient pharmacotherapy plans. (R1.2.1, R2)
C. Appropriately assess the patient’s status and monitor response to therapy. (R2.7 –
2.11)
D. Apply pharmacokinetic principles to make dosing recommendations. (R2)
E. Describe the pathophysiology, clinical presentation, and appropriate therapies for each
patient. (R2)
F. Collect and analyze patient data in accordance with current standards of practice,
including use of primary literature. (R2)
G. Demonstrate a knowledge of drug classes, mechanisms of action, common adverse
effects, drug-drug, drug-diet, drug-disease interactions, monitoring parameters, and
therapeutic endpoints. (R2, R6)
H. Appropriately document clinical findings and interventions. (R2.12)
I. Demonstrate a working knowledge of non-drug therapies and alternative therapies. (R2)
J. Demonstrate the ability to effectively understand and interpret the medical management
of a patient and communicate the work-up of the patient and an assessment of the drug
therapy decisions in a case presentation. (R1.2.1, R2, R5)
K. Obtain and record a complete medication history. (R2, R5)
L. Obtain and record each patient’s home medications. (R2, R5)
2. Information Resources
A. Effectively use drug information resources. (R6)
B. Apply drug literature appropriately in patient care decisions. (R2, R6)
C. Supplement textbook knowledge with primary literature for use in patient care
decisions. (R2, R6, R1.2.1)
3. Communication Skills
A. Effectively communicate, verbally and in writing (e.g., consultations, progress notes, drug
information responses and other documents), with other health care professionals
(pharmacists, physicians, nurses, etc.) about therapeutic plans, other patient care needs,
and health care issues. (R2.11, R5)
B. Articulate and support drug therapy recommendations. (R1.2.1, R5, R6)
C. Write patient care notes/documents that: (R2.12, R5)
i. Are accurate, logical, yet only pertinent information
ii. Provide complete drug therapy directions (dosage, route, frequency, duration,
monitoring parameters, and time of follow up)
iii. Use correct terminology, spelling, and grammar.
Anticoagulation Clinic Experience – VA Hospital
ACTIVITIES AND RESPONSIBILITIES
D. Effectively communicate patient and/or medication self-management information to patients
and health professionals. (R2.8.1, 2.11, R5)
E. Deliver appropriate and effective patient counseling skills. (R2.11, R5)
4. Professional Ethics and Identity:
The resident shall behave ethically. The resident shall accept the responsibilities embodied in
the principles of pharmaceutical care. (R3.1.3, 3.2.2)
a. Make appropriate ethical and legal decisions.
b. Accept responsibility and provide patient-centered care.
c. Maintain excellence in personal practice.
d. Exhibit a professional demeanor.
e. Conduct direct patient care activities using a consistent approach that reflects the
philosophy of primary care as well as pharmacy practice.
5. Drug Therapy Assessment:
The resident shall assess the appropriateness of patient's drug therapy, including
consideration of the chemical, pharmaceutical, pharmacokinetic, and pharmacological
characteristics of the administered medications. . (R1.2.1, R2)
A. Assess each acute and chronic medical problem. (R1.2.1, R2)
B. Identify the following drug-related problems: (R1.2.1, R2)
i. Drug therapy is needed for untreated indications.
ii. Patient is receiving a drug that has no indication and/or there is therapeutic
duplication.
iii. There is a better choice of drug based on patient/disease characteristics, formulary,
cost, etc.
iv. Drug therapy needs optimization (population and patient-specific pharmacokinetic
and pharmacodynamic data indicate a drug regimen is not optimized).
v. Medication nonadherence.
vi. Drug induced disease/medical conditions.
vii. Socio-behavioral and economic barriers to effective drug therapy.
viii. Adverse drug reactions that are substantiated by laboratory, test, and physical
findings.
ix. Routes of administration that are not the best, safest, and most cost-effective.
x. Drug interactions that are substantiated with pharmacokinetic/dynamic and
compatibility information.
C. Identify and evaluate each drug-related problem. (R1.2.1, R2)
D. Prioritize drug-related problem list. (R1.2.1, R2)
6. Develop, Implement, and Monitor Drug Therapy Plans:
The resident shall develop a therapeutic plan for the patient, which includes appropriate
monitoring to address any problem identified. (R1.2.1, R2)
A. Establish desired therapeutic outcomes.
B. Consider drug and non-drug therapy alternatives.
C. Develop drug therapy plans that are patient-specific, comprehensive, logical, practical,
consider current evidence-based medicine recommendations, include strategies for
prevention, and include patient education.
Anticoagulation Clinic Experience – VA Hospital
ACTIVITIES AND RESPONSIBILITIES
D. Establish a plan for therapeutic drug monitoring that includes accurate documentation of
population and patient-specific parameters, dosing history/administration times, monitoring
parameters, and daily SOAP notes/plans.
E. Develop and implement the pharmacotherapeutic plan promptly, efficiently, accurately, and
effectively.
F. Use an effective patient monitoring system.
G. Monitor the patient and follow up at appropriate intervals.
H. Revise drug therapy plans on an ongoing basis.
I. Ensure continuity of pharmaceutical care to and from the acute and ambulatory care patient
care settings.
7. Presentations/Projects:
A. Oral Presentation: The resident will be responsible for one presentation, with topic approval
by the preceptor, and must pertain to drug therapy and disease management in
anticoagulation, hyperlipidemia, immunizations or smoking cessation. This will be
presented to the pharmacy staff, residents, and pharmacy students. (R5)
B. Demonstrate appropriately the use of devices commonly encountered in the primary care
setting, including: (R4, E1)
Metered Dose Inhalers/Dry Powder Inhalers
Peak Flow Meters
Spacers
Injection Techniques (subcutaneous and intramuscular)
Blood Pressure Monitors
8. Other Responsibilities:
A.
Perform self-assessments by: corroborating midpoint and final rotation self-assessment
ratings with those of the instructor, performing a self- assessment of each document,
and writing a reflective self-evaluation at the end of the rotation. (R3.1.1)
B.
Demonstrate professional written communication skills by thorough documentation of
patient information in the patient’s record. (R5)
C.
Review appropriate literature to prepare for topic discussions. (R5, R6)
D.
Attend and contribute to all topic discussions. (R5, R6)
E.
Record recommendations made and drug information given to all health care
professionals daily. (R2.12, R5)
F.
Conducting administrative activities to ensure continual performance of the clinics in an
efficient manner. R3.1.3, 3.2.1, 3.2.2, 3.2.3,3.2.4, 3.3.3, 3.3.4)
G.
Reviewing and updating protocols as deemed necessary by the preceptor. (R1.2.1)
H.
Researching and writing functional protocols when applicable to current clinic
requirements. (R1.2.1, R6, R5)
I.
Actively serving as a preceptor for pharmacy student(s) which includes teaching
therapeutic principals, facilitating case discussions, and guiding clinical activities.(R5)
Competency-Based Learning Goals and Corresponding Objectives
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Anticoagulation and Asthma Clinics Experiences
Competency-Based Learning Goals and Corresponding Objectives
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
REQUIRED READINGS
1.
2.
3.
The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy:
Evidence-Based Guidelines (CHEST Guidelines)
National Cholesterol Education Program Adult Treatment Panel III Guidelines
Readings also assigned daily during rotation.
Ambulatory Care Clinics Experience - VA
Primary Preceptor: Erika A. Webster, Pharm.D, BCPS, CDE
Clinical Assistant Professor, Department of Pharmacy Practice,
University of Mississippi Medical Center
Office Phone:
(601) 362-4471 ext. 6764
Cell Phone:
(601) 291-9817
Digital Pager:
(601) 929-3145
E-mail:
webster.erika@gmail.com
Additional Preceptors:
Margaret Pitcock, PharmD, BCPS, CDE
Billy Brown, Pharm D, BCPS
SITE:
Ambulatory Care Clinics
G.V. (Sonny) Montgomery VA Medical Center
Department of Pharmacy Services
1500 E. Woodrow Wilson Drive
Jackson, MS 39216
Introduction to the Site
The Jackson VA Medical Center provides primary, second and tertiary medical, neurological
and mental health inpatient care as well as both primary and specialized outpatient services. A
120-bed nursing home care unit, community nursing homes, three 150-bed state veterans’
nursing homes, VA community clinics, and a variety of outpatient programs are utilized to
support the needs of aging veterans.
Parking
Paved lot east of the center (behind the Research and Education building, near the water
tower). Violations of such policy are subject to disciplinary action, Federal Violations Notice, or
towing at owner’s expense.
PURPOSE:
To gain knowledge and clinical experience in the ambulatory care
setting using a multidisciplinary team approach to disease
management and treatment of primary care disease states. To gain
knowledge and clinical experience in development of problemsolving and communication skills, with an emphasis on effective
patient assessment and education techniques. The resident will
participate as an active member of a collaborative health care
team, primarily dealing with diseases such as hypertension,
dyslipidemia, diabetes, obesity, anticoagulation, depression and
HIV/ AIDS.
AREAS OF EMPHASIS
1. Training in the appropriate management and assessment of the ambulatory care patient.
(R2 and R5 inclusive)
2. Training in the appropriate measurement and assessment of blood pressure and other
physical assessments (R2 inclusive, R5.1.1)
3. Management of commonly encountered ambulatory care disease states to include but not
limited to: hypertension, diabetes, dyslipidemia, depression and other mental health disease
states, COPD and asthma, CHF, CVA/ TIA, thyroid disorders, HIV/AIDS, Men’s health (BPH),
hepatitis and chronic kidney disease. (R2.1-2.12 inclusive, R5.1.1)
4. Assessment, management and documentation of medication intolerances and adverse drug
reactions in the ambulatory care patient. (R1.1.2, R1.1.3)
5. Assessment of medication adherence and all obstacles that influence adherence including
access to medications. (R2.1-2.12 inclusive, R5.1.1)
6. Assessment of indications for and appropriate administration of seasonal and nonseasonal
vaccinations, including all required documentations. (R1.1.2, R1.3.3, R1.3.4, R2.1-2.12
inclusive, R5.1.1)
7. Provide patient education regarding disease states, pharmacological interventions and
lifestyle intervention. (R1.1, R2.1-2.12 inclusive, R5.1.1, R5.1.5, R5.1.6, R6.1.1, R6.1.3)
8. Educate other health care providers in both formal and informal settings (by daily
interactions, documentation in patient records, providing formal topic presentations). (R3.1.13.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
9. Documentation of all encounters and interventions in the permanent medical record.
10. Help in maintaining the accuracy of all patients’ medication profiles and clinical records.
(R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1, R6.1.3)
11.Participate in community activities including health fairs, educational sessions, and other
outreach efforts. (R2.4.2, R2.4.3, R3.1, R5.1.1, R5.1.5, R5.1.6)
12. Assist with ambulatory blood pressure measurements as needed. (R2)
13. Participate in journal reviews and other ongoing internal and external educational efforts as
the opportunity arises. (R3.1.1-3.1.3, R5.1.1, R5.1.3-5.1.6 inclusive)
14. Assist with all medication sample coordination including medication selection, dispensing,
recording and counseling. (R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1)
15. Attend all internal and external activities and programs that would be expected as part of
the clinic health care team or professional pharmacy involvement (for example, weekly Grand
Rounds and pharmacy meetings). (R3.1 inclusive, R5.1.1)
16. Assist with all necessary clinical and operational aspects of daily functions. (R1.1.2,
R1.1.3, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3, R3.3.1-3.3.3, R5.1.1)
17.Exercise leadership and initiative in a collaborative environment. (R3.1.1, R3.1.2, R3.1.3,
R3.3.1-3.3.3)
18. Assist with student coordination, supervision, training, and instruction, serving as a
pharmacy practice role model at all levels of contact. (R3.1, R3.3, R5.1.1, R5.1.3-5.1.6
inclusive)
COMPETENCY-BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4:
Goal R2.5:
Goal R2.6:
Goal R2.7:
Goal R2.8:
Goal R2.9:
Goal R2.10:
Goal R2.11:
Goal R2.12:
Collect and analyze patient information.
When necessary, make and follow up on patient referrals.
Design evidence-based therapeutic regimens.
Design evidence-based monitoring plans.
Recommend or communicate regimens and monitoring plans.
Implement regimens and monitoring plans.
Evaluate patients’ progress and redesign regimens and monitoring plans.
Communicate ongoing patient information.
Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBITIES
1. Serve as an integral member of the clinic team. Assist with all necessary clinical and
operational aspects of daily functions including assisting with patient calls as requested
by clinic providers (physician, nurse, practitioner, and pharmacist). Interact and
communicate effectively with providers and staff within the clinic. (R1.1.2, R1.1.3,
R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3, R3.3.1-3.3.3, R5.1.1)
2. Make pharmacologic and nonpharmacologic recommendations regarding therapy based
on all relevant considerations. Counsel patients and assess understanding of both
pharmacologic and nonpharmacologic therapy and disease states. Follow-up with
communication regarding lab results and any changes in medication regimens. This
shall include management of commonly encountered ambulatory care disease states to
include but not limited to: hypertension, diabetes, dyslipidemia, depression, HIV/AIDS,
men’s health, thyroid, and chronic kidney disease. (R2.1-2.12 inclusive, R5.1.1)
3. Help with assessment, management and documentation of medication intolerances and
adverse drug reactions in all patients. (R1.1.2, R1.1.3)
4. Continually assess medication adherence and all obstacles that influence adherence
including access to medications for all patients. (R2.1-2.12 inclusive, R5.1.1)
5. Provide immunizations, including assessment of indications for and appropriate
administration of seasonal and nonseasonal vaccinations. Provide all required
documentations. (R1.1.2, R1.3.3, R1.3.4, R2.1-2.12 inclusive, R5.1.1)
6. Help identify and maintain patient education resources within the clinic. (R1.1, R2.12.12 inclusive, R5.1.1, R5.1.5, R5.1.6, R6.1.1, R6.1.3)
7. Prepare a formal presentation detailing or reviewing pharmacotherapy (topic will be a
primary care issue approved by the preceptor). Other presentations may be performed
as assigned. (R3.1.1-3.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
8. Serve as a drug information resource for the clinic utilizing evidenced-based medicine
as well as current literature. Perform literature searches as requested. Educate other
health care providers in both formal and informal settings (by daily interactions,
documentation in patient records, and providing formal topic presentations). (R3.1.13.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
9. Review patient records prior to providing care and, when indicated, as a screening for
clinical trials. Document all encounters and interventions in the permanent medical
record. (R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1,
R6.1.3)
10. Interview patients, obtaining a complete medication history, including changes in
therapy, efficacy, adverse effects, drug interaction and allergies. Assist in maintaining
the accuracy of all patients’ medication profiles and clinical records. (R1.1.2, R1.1.3,
R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1, R6.1.3)
11. Participate in community activities including health fairs, educational sessions, and
other outreach efforts. (R2.4.2, R2.4.3, R3.1, R5.1.1, R5.1.5, R5.1.6)
12. Participate in journal reviews and other ongoing internal and external educational efforts
as the opportunity arises. (R3.1.1-3.1.3, R5.1.1, R5.1.3-5.1.6 inclusive)
13. Interact with providers to ensure patients have prescriptions and refills on all
medications, including assistance with patient and pharmacy calls, enrollment in
medication assistance programs or communication with third party sources if applicable.
(R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1)
14. Attend all internal and external activities and programs that would be expected as part
of the clinic health care team or professional pharmacy involvement (for example,
weekly Grand Rounds and pharmacy meetings). A schedule will be provided at the
beginning of each rotational experience. (R3.1 inclusive, R5.1.1)
15. Maintain a positive attitude, the highest ethical standards, and a mutual respect for all
those encountered in the clinic. Practice leadership and initiative in a collaborative
environment. (R3.1.1, R3.1.2, R3.1.3, R3.3.1-3.3.3)
16. Assist in teaching of pharmacy students on rotation when applicable, including student
coordination, supervision, training, and instruction and serving as a pharmacy practice
role model at all levels of contact. (R3.1, R3.3, R5.1.1, R5.1.3-5.1.6 inclusive)
17. Complete all assigned projects prior to the end of the rotation. (R3)
REQUIRED READINGS
1.
JNC 7
2.
NCEP III & Updates
3.
Chest Guidelines
4.
Diabetes Care Standards (ADA, NKF Guidelines)
5.
Asthma and COPD Guidelines
6.
Smoking cessation
7.
Obesity
8.
Thyroid disorders
9.
CHF, Hepatitis; CVA
10.
HIV/AIDS management
11.
Mental health
12.
Men’s Health – BPH
13.
Others as determined by preceptor
CARDIOMETABOLIC CLINIC AMBULATORY EXPERIENCE
PRECEPTOR:
Daniel M. Riche, Pharm.D., BCPS, CDE
Assistant Professor, Departments Pharmacy Practice and Medicine
Work Phone: 601-984-2640
Home Phone 601-937-1765
Pager: 601-471-1379
Fax: 601-984-2618
Email: driche@umc.edu
PURPOSE:
To gain knowledge and clinical experience in the ambulatory management
of patients in a multidisciplinary team approach for cardiometabolic
disease. To gain knowledge and clinical experience in the management of
diabetes, hyperlipidemia, and hypertension (as well as other disease
states). The resident will also gain experience in teaching by providing
pharmaceutical information to a variety of health care professionals in
different stages of training to include pharmacists, medical, pharmacy and
nursing students, medical and pharmacy residents and nurse
practitioners. Patient education is emphasized on an individual patient
basis. The resident will also develop and improve teaching skills in an
academic setting. This is an option of the required Medicine experience.
PRACTICE SITE:
University of Mississippi Medical Pavilion, Jackson, Mississippi
University of Mississippi School of Pharmacy, Jackson, Mississippi
Areas of Emphasis
1. Drug literature evaluation as it pertains to ambulatory care, including application of
evidence-based research and outcomes to patient specific situations. (R6)
2. Limited physical assessment of the patient in the Cardiometabolic Clinic. (R2.4.1)
3. Establishment and management of pharmacy clinical services, with a focus on protocol
development/review, implementation, reimbursement, and maintenance issues. (R1.2.1,
R3.2.1, R3.2.3)
4. Understanding of ambulatory care pharmacology and monitoring therapeutic effect.
(R2.7.1)
5. Communication with health care providers and patient education techniques. (R2.8.1,
R2.11.1, R2.11.2)
6. Recommending pharmacological management taking into consideration drug
interactions, side effects, and disease state management based on cardiometabolic
medicine. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R 2.9.2, R2.10.1, R2.10.2, R2.11.1
R2.11.2)
7. Management of adult hypertensive patients. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1,
R2.9.2, R2.10.1, R2.10.2, R2.11.2)
8. Management of adult non-insulin dependent and insulin dependent diabetic patients.
(acute ingestions both accidental and intentional; snake bites; illicit drug ingestions).
(R1.2.1, R2.4.1, R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.1,
R2.11.2)
9. Management of a familial hyperlipidemic patient. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1,
R2.9.2, R2.10.1, R2.10.2, R2.11.2)
Cardiometabolic Clinic Experience continued
Areas of Emphasis
10. Management of acute disease states to include but not limited to: PE/DVT; AMI; cardiac
arrhythmias; HF exacerbation; hyperglycemic crisis. (R1.2.1, R2.4.1, R2.4.2, R2.6.1,
R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2, R2.12.1)
11. Management of non-metabolic disease states as perceived by the patient to include but
not limited to: STD’s; flu like symptoms; otitis media; rashes; etc. (R1.2.1, R2.4.1,
R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
12. Management of Adverse Drug Reaction (ADR) in the ambulatory patient. Also
participate in reporting of ADR’s. (R1.1.1, R1.1.2, R1.1.3)
13. Management of acute and chronic pain to include but not limited to: sickle cell pain;
chronic back pain; migraine headaches; cancer pain; etc. (R2.4.1,R2.4.2, R2.6.1,
R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R 2.11.2)
14. Administration techniques for oral, subcutaneous, intramuscular, and topical
medications. (R2.2.1)
15. Documentation of specific interventions in the medical record. (R2.12.1, R2.12.2,
R2.12.3)
16. Participate in performance improvement in the Cardiometabolic clinic. (R1.1.3, R1.4.1)
17. Provide patient education pertaining to disease state and pharmacological
management. (R2.12, R5.1)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication use system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members of
the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.11: Communicate ongoing patient information.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1: Provide effective medication and practice-related education, training, or counseling
to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Cardiometabolic Clinic Experience continued
ACTIVITIES AND RESPONSIBILITIES (include, but are not limited to)
1. Serve as a drug information resource utilizing evidence based medicine. Provide responses
to questions in a timely manner.(R6.1.1, R6.1.2 R6.1.3)
2. Serve as an integral member of the interdisciplinary clinic team, interacting and
communicating effectively and professionally with health care professionals and patients
(R2.1.1, R2.3.1, R5)
3. Participate in the management of diabetes, dyslipidemia and hypertension in the
Cardiometabolic Clinic by recommending initial pharmacotherapy (including herbal
supplementation), identifying therapeutic goals, and modifying current medication therapy.
Consider the addition of non-pharmacologic methods (e.g., dietary adjustments, exercise
encouragement and direction, appropriate referral, and smoking cessation counseling).
(R2.2.1, also R2.4 – 2.12 all inclusive of goals and objectives)
4. Monitoring patients for appropriate and inappropriate responses to treatment (R2.7 – 2.10)
5. Attend and present monthly Ambulatory Care Journal Club. (R2.1.1, R2.3.1, R6.1.1R6.1.3)
6. Documenting direct patient care activities in the electronic medical record (R2.12)
7. Complete assigned projects prior to end of rotation. (R6, R3.1.1)
8. Prepare a formal presentation for the Ambulatory Care Grand Rounds detailing or
reviewing pharmacotherapy (topic will be a primary care issue approved by the preceptor).
Other presentations may be performed as assigned. (R5, R6)
9. Assist in teaching of pharmacy students on rotation when applicable. (R5)
10. Establish a relationship and counsel patients, assessing an understanding of both
pharmacologic and non-pharmacologic therapy. Follow-up with communication regarding
lab results, prior authorizations, phone calls, refills, and any changes in medication
regimens. (R2)
11. Identifying medication therapy problems and approaches to resolving these problems
(2.10)
12. Assist in continually expanding the credibility and scope of clinical pharmacy services in the
Medical Pavilion. Become a valuable member of the team by assisting in any aspect of
medication therapy (R1.2)
13. Perform a quality assurance project prior to the end of the rotation (R1.1, R1.2)
14. Assess drug–drug, drug–food, and drug–disease interactions. Conduct Medication
Reconciliation by interviewing the patient or family members or contacting their pharmacies
(R2.2.1, also R2.4 – R2.12 all inclusive of goals and objectives)
15. Administer medications by various routes: PO; SL; IM; subcutaneous; topically; rectally and
nebulization, if necessary (e.g., hypertensive urgency, hyperglycemic crisis, angina, or
vaccination). (R2.2.1, also R2.4 – R2.12 all inclusive of goals and objectives)
16. Understand and adjust continuous insulin infusion pumps for diabetes. (R6.1)
17. Participate in Problem-Based Learning series, if applicable (R5)
18. Understand invasive and non-invasive monitoring and its relationship to pharmacotherapy,
particularly mediation adjustment based on the findings. (R2 in its entirety)
19. Perform limited physical assessments (e.g., lungs, blood pressure, heart rate, respiratory
rate, temperature) of the patients to assist with therapeutic interventions. (R2.4.1)
Cardiometabolic Clinic Experience continued
REQUIRED READINGS
1. Cardiometabolic Clinic Protocol - Provided
2. Pharmacology and Management of the Vitamin K Antagonists: American College of Chest
Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest 2008; 133;
160-198 – Available at Rowland Medical Library
3. Executive Summary: American College of Chest Physicians Evidence-Based Clinical
Practice Guidelines (8th Edition) Chest 2008; 133;71-109 – Available at Rowland Medical
Library
4. American Diabetes Association: Clinical Practice Recommendations 2009. Standards of
Medical Care in Diabetes – 2009 – Available at Rowland Medical Library
5. Ray KK, Seshasai S, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D, et al. Effect of
intensive control of glucose on cardiovascular outcomes and death in patients with diabetes
mellitus: a meta-analysis of randomized controlled trials. Lancet 2009: 373; 1765-72 –
Available at Rowland Medical Library
6. Gerich JE, Odawara M, Terauchi Y. The rationale for paired pre- and postprandial selfmonitoring of blood glucose: the role of glycemic variability in micro- and macrovascular
risk. Curr Med Res Opin 2007;23(8):1791-8 – Available at Rowland Medical Library
7. Nissen SE and Wolski K. Effect of Rosiglitazone on the Risk of Myocardial Infarction and
Death from Cardiovascular Causes. N Engl J Med. June 14, 2007; 356: 2457-71 –
Available at Rowland Medical Library
8. American Diabetes Association. Management of hyperglycemia in type 2 diabetes: A
consensus algorithm for the initiation and adjustment of therapy. Diabetes Care 2009; 32:
193-203 – Available at Rowland Medical Library
9. The Executive Summary of the Third Report of the National Cholesterol Education Expert
Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult
Treatment Panel III) – Available at Rowland Medical Library
10. Grundy SM, Cleeman JI, Merz CN, et al for the Coordinating Committee of the NCEP.
Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult
Treatment Panel III Guidelines. Circulation. 2004;110:227-239 – Available at Rowland
Medical Library
11. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure: The JNC 7. JAMA. 2003;289:2560-2571 –
Available at Rowland Medical Library
12. Rosendorff C, Black HR, Cannon CP, Gersh BJ, Gore J, Izzo JL, et al. Treatment of
hypertension in the prevention and management of ischemic heart disease. A scientific
statement from the American Heart Association Council for High Blood Pressure Research
and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation
2007; 115: 2761-88 – Available at Rowland Medical Library
13. Micromedex™ and Poisondex™ – Available on UMMC Intranet
Cardiometabolic Clinic Personnel
Daniel M. Riche, Pharm.D., BCPS, CDE
Marion Wofford, MD, MPH
Lorraine K. Findley, RN
\
CRITICAL CARE EXPERIENCE – MICU
PRECEPTOR:
Katherine Artman, Pharm D
Work Phone: 601-815-1478 (SICU Pharmacy)
Pager: 601-929-4019
Fax: 601-815-8835
Email: klutz@umc.edu
PRACTICE SITE:
University of Mississippi Medical Center, Jackson, MS
Wallace Conerly Critical Care Tower – Neurosurgical Intensive Care Unit
PURPOSE: The Critical Care Experience is a 4-week rotation offered at University of
Mississippi Medical Center in the Medical Intensive Care Unit (MICU). It is one of
option of the required Critical Care Experiences. It is designed to integrate the
application and synthesis of didactic information to the day-to-day activities of an
intensive care clinical pharmacist. This experience will allow the student to
interact with patients, round daily with the internal medicine residents/ pulmonary
fellows, and interact with other health care practitioners in matters concerning
drug therapy, monitoring, evaluation, and education. The resident will become
part of the healthcare team whose goal is the well-being and successful
management of the problems and diseases of the critically ill patients.
GOALS
1. To provide an opportunity for the resident to apply basic knowledge in a variety of practical
critical care patient care settings.
2. To expose the resident to the effects of drugs and disease states in the critically ill and
allow him/her the opportunity to observe and participate in the decision making process
which will lead to rational drug therapy.
3. To prepare the resident to effectively communicate with other healthcare professionals as
related to drug information and to provide medical resident, pulmonary fellow, patient, and
family education.
AREAS OF EMPHASIS
1. Pulmonary: ARDS; community, aspiration, nosocomial pneumonia; PE; asthma
exacerbation; drug-induced lung disease; acute respiratory failure; CF.
2. Autoimmune: lupus erythematosus
3. Cardiology: arrhythmias; CHF exacerbation; AMI; UA; hypertensive emergency; DVT.
4. Neurology: myasthenia gravis; head trauma; CVA; status epilepticus.
5. Hematology/Oncology: DIC; drug-induced blood dyscrasias; sickle cell anemia crisis; CA;
BMT.
6. Dermatology: burns; SJS; TENS.
7. Endocrinology: pheochromocytoma; thyroid storm; acute adrenal insufficiency; DKA/
NKHOC; hypoglycemia.
8. Gastroenterology: esophageal varices; hepatorenal syndrome; GI bleeding; stress
ulceration; pancreatitis; liver failure; portal hypertension; hepatitis.
9. Nephrology: rhabdomyolysis; acute/chronic renal failure; acid-base; nutrition imbalance;
fluid/electrolyte disorders; diabetes insipidus; SIADH; conventional HD; CRRT.
Critical Care Experience
Areas of Emphasis
10. Infectious Disease: meningitis/encephalitis; nosocomial infections; pneumonia; HIV/AIDS;
sepsis; SIRS; wound/surgical infection, endocarditis; opportunistic infections; fungal
infections.
11. Shock: cardiogenic; septic; hemorrhagic; and neurogenic shock; MODS.
12. Analgesia/Anesthesia: acute/chronic pain; opioid tolerance/withdrawal/addiction;
paralyzation, sedation.
13. Toxicology: medication overdose(especially acetaminophen).
14. Psychiatry: ICU psychosis; drug-induced psychosis; neuroleptic malignant syndrome;
agitation/anxiety; substance abuse; alcohol withdrawal syndrome.
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Critical Care Experience
ACTIVITIES AND RESPONSIBILITIES
Competencies
Clinical Skills:
a. Appropriately identify real and potential drug therapy problems. (R2.4.2)
b. Construct appropriate patient pharmacotherapy plans. (R2.4.1)
c. Appropriately assess the patient’s status and monitor response to therapy.
(R2.7.1)
d. Apply pharmacokinetic principles to make dosing recommendations. (R2.10)
e. Describe the pathophysiology, clinical presentation, and appropriate therapies for
each patient. (R2.4.1,2.4.2)
f. Collect and analyze patient data in accordance with current standards of
practice, including use of primary literature. (R2.4.1)
g. Demonstrate knowledge of drug classes, mechanisms of action, common
adverse effects, drug-drug, drug-diet, drug-disease interactions, monitoring
parameters, and therapeutic endpoints. (R2.4, 2.7.1, 2.11.2)
h. Appropriately document clinical findings and interventions. (R2.12)
i. Evaluate drug orders for accuracy and safety. (R1.3.1)
j. Demonstrate a working knowledge of non-drug therapies and alternative
therapies. (R2.4.2)
k. Demonstrate the ability to effectively understand and interpret the medical
management of a patient and communicate the work-up of the patient and an
assessment of the drug therapy decisions in a case presentation. (R2.6.2, 2.8.1,
2.10)
Information Resources:
1. Effectively use drug information resources. (R6.1 – 6.3)
2. Apply drug literature appropriately in patient care decisions. (R6.1 – 6.3)
3. Supplement textbook knowledge with primary literature for use in patient care decisions.
(R6.1- 6.3)
Communication Skills:
1. Appropriately communicate orally and in writing with other health care professionals.
(R5.1.4- 5.1.6)
2. Demonstrate the appropriate level of professionalism during projects and case
presentations. (R5.1.4- 5.1.6)
Presentations/Projects:
1. Oral Presentation: The resident will be responsible for one presentation, with topic
approval by the preceptor, and must pertain to drug therapy and disease management
in critical care. This will be presented to the pharmacy staff, residents, and pharmacy
students. (R5.1.5)
2. Internal Medicine Resident Presentation: The resident will also give an oral
presentation to the internal medicine residents, pulmonary fellows and pulmonary
attending on a drug therapy topic of choice during the rotation. (R5.1.5)
3. Critical Care Project: During the experience, the resident will be responsible for a
project that pertains to critical care. Projects may include nursing inservices, medication
Critical Care Experience
ACTIVITIES AND RESPONSIBILITIES
Competencies
safety tips, compatibility charts, presentation of a device, medication admixture, etc. (R4)
Other Responsibilities:
1. Attend and actively participate in MICU rounds daily with Internal Medicine residents and
pulmonary fellows. (R2.1, 2.8,2.10, 2.11)
2. Monitor all patients daily including labs, cultures, MD notes, current medications, especially
antibiotics days. (R2.4.1, 2.4.2, 2.4.3, 2.7.1)
3. Record recommendations made on rounds and drug information given to all health care
professionals daily. (R2.1.1, R6)
4. Obtain home medications on all new admissions to the MICU. (R2.4.2)
5. Observe critical care procedures: central line placement, lumbar puncture, bronchoscopy,
EGD, Swan-Ganz catheter placement, NG/OG placement, ACLS in code situations, chest
compressions, echocardiogram, ABG lab draw, arterial line placement, intubation, etc. (R2)
REQUIRED READINGS:
Reading assigned daily during rotation.
CRITICAL CARE EXPERIENCE – SICU
PRECEPTOR:
Eric Boone, Pharm D
Work Phone: 601-815-1478 (SICU Pharmacy)
Pager: 601-929-0906
Fax: 601-815-8835
Email: tboone@umc.edu
PRACTICE SITE:
University of Mississippi Medical Center, Jackson, MS
Wallace Conerly Critical Care Tower – Surgical and Neuroscience
Intensive Care Units
PURPOSE: The Critical Care Experience is a 4-week rotation offered at University of
Mississippi Medical Center in the Surgical and Neuroscience Intensive Care
Units (SICU/NSICU). It is designed to integrate the application and synthesis of
didactic information to the day-to-day activities of an intensive care clinical
pharmacist. This experience will allow the student to interact with patients, round
daily with residents/fellows, and interact with other health care practitioners in
matters concerning drug therapy, monitoring, evaluation, and education. The
resident will become part of the healthcare team whose goal is the well-being
and successful management of the problems and diseases of the critically ill
patients. It is one option of the required Critical Care Experiences.
GOALS
1. To provide an opportunity for the resident to apply basic knowledge in a variety of
practical critical care patient care settings.
2. To expose the resident to the effects of drugs and disease states in the critically ill and
allow him/her the opportunity to observe and participate in the decision making process
which will lead to rational drug therapy.
3. To prepare the resident to effectively communicate with other healthcare professionals
as related to drug information and to provide medical resident, pulmonary fellow,
patient, and family education.
AREAS OF EMPHASIS
1. Pulmonary: ARDS; aspiration, nosocomial pneumonia; PE; acute respiratory failure;
2. Cardiology: arrhythmias; UA; hypertensive emergency; DVT.
3. Neurology: myasthenia gravis; head trauma; CVA; status epilepticus.
4. Hematology/Oncology: DIC; CA.
5. Dermatology: burns; SJS; TENS.
6. Endocrinology: pheochromocytoma; thyroid storm; acute adrenal insufficiency;
hypoglycemia.
7. Gastroenterology: hepatorenal syndrome; GI bleeding; stress ulceration; pancreatitis;
liver failure; portal hypertension; total parenteral nutrition.
8. Nephrology: rhabdomyolysis; acute/chronic renal failure; acid-base; nutrition
imbalance; fluid/electrolyte disorders; diabetes insipidus; SIADH; conventional HD;
CRRT.
9. Infectious Disease: meningitis/encephalitis; nosocomial infections; pneumonia; sepsis;
SIRS; wound/surgical infection, endocarditis; opportunistic infections; fungal infections.
10. Shock: cardiogenic; septic; hemorrhagic; and neurogenic shock; MODS.
11. Analgesia/Anesthesia: acute/chronic pain; opioid tolerance/withdrawal/addiction;
paralyzation, sedation.
12. Psychiatry: ICU psychosis; drug-induced psychosis; neuroleptic malignant syndrome;
agitation/anxiety; substance abuse; alcohol withdrawal syndrome.
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Critical Care Experience
ACTIVITIES AND RESPONSIBILITIES
Competencies
Clinical Skills:
l.
Appropriately identify real and potential drug therapy problems. (R2.4.2)
m. Construct appropriate patient pharmacotherapy plans. (R2.4.1)
n. Appropriately assess the patient’s status and monitor response to therapy.
(R2.7.1)
o. Apply pharmacokinetic principles to make dosing recommendations. (R2.10)
p. Describe the pathophysiology, clinical presentation, and appropriate therapies for
each patient. (R2.4.1,2.4.2)
q. Collect and analyze patient data in accordance with current standards of
practice, including use of primary literature. (R2.4.1)
r. Demonstrate knowledge of drug classes, mechanisms of action, common
adverse effects, drug-drug, drug-diet, drug-disease interactions, monitoring
parameters, and therapeutic endpoints. (R2.4, 2.7.1, 2.11.2)
s. Appropriately document clinical findings and interventions. (R2.12)
t. Evaluate drug orders for accuracy and safety. (R1.3.1)
u. Demonstrate a working knowledge of non-drug therapies and alternative
therapies. (R2.4.2)
v. Demonstrate the ability to effectively understand and interpret the medical
management of a patient and communicate the work-up of the patient and an
assessment of the drug therapy decisions in a case presentation. (R2.6.2, 2.8.1,
2.10)
Information Resources:
1. Effectively use drug information resources. (R6.1 – 6.3)
2. Apply drug literature appropriately in patient care decisions. (R6.1 – 6.3)
3. Supplement textbook knowledge with primary literature for use in patient care
decisions. (R6.1- 6.3)
Communication Skills:
1. Appropriately communicate orally and in writing with other health care professionals.
(R5.1.4- 5.1.6)
2. Demonstrate the appropriate level of professionalism during projects and case
presentations. (R5.1.4- 5.1.6)
Presentations/Projects:
1. Oral Presentation: The resident will be responsible for at least one presentation, with
topic approval by the preceptor, and must pertain to drug therapy and disease
management in critical care. This will be presented to the pharmacy staff, residents,
and pharmacy students. (R5.1.5)
2. Resident Presentation: The resident will also give an oral presentation to the
residents, fellows and attending on a drug therapy topic of choice during the rotation.
(R5.1.5)
3. Critical Care Project: During the experience, the resident will be responsible for a
project that pertains to critical care. Projects may include nursing inservices,
medication safety tips, compatibility charts, presentation of a device, medication
admixture, etc. (R4)
Other Responsibilities:
1. Attend and actively participate in SICU/NSICU rounds daily with residents and fellows.
(R2.1, 2.8,2.10, 2.11)
2. Monitor all patients daily including labs, cultures, MD notes, current medications,
especially antibiotics days. (R2.4.1, 2.4.2, 2.4.3, 2.7.1)
3. Record recommendations made on rounds and drug information given to all health care
professionals daily. (R2.1.1, R6)
4. Obtain home medications on all new admissions (R2.4.2)
5. Observe critical care procedures: central line placement, lumbar puncture,
bronchoscopy, EGD, Swan-Ganz catheter placement, NG/OG placement, ACLS in code
situations, chest compressions, echocardiogram, ABG lab draw, arterial line placement,
intubation, etc. (R2)
REQUIRED READINGS:
Reading assigned daily during rotation.
INPATIENT DIABETES MANAGEMENT EXPERIENCE
Primary Preceptor:
INACTIVE
Office Number:
Email:
Secondary Preceptors:
Purpose:
The Inpatient Diabetes Management Experience is a 4-week elective rotation offered at Baptist
Health Systems in Jackson, Mississippi. The overall purpose of this rotation is two-fold: to gain
knowledge and clinical experience in disease management and treatment modalities used in
the inpatient setting, with a focus on diabetes and its associated complications and to develop
and improve problem-solving and communication skills, develop effective patient education
techniques, and participate as an active member of a multidisciplinary team. The resident will
also gain experience in teaching by providing pharmaceutical information to a variety of health
care professionals in different stages of training to include, but not limited to, medical,
pharmacy, & and nursing students, medical & pharmacy residents, clinical pharmacists,
physicians, dieticians, and nurse practitioners. Patient education is emphasized on an
individual patient basis.
Practice Site:
Baptist Health Systems
Jackson, Mississippi
Areas of Emphasis:
1.
2.
3.
Participation in collaborative multidisciplinary patient management. (R1.2.1, 2.1.1, 2.3.1)
Patient assessment, including medication and non-medication related factors. (R2, R6)
Laboratory monitoring for therapeutic outcomes and potential adverse effects of
medication therapy. (R2.7-2.11)
4. Monitoring and interpretation of data related to disease management and medication
safety and effectiveness. (R2.7-2.11)
5. Recommendations for initiation and modification in pharmacotherapy based on all
relevant considerations. (R2)
6. Patient education and counseling on both pharmacologic and non-pharmacologic
recommendations and therapy. This includes patient education and counseling on
therapeutic lifestyle changes. (R5, R2.11)
7. Medical record documentation of all interventions and care provided. (R2.12)
8. Identification and evaluation of patient compliance, including barriers such as payer
issues or need for medication assistance. Development of strategies to improve
adherence. (R1.3, R2, R3.2.3)
9. Drug literature evaluation including application of evidence-based research and outcomes
to patient specific situations. (R1.2.1, R2, R6)
10. Establishment and management of pharmacy clinical services, with a focus on protocol
development, implementation, reimbursement, and maintenance issues. (R3.3.2, R1.2.1)
Inpatient Diabetes Management Experience (continued)
Competency-Based Learning Objectives and Goals





Outcome R1: Manage and improve the medication-use process.
o Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy management
with interdisciplinary teams.
o Goal R2.1: As appropriate, establish collaborative professional relationships with
members of the health care team.
o Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
o Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
o Goal R2.4: Collect and analyze patient information.
o Goal R2.5: When necessary, make and follow up on patient referrals.
o Goal R2.6: Design evidence-based therapeutic regimens.
o Goal R2.7: Design evidence-based monitoring plans.
o Goal R2.8: Recommend or communicate regimens and monitoring plans.
o Goal R2.9: Implement regimens and monitoring plans.
o Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
o Goal R2.11: Communicate ongoing patient information.
o Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
o Goal R3.1: Exhibit essential personal skills of a practice leader.
Outcome R5: Provide medication and practice-related education/training.
o Goal R5.1: Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
o Goal R6.1: Use information technology to make decisions and reduce error.
Activities and Responsibilities include, but are not limited to:
1. Serve as an integral member of the interdisciplinary diabetes team (R2.1.1, 2.3.1)
2. Establishing a covenant relationship with each patient requiring direct patient care (R2,
R5)
3. Identifying specific glycemic/therapeutic goals for patients (R2)
4. Obtain complete patient assessment by including the following information: reason for
admission, medical history, social/family history, review of systems, physical
examination, home medications, adherence to therapy, need for medication assistance,
and current diagnosis and treatment (R2)
5. Contact community pharmacies to obtain home medication list if necessary (R2, R5)
6. Monitor patient profiles for appropriateness of therapy, complete therapeutic
management, potential drug-drug/food/disease interactions, and adverse drug effects.
This includes daily lab review to ensure patient safety, therapeutic response to therapy,
and to identify needed changes in therapy (R1.2.1, R2)
7. Identifying medication therapy problems and approaches to resolving these problems
(R2)
8. Initiating or optimizing therapeutic regimens for diabetes and other applicable disease
states/complications according to established protocols (R1.2.1, R2, R6)
9. Ensuring access to medication therapies through completion of appropriate paperwork
for patient assistance (R3.3.2, R1.3)
Inpatient Diabetes Management Experience (continued)
10. Counsel patients and assess understanding of both pharmacologic and nonpharmacologic therapy. Follow-up with communication regarding lab results and any
changes in medication regimens. (R2.11, R5)
11. Documenting direct patient care activities in the medical record (R2.12)
12. Observing patient confidentiality (R3.1.3, 3.2.3)
13. Providing patient-specific and caregiver-specific medication and disease related
education (R2.12, R5)
14. Educate patients on both pharmacologic and non-pharmacologic recommendations
prior to discharge (R2.11, R5)
15. Referring patients to other health care providers as appropriate, including dietician and
diabetes educators (R2.5)
16. Ensuring continuity of care by communicating pertinent information to the provider
responsible for the patient (R2, R2.11, R2.5)
17. Serve as a drug information resource by utilizing evidenced-based medicine as well as
current literature. Perform literature searches as requested. (R6, R5, R2.1.1, 2.3.1)
18. Reviewing, researching, and up-dating/writing functional protocols, when applicable.
(R6, R1.2.1)
19. Actively serving as a preceptor and role model for pharmacy student(s) which includes
teaching therapeutic principals, facilitating case discussions, and guiding clinical
activities (R5.1.3, 5.1.4)
20. Interact and communicate effectively with other providers and staff (R5, R2.1.1, 2.3.1)
21. Provide inservices to the nursing staff or medical staff as necessary (R5, R6)
22. Prepare a formal presentation on inpatient topic of choice to be presented at end of
rotation (R5, R6)
23. Help to continually expand the credibility and scope of pharmacy services. (R3.3.1, 3.2)
24. Continue other research, clinical, and service activities that fall outside the rotation as
required by the residency (R3.1.1, R4, E1)
Required Reading
1. Standards of Medical Care in Diabetes. American Diabetes Association. Available
Online.
2. National Kidney Foundation Guidelines for Diabetes. Available Online.
3. Improving Care of the Hospitalized Patient with Hyperglycemia and Diabetes from the
SHM Glycemic Control Task Force. The Society of Hospital Medicine. Will be provided
by preceptor.
4. MicromedexTM. Available on Intranet.
5. Others as determined by preceptors.
Drug Information and Investigational Studies Experience
Preceptor:
Richard “Buddy” Ogletree, Pharm D
Drug Information Services Supervisor
Chair, Institutional Review Board
Work Phone: 601-984-2056
Pager: 601-929-1090
Fax: 601-984-2063
Email: rogletree@umc.edu
Purpose:
An elective experience to gain knowledge and practical experience in
purpose, practices, and philosophy of the drug information services of a
major teaching hospital. To develop and improve problem-solving and
communication skills, to develop effective education techniques for the
dissemination of information to healthcare professionals and students.
Practice Site:
University of Mississippi Medical Center
Department of Pharmacy Services Drug Information Center
Jackson, Mississippi
Areas of Emphasis
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Appropriate and timely receiving, recording, researching, and responding as applied to
requests for drug information. (R6, R2.12)
Familiarization with and utilization of drug information resources, both bound and
electronic. (R6)
Drug literature retrieval and evaluation. (R6)
Education of healthcare professionals and students as it applies to drug information.
(R5)
Development of personal strategies for keeping current with new information from the
medical and pharmaceutical fields. (R6, 3.1.1, 3.2.2, 3.2.4, R4)
Participation in the IRB training course. (R4, E1)
Review of proposed research for the evaluation of issues of safe and ethical treatment
of research participants. (R4, E1)
Review of proposed research for the evaluation of potential Department of Pharmacy
involvement. (R4, E1)
Evaluation and development of appropriate Department of Pharmacy activities as they
apply to potential research (R4, E1)
Preparation of procedure guides for pharmacy responsibilities of specific research
projects. (R4, E1)
Education of healthcare professionals and students as it applies to Department of
Pharmacy involvement in research. (R5, R6)
Drug Information Experience
Competency Based Learning Goals and Objectives
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R4:
Demonstrate project management skills.
Goal R4.1: Conduct practice-related investigations using effective project management
skills.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce erro
Activities and Responsibilities
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Provide coverage for the Drug Information Center. (R5, R6)
Utilize and optimize documentation techniques for DIC activities. (R6, R5, R2.12)
Evaluation current Drug Information resources and provide suggestions for staying up to
date or current. (R5, R3,2,4, 3.1.1)
Participate in journal club activities with students and preceptor. (R6, 5.1.3, 5.1.5, 5.1.6)
Prepare an article for the Department of Pharmacy newsletter. (R5, R6)
Prepare and present a presentation on New Drugs (R6, R5)
Complete the IRB training course. (R4, E1)
Prepare for and attend a meeting of the Institutional Review Board. (R4, E1)
Attend a PBL group session. (R5.1.3, 5.1.4)
Assist in teaching of pharmacy students on rotation. (R5.1.3, 5.1.4)
Other presentations may be performed as assigned. (R5)
Help to continually expand the credibility and scope of pharmacy services (R3.3.1,
3.3.2, 3.3.4)
Complete assigned projects prior to the end of rotation unless otherwise specified.
(R3.2.4, 3.1.1)
Required Readings
Familiarize self with information sources in the Center
As assigned during the experience
EMERGENCY MEDICINE EXPERIENCE
PRECEPTOR:
Stephanie Tesseneer, PharmD
Clinical Pharmacy Specialist, Emergency Medicine
Assistant Professor, Department Pharmacy Practice
Work Phone: 601-815-4311
Pager: 601-952-5020
Email: STesseneer@umc.edu
PURPOSE:
To gain knowledge and clinical experience in the acute management of
medical and trauma critically ill patients in a multidisciplinary team
approach. To gain knowledge and clinical experience in the management
of toxicology patients, for example overdoses and snakebites. To gain
knowledge in the management of emergencies as perceived by the
patient. The resident will also gain experience in teaching by providing
pharmaceutical information to a variety of health care professionals in
different stages of training to include pharmacists, medical, pharmacy and
nursing students, medical and pharmacy residents and nurse
practitioners. Patient education is emphasized on an individual patient
basis. The resident will also develop and improve teaching skills in an
academic setting. The resident will also assist in providing care through
distance consultation via Telemedicine with the medical staff. This is an
option for the required critical care experience.
PRACTICE SITE:
University of Mississippi Health Care, Jackson, Mississippi
Adult and Pediatric Emergency Departments
Level 1 Trauma Center
Telemedicine locations throughout the state of Mississippi
AREAS OF EMPHASIS
1. Limited physical assessment of the patient in the emergency department. (R2.4.1)
2. Understanding of acute care pharmacology and monitoring therapeutic effect. (R2.7.1)
3. Communication with health care providers and patient education techniques.
(R2.8.1,2.11.1,2.11.2)
4. Drug literature evaluation as pertains to emergency medicine literature. (R6.1.1, R6.1.2)
5. Recommending pharmacological management taking into consideration drug
interactions, side effects, and disease state management based on evidence based
medicine. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R 2.9.2, R2.10.1, R2.10.2, R2.11.1
R2.11.2)
6. Management of adult and pediatric trauma patients. (R2.4.1,R2.4.2, R2.6.1, R2.6.2,
R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
7. Participation and understanding of Disaster Preparedness, including participation in
local, city, and state wide disaster drills. (R1.4.1, R3.3.3, R3.3.4)
8. Participation in the Joint Commission surveys in the Emergency Department. (R3.2.2)
9. Management of the adult and pediatric toxicology patient (acute ingestions both
accidental and intentional; snake bites; illicit drug ingestions). (R1.2.1, R2.4.1, R2.4.2,
R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.1, R2.11.2)
10. Management of the acutely psychotic patient. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1,
R2.9.2, R2.10.1, R2.10.2, R2.11.2)
Emergency Medicine Experience Continued
AREAS OF EMPHASIS
11. Management of adult and pediatric patients in cardiopulmonary arrest or trauma arrest.
(R1.2.1, R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2,
R2.12.1)
12. Management of acute disease states to include but not limited to: PE/DVT; AMI; Sepsis;
Status Asthmaticus; Status Epilepticus; Cardiac Arrhythmias; Shock; Anaphylactic
reactions; Foreign bodies; CHF; Assault both physical and sexual; DKA; Trauma
patients; the burn patient; Spinal Cord injury patients; blood/ body fluid exposures.
(R1.2.1, R2.4.1, R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2,
R2.12.1)
13. Management of non-acute disease states as perceived by the patient to include but not
limited to: STD’s; flu like symptoms; otitis media; rashes; etc. (R1.2.1, R2.4.1, R2.4.2,
R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
14. Management of Adverse Drug Reaction (ADR) in the acute patient. Also participate in
reporting of ADR’s. (R1.1.1, R1.1.2, R1.1.3)
15. Management of acute and chronic pain in the emergency department to include but not
limited to: sickle cell pain crisis; chronic back pain; migraine headaches; etc.
(R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R 2.11.2)
16. Management of patients providing procedural sedation in both pediatric and adult
patients. Also management of adverse events that might occur with procedural sedation
such as paradoxical excitation or respiratory depression or apnea. (R1.2.1, R2.4.1,
R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
17. Management of the patient with acute blunt spinal cord trauma. (R1.2.1, R2.4.1, R2.4.2,
R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
18. Management of patients/ employees that have an exposure to blood and body fluids.
(R1.2.1, R 2.4.1, R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
19. Administration techniques for oral, subcutaneous, intravenous, intramuscular, and
topical medications. (R1.3.3, R1.3.4)
20. Assist with access to medications for patients that are unable to procure them. (R1.3.4)
21. Documentation of specific interventions in the medical record. (R2.12.1, R2.12.2,
R2.12.3)
22. Participate in performance improvement in the pharmacy department as well as
emergency department. (R1.1.3, R1.4.1)
23. Provide patient education pertaining to disease state and pharmacological
management. Documentation of this education intervention on the Patient/Family
Education Form. (R2.12, R5.1.1 through R5.1.6)
24. Interaction with the automated dispensing systems in the emergency areas. (R1.3.4)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Emergency Medicine Experience
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBILITIES
1. Serve as a drug information resource utilizing evidence based medicine. Provide
responses to questions in a timely manner.(R6.1.1, R6.1.2 R6.1.3)
2. Participate in cardiopulmonary arrest and trauma arrest in the adult and pediatric
patient. Actually prepare medications, administer medications, and perform chest
compressions. Learn what medications are compatible at a Y-site of IV tubing(R1.2.1)
3. Assist in therapeutic management of the acutely ill patient, monitor therapy, and modify
therapy and interventions as needed. Recommend vasoactive medications and alter the
dose based on the patient response to the medication or change in hemodynamic
parameters(R2.2.1, also R2.4 – R2.12 all inclusive of goals and objectives)
4. Participate in the management of acute and chronic pain in the Emergency Department
patient by recommending initial medication therapy or modifying current medication
therapy. Consider the addition of non-pharmacologic methods such as water exercise,
physical therapy, TENS units, etc. (R2.2.1, also R2.4 – 2.12 all inclusive of goals and
objectives)
5. Assist in toxicology cases by providing information regarding overdose of a medication
or chemical; identification of the medication as well as pill counts. Provide information
from Posiondex™ found within Micromedex™ to the physicians and nurses. Rounds will
be performed with the Toxicology Service on a patient specific basis. (R2.2.1, R2.4 –
R2.12 all inclusive of goals and objectives )
Emergency Medicine Experience
Activities and Responsibilities
6. Assist in initiation of drug therapy after patient interview to assess drug- drug, drug-food,
and drug –disease interactions. Conduct Medication Reconciliation by interviewing the
patient or family members or contacting their pharmacies(R2.2.1, R2.4 – R2.12 all
inclusive of goals and objectives)
7. Contact community pharmacies to obtain medication history. Contact transferring
hospitals for clarification of medications administered prior to transfer. (R2.2.1, R2.4 –
R2.11 All inclusive of goals and objectives– R2.12.1, R2.12.2)
8. Provide discharge counseling to the emergency patient focusing of medication
information for the patient. (R5 all inclusive of goals and objectives)
9. Provide information to patients of sexual assault pertaining to emergency contraception;
STD’s; and Tetanus and assist with patient assistance programs in procuring the
medications. (R5 all inclusive)
10. Use innovative methods to assist indigent patients in procuring their medications –
patient assistance programs from manufacturers; indigent fill program associated with
the hospital and the current $4 medication programs. (R1.3 all inclusive, R3.2.3)
11. Learn to assess and handle phone triage as needed. (R2.2.1, R2.4 – R2.12 all inclusive
of goals and objectives)
12. Administer medications by various routes: PO; SL; IV; IM; subcutaneous; topically;
rectally and nebulization. (R2.2.1, R2.4 – R2.12 all inclusive of goals and objectives)
13. Attend weekly Emergency Medicine Conferences on Tuesday and Thursday mornings.
(R2.1.1, R2.3.1)
14. Attend weekly Emergency Medicine Grand Rounds and Morbidity and Mortality
Conference. (R2.1.1, R2.3.1)
15. Attend monthly Emergency Medicine Journal Club. (R2.1.1, R2.3.1, R6.1.1- R6.1.3)
16. Attend monthly Trauma Morbidity and Mortality Conference. (R2.1.1, R2.3.1)
17. Provide inservices to the nursing staff or medical staff as necessary related to
medications or pharmacy related issues. (R5.1 all inclusive)
18. Assist in continually expanding the credibility and scope of clinical pharmacy services in
the emergency department. Become a valuable member of the team by assisting in any
aspect of medication therapy (R1.2)
19. Assist in teaching medical, nursing, Emergency Medical Technicians (basics and
paramedics) and pharmacy students. This may involve bedside teaching techniques as
well as more formal presentations or small group discussions (R5.1 all inclusive)
20. Interact and communicate effectively and professionally with health care professionals
and patients within the emergency department. (R5.1)
21. Perform limited physical assessments (lungs, blood pressure, heart rate, respiratory
rate, temperature) of the patients to assist with therapeutic interventions. (R2.4.1)
22. Gain an understanding of the medications used in the acute setting. Review the
medications found in the code carts within the ED – know mechanism, dose, side
effects, administration and compatibility, how to mix and administer (R6 all inclusive)
23. Complete several pharmacokinetic problems (digoxin and phenytoin) and calculation
problems (rates of infusions) and a formal written assignment as relates to a
pharmacokinetic consult in a malpractice case. (R2.7.1)
24. Understand the infusion pumps and tubing used to administer intravenous medications
and fluids. Learn to program an infusion pump (Smart Pump) and compatibilities of
common mediations used in the acute care setting. (R1.3.3, R6.1)
Emergency Medicine Experience
Activities and Responsibilities
25. Understand invasive and non-invasive monitoring and its relationship to
pharmacotherapy and how to adjust mediations based on the findings. (R1.3, R2 in its
entirety)
26. Participate in hospital wide committees that relate to emergency medicine to see how a
pharmacist can interact and provide input – Disaster Committee, Procedural Sedation
Committee, etc. (R3.3.3, R3.3.4)
27. Become familiar with the automated dispensing machines and their usefulness in the
emergency department as well as methods to deal with problems and name
discrepancies associated with the machines. Also become familiar with other
technology that enhances drug delivery to the patient such as pneumatic tube systems;
etc. (R1.3 in its entirety)
REQUIRED READINGS
Conscious Sedation Protocol – Hospital Administration Policy and Procedure on Intranet.
Restraint Protocol – Hospital Administration Policy and Procedure on Intranet.
Solu-Medrol Spinal Cord Protocol – provided.
Guillermo,E, et.al. Review: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic
Syndrome. Am J Med Sci 1996; 311(5):225-233 – provided. Has very good etiology and a good
algorithm that is still useful even though the article may be dated.
5. Current CDC Recommendations for Treatment of STD’s - Medical letter or CDC website
6. Student/ Employee Exposure Protocol – provided
7. Snake bite protocol – provided
8. Selected readings from Tintinalli’s and Rosen’s Emergency Medicine Texts – provided
9. Selected readings from Fleisher’s Synopsis of Pediatric Emergency Medicine – provided
10. Selected readings from Ellenhorn’s and Goldfrank’s Toxicology Texts as well as APHA
Toxicology Handbook – provided
11. Harriet Lane’s Pediatric Medication Dosing – provided
12. ACLS protocols – provided
13. ECG arrhythmia recognition – provided
14. Micromedex™ and Poisondex™ – intranet
15. Rapid Sequence Intubation (RSI) Protocol – provided article and handout
16. Hollander, J. Management of Cocaine Myocardial Infarction – provided
17. AHA Guidelines for Management of Acute Myocardial Infarction – current guidelines provided
18. Sexual Assault Forensic Evidence (SAFE) Hospital Protocol - provided.
1.
2.
3.
4.
Family Medicine Clinic Experience
Preceptors: Katie McClendon, Pharm.D., BCPS
Clinical Assistant Professor, Department Pharmacy Practice
Work Phone: 601-984-2794
Pager: 601-929-3806
Fax: 601-984-2751
Email: jpitcock@umc.edu
Deborah Minor, Pharm.D.
Professor- Medicine and Pharmacy Practice
Division of General Internal Medicine/Hypertension
Phone: 601-984-6888, 790-4376 (H), 506-7303 (C)
Fax: 984-6853
Email: dminor@umc.edu
Purpose:
To gain knowledge and clinical experience in disease management and treatment
modalities used for ambulatory care disease states. To develop and improve problemsolving and communication skills, to develop effective patient education techniques
and to participate as an active member of a collaborative health care team. This is an
option of the required Family Medicine experience component.
Practice Site:
Lakeland Family Practice Clinic
878 Lakeland Drive
Jackson, MS 39216
Hours: 8:00-5:00, Monday-Friday
COMPETENCY-BASED EDUCATIONAL OUTCOMES AND GOALS
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.11: Communicate ongoing patient information.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Family Medicine Experience
ACTIVITIES AND RESPONSIBITIES REQUIRED TO MEET OBJECTIVES
1.
Serve as an integral member of the clinic team. (R2 and R5, inclusive)
2.
Make pharmacologic and nonpharmacologic recommendations regarding therapy based
on all relevant considerations. (R2.1, R2.6, R2.7, R2.8, R2.9, R2.12, R5.1)
3.
Review patient records prior to providing care and, when indicated, as a screening for
clinical trials. (R2.2, R2.4, R2.10)
4.
Serve as a drug information resource for the clinic utilizing evidenced-based medicine
as well as current literature. Perform literature searches as requested. (R2.6, R5.1)
5.
Interview patients, obtaining a complete medication history, including changes in
therapy, efficacy, adverse effects, drug interaction and allergies. (R2.1-R2.12, R5.1)
6.
Document all medication histories as well as other patient contacts in the medical
record. (R2.1-R2.12)
7.
Counsel patients and assess understanding of both pharmacologic and
nonpharmacologic therapy. Follow-up with communication regarding lab results and
any changes in medication regimens. (R2, inclusive)
8.
Interact with providers to ensure patients have prescriptions and refills on all
medications, including assistance with patient and pharmacy calls, enrollment in
medication assistance programs or communication with third party sources. (R2,
inclusive)
9.
Assist with patient calls as requested by clinic providers. (R2 and R5, inclusive)
10.
Help identify and maintain patient education resources within the clinic. (R2.1, R2.2,
R5.1)
11.
Assist with sample coordination, including dispensing, counseling, and contacting
pharmaceutical representatives when samples are needed. (R2.1)
12.
Interact and communicate effectively with providers and staff within the clinic. (R2.1,
R2.3, R5.1)
13.
Assist in teaching of pharmacy students on rotation where applicable. (R2.1, R5.1)
14.
Attend hospital and nursing home rounds as suggested by the preceptors. (R2 and R5,
inclusive)
15.
Attend other lectures as deemed pertinent by the preceptors. (R2.1)
16.
Prepare a formal presentation for the clinic providers detailing or reviewing
pharmacotherapy (topic should be approved by the preceptors). Other presentations
may be performed as assigned. (R5.1)
17.
Help to continually expand the credibility and scope of pharmacy services. (R2.1, R2.3,
R2.3, R5.1)
18.
Complete assigned projects prior to end of rotation. (R2.1, R5.1)
READINGS
1. JNC 7
2. NCEP III & Updates
3. Chest Guidelines
4. Diabetes Care Standards (ADA, NKF Guidelines)
5. Asthma Guidelines
6. Others as determined by preceptors
Resident Progression Objectives
Objective(s)
Week 1
Week 4
1) Resident should be able to independently see patients for DM visits and
document note in EPIC effectively with guidance.
1) to give effective teaching presentation to FM residents
2) lead a topic discussion related to FM topic with students
3) see all patients scheduled for pharmacy visits and complete
documentation in the clinic time with little needed changes to note.
HEART FAILURE DISEASE MANAGEMENT (HFDM) CLINIC EXPERIENCE
PRECEPTOR:
Jay Pitcock, Pharm.D., BCPS
Clinical Assistant Professor, Department of Pharmacy Practice
Office Phone: 601-984-2794
Fax: 601-984-2751
Email: jpitcock@umc.edu
PURPOSE:
The overall purpose of this elective experience rotation is three-fold: to
improve knowledge of heart failure, dyslipidemia, and hypertension (and
potentially other diseases), to gain clinical experience in the ambulatory
management of patients in a multidisciplinary team approach for treatment
of heart failure, and to become a more effective educator by gaining
experience in providing pharmaceutical information to a variety of health
care professionals in different stages of training, as well as in group and
individualized patient settings. The resident will also have the opportunity
to develop and improve both teaching and precepting skills in an
academic setting.
PRACTICE SITE:
Heart Failure Disease Management (HFDM) Clinic
University of Mississippi Medical Center
Jackson, Mississippi
AREAS OF EMPHASIS:
1. Drug literature evaluation as it pertains to ambulatory care, including application of
evidence-based research and outcomes to patient specific situations. (R6)
2. Limited physical assessment of the patient in the HFDM Clinic. (R2.4.1)
3. Establishment and management of pharmacy clinical services, with a focus on protocol
development/review, implementation, and maintenance issues. (R1.2.1, R3.2.1, R3.2.3)
4. Understanding of ambulatory care pharmacology and monitoring therapeutic effect.
(R2.7.1)
5. Communication with health care providers and patient education techniques. (R2.1, R2.8.1,
R2.11.1, R2.11.2)
6. Recommending pharmacological management taking into consideration drug interactions,
side effects, and disease state management based on current standards of practice.
(R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1, R 2.9.2, R2.10.1, R2.10.2, R2.11.1 R2.11.2)
7. Management of adult heart failure patients in the ambulatory setting. (R2.4.1,R2.4.2,
R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2, R2.11.2)
8. Management of familial hyperlipidemic patients. (R2.4.1,R2.4.2, R2.6.1, R2.6.2, R2.7.1,
R2.9.2, R2.10.1, R2.10.2, R2.11.2)
9. Management of the other issues associated with heart failure to include but not limited to:
HTN; heart failure acute exacerbation; arrhythmias; PVD; anticoagulation management,
smoking cessation, etc. (R2.4.1, R2.4.2, R2.6.1, R2.6.2, R2.7.1, R2.9.2, R2.10.1, R2.10.2,
R2.11.2)
10. Management of Adverse Drug Reaction (ADR) in the ambulatory patient. Also participate in
reporting of ADR’s. (R1.1.1, R1.1.2, R1.1.3)
11. Administration techniques for oral, subcutaneous, intramuscular, and topical medications.
(R2.2.1)
12. Assist with access to medications for patients that are unable to procure them. (R1.1)
13. Documentation of specific interventions in the electronic medical record. (R2.12.1, R2.12.2,
R2.12.3)
HFDM CLINIC EXPERIENCE CONTINUED
14. Participate in performance improvement in the HFDM clinic. (R1.1.3, R1.4.1)
15. Provide patient education pertaining to disease state and pharmacological management.
(R2.3, R2.12, R5.1)
COMPENTENCY-BASED LEARNING GOALS AND OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with
members of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.11: Communicate ongoing patient information.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1: Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Goal R5.2: Provide concise, applicable, comprehensive, evidence-based, and timely
responses to requests for drug information from health care providers and
patients.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
HFDM CLINIC EXPERIENCE CONTINUED
ACTIVITIES AND RESPONSIBILITES
1. Serve as a drug information resource utilizing evidence based medicine. Provide responses
to questions in a timely manner. (R6.1.1, R6.1.2 R6.1.3)
2. Serve as an integral member of the interdisciplinary clinic team, interacting and
communicating effectively and professionally with health care professionals and patients.
(R2.1.1, R2.3.1, R5)
3. Participate in the management of heart failure, as well as other related diseases, in the
HFDM Clinic by recommending initial pharmacotherapy (including herbal supplementation),
identifying therapeutic goals, and modifying current medication therapy. Consider the
addition of non-pharmacologic methods (e.g., dietary adjustments, exercise
encouragement and direction, appropriate referral, and smoking cessation counseling).
(R2.2.1, also R2.4 – 2.12 all inclusive of goals and objectives)
4. Monitoring patients for appropriate and inappropriate responses to treatment. (R2.7 – 2.10)
5. Documenting direct patient care activities in the electronic medical record. (R2.12)
6. Complete assigned patient education project(s) prior to end of rotation. (R6, R3.1.1)
7. Assist in teaching and precepting of pharmacy students on rotation when applicable. (R5)
8. Establish a relationship and counsel patients, assessing an understanding of both
pharmacologic and non-pharmacologic therapy. Follow-up with communication regarding
lab results, prior authorizations, phone calls, refills, and any changes in medication
regimens. (R2)
9. Identifying medication therapy problems and approaches to resolving these problems.
(R2.10)
10. Assist in continually expanding the credibility and scope of clinical pharmacy services.
Become a valuable member of the team by assisting in any aspect of medication therapy.
(R1.2)
11. Assist in assessing quality assurance performance measures. (R1.1, R1.2)
12. Assess drug–drug, drug–food, and drug–disease interactions. Conduct Medication
Reconciliation by interviewing the patient or family members or contacting their
pharmacies. (R2.2.1, also R2.4 – R2.12 all inclusive of goals and objectives)
13. Understand invasive and non-invasive monitoring and its relationship to pharmacotherapy,
particularly mediation adjustment based on the findings. (R2 in its entirety)
14. Perform limited physical assessments (e.g., lungs, blood pressure, heart rate, respiratory
rate, temperature) of the patients to assist with therapeutic interventions. (R2.4.1)
15. Demonstrate, educate, and patient assessment of various administration techniques and
devices used in the ambulatory care setting (R2.6.1, R2.6.2, R2.8.2, R5)
16. The resident shall behave ethically. The resident shall accept the responsibilities embodied
in the principles of pharmaceutical care and the profession of pharmacy (R3.1)
REQUIRED READING
1. 2009 Focused Update Incorporated into the ACC?AHA 2005 Guidelines for the Diagnosis
and Management of Heart Failure in Adults: A Report of the American College of
Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation 2009;119;e391-e479 (available on line)
HFDM CLINIC EXPERIENCE CONTINUED
2. The Executive Summary of the Third Report of the National Cholesterol Education Expert
Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult
Treatment Panel III). NIH Publication No. 02-5215. Bethesda, MD: National Heart, Lung,
and Blood Institute, September 2002 (available on line)
3. Grundy SM, Cleeman JI, Merz CN, et al for the Coordinating Committee of the NCEP.
Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult
Treatment Panel III Guidelines. Circulation. 2004;110:227-239 (available on line)
4. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure: The JNC 7. JAMA. 2003;289:2560-2571 (available
on line)
5. Antithrombotic and Thrombolytic Therapy, 8th ED: ACCP Guidelines Ansell J, Guyatt GH,
Albers GW, Harrington R, Schünemann HJ. Antithrombotic and Thrombolytic Therapy,
Eighth Edition: ACCP Guidelines. CHEST 2008; 133(6): 160S-198S (focus on chapter
pertaining to oral anticoagulants)
Heart Failure Disease Management Clinic
Week
Week 1
1.
2.
Week 2
1.
Week 3
1.
Week 4
4)
5)
6)
Objective(s)
Resident should be able to work up patients scheduled for clinic
prior to their arrival in clinic.
Resident should decide on area of focus for their patient education
project.
Resident should be able to independently see patients for HF visits
and document note in EPIC with guidance.
Resident should be able to independently see patients for HF visits
and document note in EPIC with minimal to no guidance.
Resident should lead a topic discussion on a HF-related topic with
students.
Resident should be able to see all patients scheduled for HF visits
and complete documentation in EPIC with little needed changes to
the note.
Resident should have the final draft of their patient education
project completed.
Activities for Heart Failure Disease Management (HFDM) Clinic
Clinic Location and Time
 Select Specialty Hospital (located on I-55 North Frontage Road), HFDM Clinic, Suite
410
 Patients are seen in the morning and afternoon Monday – Thursday and Friday
mornings
o Morning patients are usually scheduled between 8:00 AM and 11:00 AM
o Afternoon patients are usually scheduled between 1:00 PM and 2:30 PM
o Typically there are 8 – 12 patients scheduled on days there are AM and PM
clinics
 Residents can park in the front parking lot in the area set aside for staff. As you face the
entrance, this is the area on the left hand side of the parking lot. This will be shown to
you once you arrive. You are not allowed to park in spaces designated for “physicians.”
Preceptor Information
 Jay Pitcock, Pharm.D., BCPS
o Clinical Assistant Professor
o Department of Pharmacy Practice, University of Mississippi School of Pharmacy
o Office Phone: 601-984-2794
o Clinic Phone: 601-815-8737 or 601-984-4287
o Clinic Fax: 601-984-2751
o Email: jpitcock@umc.edu
Other Clinic Personnel
 Kim Miller, NP
 Lafrieda Coleman, RN
 Carolyn Amos, clinic secretary
Computer Charting
 The resident will need access to UMC Portal.
 The HFDM Clinic utilizes the Apollo EHR charting system to document patient
interactions. A report is generated from this note, which is then electronically tied to
UMC Portal. Access to Apollo requires special registration and passwords, thus it is
probably not feasible for the resident to obtain this for the short duration of the rotation.
However, the resident will be educated on how to retrieve, utilize, and input data into
Apollo (under the supervision of clinic personnel). Any further questions about Apollo
will be answered at the start of the rotation. Apollo is easier demonstrated that
explained.
 Due to the set up the system it is hard to show an “actual” note, but the reports that are
generated by Apollo are viewable in UMC Portal under the “Cardiology” tab –
“Cardiowellness” subtab. Look for notes assigned to “Kim Miller” under that subtab, as
she is the NP in the clinic.
Patient Work Flow
 Patients arrive to clinic and are checked in by Carolyn
 Lafrieda sees patient to do initial interview, vitals, weight, etc. and then hands off patient
to pharmacist
 Pharmacist interviews patient with focus on:
o Medication Reconciliation: prescription, OTC, vitamins, and herbals
o Identification of any medication-related problems (i.e. compliance, AEs, etc.)



o Answers any questions the patient may have about medications
o Updates all medications in the Apollo HER system
 Meds are listed by: Drug name, tablet strength, route of administration,
directions
Once done, the pharmacist reviews what they learned with Kim
Usually Kim and the pharmacist both then interview the patient
Once the interview is complete and plan developed the pharmacist is responsible for
any medication related issues or changes that were identified. These include, but are
not limited to:
o Patient education on new medications or any changes to medications
o Relabeling of patient bottles to ensure proper compliance
o Identification, education, and development of plans to improve patient
compliance and understanding of medications
o Calling in or writing new prescriptions, which may include cancelling old
prescriptions
o Medication reconciliation sheets are completed and given to the patient. These
are written in lay person terms
o If appropriate, a separate pharmacist note or addendum to the NP note may be
added to Apollo.
Other Clinical Duties
 The clinical pharmacist is responsible for managing the anticoagulation of a very small
group of patients in the clinic. This involves, but is not limited to, getting INR drawn,
patient interview, evaluation of results, dosing adjustments, and rescheduling of
patients.
 The clinical pharmacist helps Kim with lipid management of the patients enrolled in the
HFDM Clinic.
Data Collection
 On Thursday or Friday of each week, the pharmacist reviews and documents for Kim
when the last ECHO was performed for each patient scheduled for the upcoming week.
She uses this information to schedule ECHOs for patients needing them the day of their
appointment.
 The pharmacist is responsible for collecting, entering, and reporting on certain items for
every patient enrolled in the clinic. This data is shared with members of the Cardiology
Service in monthly and quarterly reports. The majority of this information is easiest
collected on a daily basis at the time of the patient visit.
o On EVERY patient schedule the following is documented: payer source and if
they are a follow-up or initial visit.
 IF the patient is an INITIAL VISIT then the referral source is also
documented.
o On EVERY patient it is documented if they: attended, no-showed, rescheduled,
or cancelled their appointment for that day.
 IF the patient ATTENDED their clinic visit then their heart failure class and
any procedures/referrals are documented.
o The data collected is entered into an Excel program and later tabulated and
reformatted for the reports.
Other Pharmacist’s Duties





Assisting with completion, filing, and maintenance of patient assistance program
applications.
Patients can call the clinic with any and all problems. These calls are taken by the clinic
secretary. Those calls pertaining to medication-related issues are given to the clinic
pharmacist. It is our job to assess and resolve this issue. Problems could be, but aren’t
limited to, medication refills, adverse effects, OTC recommendations, or general
education.
Performing follow-up calls to patient regarding lab work and/or necessary medication
changes.
o If appropriate, a separate pharmacist note or addendum to the NP note may be
added to Apollo. As stated earlier, any and all questions surrounding Apollo will
be answered at the beginning of the rotation.
For patient’s scheduled to RTC for lab work or procedures, the patient name, MR #,
item to be performed, and when scheduled are tracked on the dry erase board located
in the clinic office.
The pharmacist is involved with general provider and patient-related medication
education.
Hypertension Clinic Experience
PRECEPTOR:
Deborah S. Minor, Pharm.D.
Professor - Medicine and Pharmacy Practice
Division of General Internal Medicine/Hypertension
Phone: 601-984-6888, 790-4376 (H), 506-7303 (C)
Email: Dminor@umc.edu
PURPOSE:
To gain knowledge and clinical experience in the ambulatory care setting
using a multidisciplinary team approach to disease management and
treatment of primary care disease states. To gain knowledge and clinical
experience in development of problem-solving and communication skills,
with an emphasis on effective patient assessment and education
techniques. The resident will participate as an active member of a
collaborative health care team, primarily dealing with diseases such as
hypertension, dyslipidemia, diabetes, obesity, and depression. The
resident will be responsible for providing both direct patient care as well as
indirect through telephone triage. This is an option of the required
Medicine experience component.
PRACTICE SITE:
University of Mississippi Health Care, Jackson, Mississippi Division of
General Internal Medicine/Hypertension
Hypertension Clinic
826R Lakeland Drive, Bldg LD
Jackson, MS 39216
Hours: 8:00-5:00, Monday-Friday
AREAS OF EMPHASIS
1. Training in the appropriate management and assessment of the ambulatory care patient.
(R2 and R5 inclusive)
2. Training in the appropriate measurement and assessment of blood pressure and other
physical assessments (and train others). (R2 inclusive, R5.1.1)
3. Management of commonly encountered ambulatory care disease states to include but not
limited to: hypertension, diabetes, dyslipidemia, depression, migraine headaches, and chronic
kidney disease. (R2.1-2.12 inclusive, R5.1.1)
4. Assessment, management and documentation of medication intolerances and adverse drug
reactions in the ambulatory care patient. (R1.1.2, R1.1.3)
5. Assessment of medication adherence and all obstacles that influence adherence including
access to medications. (R2.1-2.12 inclusive, R5.1.1)
6. Assessment of indications for and appropriate administration of seasonal and nonseasonal
vaccinations, including all required documentations. (R1.1.2, R1.3.3, R1.3.4, R2.1-2.12
inclusive, R5.1.1)
7. Provide patient education regarding disease states, pharmacological interventions and
lifestyle intervention. (R1.1, R2.1-2.12 inclusive, R5.1.1, R5.1.5, R5.1.6, R6.1.1, R6.1.3)
8. Educate other health care providers in both formal and informal settings (by daily
interactions, documentation in patient records, providing formal topic presentations).
(R3.1.1-3.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
9. Documentation of all encounters and interventions in the permanent medical record.
Hypertension Clinic Experience continued
AREAS OF EMPHASIS
10. Help in maintaining the accuracy of all patients’ medication profiles and clinical records.
(R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1, R6.1.3)
11. Participate in community activities including health fairs, educational sessions, and other
outreach efforts. (R2.4.2, R2.4.3, R3.1, R5.1.1, R5.1.5, R5.1.6)
12. Assist with ambulatory blood pressure measurements as needed. (R2)
13. Participate in journal reviews and other ongoing internal and external educational efforts as
the opportunity arises. (R3.1.1-3.1.3, R5.1.1, R5.1.3-5.1.6 inclusive)
14. Assist with all medication sample coordination including medication selection, dispensing,
recording and counseling. (R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1)
15. Assist with all medication assistance program activities including patient eligibility
determination, medication selection, ordering, and dispensing. (R1.3.4, R1.4.1, R2.1-2.12
inclusive, R5.1.1)
16. Attend all internal and external activities and programs that would be expected as part of
the clinic health care team or professional pharmacy involvement (for example, weekly
Grand Rounds and pharmacy meetings). A schedule will be provided at the beginning of
each rotational experience. (R3.1 inclusive, R5.1.1)
17. Assist with all necessary clinical and operational aspects of daily functions. (R1.1.2, R1.1.3,
R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3, R3.3.1-3.3.3, R5.1.1)
18. Exercise leadership and initiative in a collaborative environment. (R3.1.1, R3.1.2, R3.1.3,
R3.3.1-3.3.3)
19. Assist with student coordination, supervision, training, and instruction, serving as a
pharmacy practice role model at all levels of contact. (R3.1, R3.3, R5.1.1, R5.1.3-5.1.6
inclusive)
COMPETENCY-BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Hypertension Clinic Experience continued
COMPETENCY-BASED LEARNING OBJECTIVES
Goal R2.8:
Goal R2.9:
Goal R2.10:
Goal R2.11:
Goal R2.12:
Recommend or communicate regimens and monitoring plans.
Implement regimens and monitoring plans.
Evaluate patients’ progress and redesign regimens and monitoring plans.
Communicate ongoing patient information.
Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBITIES
1. Serve as an integral member of the clinic team. Assist with all necessary clinical and
operational aspects of daily functions including assisting with patient calls as requested
by clinic providers (physician, nurse, practitioner, and pharmacist). Interact and
communicate effectively with providers and staff within the clinic. (R1.1.2, R1.1.3,
R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3, R3.3.1-3.3.3, R5.1.1)
2. Make pharmacologic and nonpharmacologic recommendations regarding therapy based
on all relevant considerations. Counsel patients and assess understanding of both
pharmacologic and nonpharmacologic therapy and disease states. Follow-up with
communication regarding lab results and any changes in medication regimens. This
shall include management of commonly encountered ambulatory care disease states to
include but not limited to: hypertension, diabetes, dyslipidemia, depression, migraine
headaches, and chronic kidney disease. (R2.1-2.12 inclusive, R5.1.1)
3. Receive training in the appropriate measurement and assessment of blood pressure
and other physical assessments (and help train students). (R2 inclusive, R5.1.1)
4. Help with assessment, management and documentation of medication intolerances and
adverse drug reactions in all patients. (R1.1.2, R1.1.3)
5. Continually assess medication adherence and all obstacles that influence adherence
including access to medications for all patients. (R2.1-2.12 inclusive, R5.1.1)
6. Provide immunizations, including assessment of indications for and appropriate
administration of seasonal and nonseasonal vaccinations. Provide all required
documentations and help with maintaining and ordering clinic supplies. (R1.1.2, R1.3.3,
R1.3.4, R2.1-2.12 inclusive, R5.1.1)
7. Help identify and maintain patient education resources within the clinic, including regular
updating of bulletin boards and other patient information forms. (R1.1, R2.1-2.12
inclusive, R5.1.1, R5.1.5, R5.1.6, R6.1.1, R6.1.3)
Hypertension Clinic Experience continued
ACTIVITIES AND RESPONSIBITIES
8. Prepare a formal presentation for the Hypertension Clinic detailing or reviewing
pharmacotherapy (topic will be a primary care issue approved by the preceptor). Other
presentations may be performed as assigned. (R3.1.1-3.1.3, R5.1.1-5.1.6 inclusive,
R6.1.1, R6.1.3)
9. Serve as a drug information resource for the clinic utilizing evidenced-based medicine
as well as current literature. Perform literature searches as requested. Educate other
health care providers in both formal and informal settings (by daily interactions,
documentation in patient records, and providing formal topic presentations). (R3.1.13.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
10. Review patient records prior to providing care and, when indicated, as a screening for
clinical trials. Document all encounters and interventions in the permanent medical
record. (R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1,
R6.1.3)
11. Interview patients, obtaining a complete medication history, including changes in
therapy, efficacy, adverse effects, drug interaction and allergies. Help in maintaining the
accuracy of all patients’ medication profiles and clinical records. (R1.1.2, R1.1.3, R1.3.2,
R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1, R6.1.3)
12. Participate in community activities including health fairs, educational sessions, and
other outreach efforts. (R2.4.2, R2.4.3, R3.1, R5.1.1, R5.1.5, R5.1.6)
13. Assist with ambulatory blood pressure measurements as needed. (R2)
14. Participate in journal reviews and other ongoing internal and external educational efforts
as the opportunity arises. (R3.1.1-3.1.3, R5.1.1, R5.1.3-5.1.6 inclusive)
15. Interact with providers to ensure patients have prescriptions and refills on all
medications, including assistance with patient and pharmacy calls, enrollment in
medication assistance programs or communication with third party sources. (R1.3.4,
R1.4.1, R2.1-2.12 inclusive, R5.1.1)
16. Attend all internal and external activities and programs that would be expected as part
of the clinic health care team or professional pharmacy involvement (for example,
weekly Grand Rounds and pharmacy meetings). A schedule will be provided at the
beginning of each rotational experience. (R3.1 inclusive, R5.1.1)
17. Maintain a positive attitude, the highest ethical standards, and a mutual respect for all
those encountered in the clinic. Practice leadership and initiative in a collaborative
environment. (R3.1.1, R3.1.2, R3.1.3, R3.3.1-3.3.3)
18. Assist in teaching of pharmacy students on rotation when applicable, including student
coordination, supervision, training, and instruction and serving as a pharmacy practice
role model at all levels of contact. (R3.1, R3.3, R5.1.1, R5.1.3-5.1.6 inclusive)
19. Complete all assigned projects prior to the end of the rotation. (R3)
Hypertension Clinic Experience continued
REQUIRED READINGS
1.
JNC 7
2.
NCEP III & Updates
3.
Chest Guidelines
4.
Diabetes Care Standards (ADA, NKF Guidelines)
5.
Asthma Guidelines
6.
Others as determined by preceptor
Hypertension Clinic and Clinical Research Program
Cathy Adair, RN
Valerie Bacon
Jennifer Banks
Demetrious Bliss
Jeb Henson, MD
Kimberly Harkins, MD
Debbie Minor, PharmD
Joyce Lovett
Madalyn Martin
Linda Monroe, MD
Candy Prentice
Amanda Purser, FNP
Jimmy Stewart, MD
Marion Wofford, MD, MPH
Sharon Wyatt, PhD, RN, CS
INFECTIOUS DISEASES EXPERIENCE
PRECEPTOR:
Kayla Stover, PharmD, BCPS
Assistant Professor
Departments of Pharmacy Practice and Medicine
Work Phone: 601-984-2617
Fax: 601-984-2618
Email: kstover@umc.edu
Travis King, PharmD
Assistant Professor
Departments of Pharmacy Practice and Medicine
Work Phone:
Pager:
Fax: 601-984-2618
Email: stking@umc.edu
PURPOSE:
An Elective rotation to gain knowledge and clinical experience in the
management of patients with infectious diseases in a multidisciplinary
team approach. The resident will also gain experience in teaching by
providing pharmaceutical information to a variety of health care
professionals in different stages of training to include pharmacists,
medical, pharmacy and nursing students, medical and pharmacy residents
and nurse practitioners. Patient education is emphasized on an individual
patient basis. The resident will also develop and improve teaching skills in
an academic setting.
PRACTICE SITE:
University of Mississippi Health Care, Jackson, Mississippi
Adult and Pediatric Departments
Only Level 1 Trauma Center in Mississippi
AREAS OF EMPHASIS
1. Limited physical assessment of the patient (R2)
2. Understanding of acute and chronic care pharmacology and monitoring therapeutic effect.
(R1.2.1, R2)
3. Communication with health care providers and patient education techniques.(R5, R2.1.1,
2.3.1)
4. Drug literature evaluation as pertains to medicine & pharmacy literature. (R6)
5. Recommending pharmacological management taking into consideration drug interactions,
side effects, and disease state management based on evidence based medicine.
(R1.2.1, R2)
6. Participation in clinical case conferences. (R5.1.4, 5.1.5, 5.1.6)
1. Participation in JCAHO surveys and medication use reviews (R3.2.2)
2. Management of the adult and pediatric patient with a broad spectrum of infectious
diseases, some of which are listed more specifically below. (R1.2.2, R2, R6)
3. Management of the HIV infected patient(R1.2.2, R2, R6)
4. Management of adult and pediatric patients with nosocomial infections (R1.2.2, R2, R6)
5. Management of acute disease states to include but not limited to: pneumonia, sinusitis,
skin and soft tissue infections, urinary tract infections, animal bites, hepatitis, trauma
with secondary infections, presumed infections in immunocompromised patients.
(R1.2.2, R2, R6)
Infectious Diseases Experience
Areas of Emphasis
7. Management of non-acute disease states as perceived by the patient to include but not
limited to: STD’s, flu-like symptoms, otitis medica, rashes, etc. (R1.2.2, R2, R6)
8. Management of Adverse Drug Reaction (ADR) in the acute patient. Also participating in
ADR reporting. (R1.1.1, 1.1.2, 1.1.3, R2)
9. Management of specific drug induced diseases (Beyond the ADRs) (R2, R6)
10. Management of patients with chronic or indolent diseases (lyme disease, chronic
fatigue, osteomyelitis, endocarditis) (R1.2.2, R2, R6)
11. Management of the patient with tuberculosis (R1.2.2, R2, R6)
12. Management of patients that have an exposure to blood and body fluids (R1.2.2, R2,
R6)
13. Administration techniques for oral, subcutaneous, intravenous, intramuscular, and
topical medications. (R1.3)
14. Assist with access to medications for patients that are unable to procure them (R1.3)
15. Documentation of specific interventions in the medical record. (R2.12)
16. Participate in performance improvement in the pharmacy department (R1.4, 3.2, R4)
17. Provide patient education pertaining to disease state and pharmacological
management. Documentation of this education intervention on the Patient/ Family
Education Form. (R5, R6, R2.12)
ACTIVITIES AND RESPONSIBILITIES
1. Serve as a drug information resource utilizing evidence based medicine. (R6)
2. Participate in the care of adult and pediatric patients. (R1.2.1, R2)
3. Assist in therapeutic management of the acutely ill patient, monitor therapy, and modify
therapy and interventions as needed. (R1.2.1, R2)
4. Participate in the management of chronically ill patients. R1.2.1, R2)
5. Assist in providing information regarding therapeutic outcomes. (R2)
6. Assist in initiation of drug therapy after patient interview to assess drug- drug, drug-food,
and drug –disease interactions. (R1.2.1, R2, R6)
7. Contact community pharmacies to obtain medication history. Contact transferring hospitals
for clarification of medications administered prior to transfer. (R2, R5)
8. Provide discharge counseling to the patient. (R6, R2.11, R2.12)
9. Use innovative methods to assist indigent patients in procuring their medications. (R1.3,
3.2.3)
10. Administer medications by various routes: PO; SL; IV; IM; subcutaneous; topically; rectally
and nebulization. (R1.3)
11. Attend weekly Medicine Conferences on Tuesday (Journal Club) and Friday (Clinical
Conference) mornings. (R2.1.1, 2.1.3)
12. Attend weekly Medicine Grand Rounds and Morbidity and Mortality Conference. (R2.1.1,
2.1.3)
13. Provide inservices to the nursing staff or medical staff as necessary related to medications
or pharmacy related issues. (R5, R6)
14. Assist in continually expanding the credibility and scope of clinical pharmacy services in
Infectious Diseases. (R2, R4, R5, R3)
15. Assist in teaching medical, nursing and pharmacy students on rotation. (R5, R6)
16. Interact and communicate effectively with health care professionals and patients within the
department. (R2.1.1, 2.1.3, 2.11)
17. Perform limited physical assessments of the patients to assist with therapeutic
interventions. (R2)
18. Gain an understanding of the medications used in the acute setting. (R1.2.1, R2, R6)
Infectious Diseases Experience
ACTIVITIES AND RESPONSIBILITIES
19. Complete several pharmacokinetic problems and calculation problems and a formal written
assignment as relates to a pharmacokinetic consult in a malpractice case. (R2, R6)
20. Understand the infusion pumps and tubing used to administer intravenous medications and
fluids. (R1.3)
21. Understand invasive and non-invasive monitoring and its relationship to pharmacotherapy.
(R1.3, R2, R6)
22. Participate in hospital wide committees that relate to pharmacy & medicine. (R3.3.3, 3.3.4)
COMPETENCY BASED LEARNING OBJECTIVES FOR PHARMACY PRACTICE:
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
REQUIRED READINGS
Readings should be directed based on cases and therapeutic problems observed during
experience. These can be assigned by the preceptor.
Inpatient Adult Internal Medicine I Experience UMHC
Preceptor:
Richard "Buddy" Ogletree, Pharm.D., RPh
Drug Information Supervisor
Chairman, Institutional Review Board
Assistant Professor of Pharmacy Practice
Phone: 601-984-2056 (office)
Phone: 601-937-1953 (cell)
Fax: 601-984-2064
Email: rogletree@umc.edu.edu
OR
Linda Strong, RPh
Clinical Staff Pharmacist, PCAP
Adult Inpatient
Phone: 601-815-2275
Pager: 601-929-2165
Email: lstrong@umc.edu.edu
OR
Allison Bell, Pharm D, M.Sc. BCPS
Assistant Professor, Department Pharmacy Practice
Office: 601-815-5211
Cell: 513-379-4770
Email: abell3@umc.edu
Purpose:
To gain knowledge and clinical experience in disease management and
treatment modalities used for acute care of adult patients. To develop and
improve problem-solving and communication skills, to develop effective
patient education techniques and to participate as an active member of a
collaborative health care inpatient medicine team.
Practice Site:
University of Mississippi Health Care, Jackson, MS
AREAS OF EMPHASIS
1. Participation in collaborative multidisciplinary patient management. (R1.2.1, R2.1.1, 2.3.1)
2. Pathophysiology of chronic and acute disease states commonly encountered within the
inpatient setting. (R2, R6)
3. Patient assessment, including medication and non-medication related factors. (R2)
4. Laboratory monitoring for therapeutic outcomes and potential adverse effects of medication
therapy. (R2.7 – 2.10)
5. Monitoring and interpretation of data related to disease management and medication safety
and effectiveness. (R2.7 – 2.10)
6. Recommendations for initiation and modification in pharmacotherapy based on all relevant
considerations. (R2)
7. Patient education and counseling on both pharmacologic and nonpharmacologic
recommendations and therapy. (R2.11, R5)
Inpatient Adult Internal Medicine I Experience UMHC continued
COMPETENCY BASED LEARNING OBJECTIVES
8. Medical record documentation of all interventions and care provided. (R2.12)
9. Identification and evaluation of patient compliance, including barriers such as payer issues
or need for medication assistance. Development of strategies to improve adherence. (R1.3,
R2, R3.2.3)
10. Recommendation and administration of appropriate immunizations for this patient
population. (R1.3, R2)
11. Drug literature evaluation including application of evidence-based research and outcomes
to patient specific situations. (R5, R6)
Outcome R1: Manage and improve the medication-use process.
Goal R1.1:
Identify opportunities for improvement of the organization’s medication-use system.
Goal R1.2:
Design and implement quality improvement changes to the organization’s medicationuse system.
Goal R1.3:
Prepare and dispense medications following existing standards of practice and the
organization’s policies and procedures.
Goal R1.4:
Demonstrate ownership of and responsibility for the welfare of the patient by performing
all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy management with
interdisciplinary teams.
Goal R2.1:
As appropriate, establish collaborative professional relationships with members of the
health care team.
Goal R2.2:
Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3:
As appropriate, establish collaborative professional pharmacist-patient relationships.
Goal R2.4:
Collect and analyze patient information.
Goal R2.5:
When necessary, make and follow up on patient referrals.
Goal R2.6:
Design evidence-based therapeutic regimens.
Goal R2.7:
Design evidence-based monitoring plans.
Goal R2.8:
Recommend or communicate regimens and monitoring plans.
Goal R2.9:
Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1:
Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1
Provide effective medication and practice-related education, training, or counseling to
patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBILITIES
12. Serve as an integral member of the inpatient medicine team. (R2.1.1, 2.3.1)
13. Make pharmacologic and non-pharmacologic recommendations regarding therapy. (R2)
14. Serve as a drug information resource utilizing evidenced-based medicine as well as current
literature. Perform literature searches as requested. (R1.2.1, 2, R6)
15. Counsel patients upon discharge and during hospitalization as necessary to assess
understanding of both pharmacologic and non-pharmacologic therapies. (R2.11, R5)
Inpatient Adult Internal Medicine I Experience UMHC continued
16. Interact and communicate effectively with other providers and staff within the hospital.
(R2.1.1, 2.3.1, R5)
17. Assist in teaching of pharmacy students on rotation where applicable. (R5.1.3 – 5.1.4)
18. Attend Medicine Grand Rounds at 12 noon each Tuesday and Pharm.D. Seminar at 12
noon each Thursday. Attend other lectures as deemed pertinent by the preceptor. (R2.1.1,
2.3.1)
19. Other presentations may be performed as assigned. (R5)
20. Help to continually expand the credibility and scope of pharmacy services. (R3.3.1)
21. Complete assigned projects prior to end of rotation. (R3, R4)
Resident Progression Objectives
Week
Week 1
Objective(s)
1) Follow all patients in coordination with preceptor
2) Review vancomycin and aminoglycoside dosing and monitoring
Week 2
9) Follow ½ of team patients independently of preceptor while
following the remaining patients in coordination with preceptor
10) Review inpatient anticoagulation and bridging
Week 3
4) Follow ¾ of team patients independently while following
remaining patients in coordination with preceptor
5) Stay on call with team one evening
Week 4
3) Cover Orange Medicine service independently of preceptor
Inpatient Adult Internal Medicine Experience II UMHC
Preceptor:
Richard "Buddy" Ogletree, Pharm.D., RPh
Drug Information Supervisor
Chairman, Institutional Review Board
Assistant Professor of Pharmacy Practice
Phone: 601-984-2056 (office)
Phone: 601-937-1953 (cell)
Fax: 601-984-2064
Email: rogletree@umc.edu
OR
Linda Strong, RPh
Clinical Staff Pharmacist, PCAP
Adult Inpatient
Phone: 601-815-2275
Pager: 601-929-2165
Email: lstrong@umc.edu
OR
Allison Bell, Pharm D, M.Sc. BCPS
Assistant Professor, Department Pharmacy Practice
Office: 601-815-5211
Cell: 513-379-4770
Email: abell3@umc.edu
OR
Karen Freeman, Pharm.D.
Clinical Pharmacist - 2 South/Renal Transplant
University of Mississippi Medical Center
Office: 601-815-2285
Cell: 601-754-3010
Pager: 601-929-4008
E-mail: kwfreeman@umc.edu
Purpose:
To gain and broaden knowledge base and clinical experience in disease
management and treatment modalities used for acute care of adult
patients. To develop and improve problem-solving and communication
skills, to develop effective patient education techniques and to participate
as an active member of a collaborative health care inpatient medicine
team.
Practice Site:
University of Mississippi Health Care, Jackson, MS
Inpatient Adult Internal Medicine II Experience UMHC continued
AREAS OF EMPHASIS
Continue participation in collaborative multidisciplinary patient management, while refining
leadership and teaching skills. (R1.2, R2.1, R2.3)
Expand knowledge of pathophysiology of chronic and acute disease states commonly
encountered within the inpatient setting. (R2, R6)
Improve patient assessment, including medication and non-medication related factors. (R2)
Laboratory monitoring for therapeutic outcomes and potential adverse effects of medication
therapy. (R2.7 - 2.10)
Monitoring and interpretation of data related to disease management and medication safety
and effectiveness. (R2.7 - 2.10)
Further develop recommendations for initiation and modification in pharmacotherapy based on
all relevant considerations. (R2)
Enhance patient education and counseling skills, on both pharmacologic and nonpharmacologic recommendations and therapy. (R2.2, R5)
Seek opportunities to provide drug-focused presentations to the team. (R2.1, R5)
Medical record documentation of all interventions and care provided. (R2.12)
Identification and evaluation of patient compliance, including barriers such as payer issues or
need for medication assistance. Development of strategies to improve adherence. (R1.3,
R2, R3.2)
Further develop/refine recommendation and administration of appropriate immunizations for
this patient population. (R1.3, R2)
Enhance drug literature evaluation, including application of evidence-based research and
outcomes to patient specific situations. (R5, R6)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization's medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization's
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and the
organization's policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members of
the health care team. Demonstrate ability to listen well and initiate communication
where appropriate, demonstrating assertiveness. Demonstrate an attitude of teamwork
and respect towards all members of the health care team as manifested by reliability,
responsibility, and honesty.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients. Involve
the patient in therapeutic decision making, explaining the risks and benefits of
treatment. Demonstrate respect for patients and a commitment to involve him/her as an
actual participant in his/her health care.
Goal R.2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships. Display understanding of the role of pharmacists in monitoring therapy,
assessing medication orders, and formulating medications for patients. Establish trust,
confidence, and rapport with patients.
Goal R.2.4: Collect and analyze patient information. Interpret medical management of patient,
communicate to preceptor and members of the health care team an assessment of drug
therapy decisions, and assess common laboratory and diagnostic test results.
Goal R.2.5: When necessary, make and follow up on patient referrals.
Goal R.2.6: Design evidence-based therapeutic regimens. Apply understanding of indications
for pharmacologic and non-pharmacologic therapy. Assess need for each medication
and apply reason to the consideration of pharmacologic and non-pharmacologic therapy
alternatives.
Goal R.2.7: Design evidence-based monitoring plans.
Goal R.2.8: Recommend or communicate regimens and monitoring plans. Evaluate each
patient's therapy for adverse effects. Identify treatment options and/or supportive care
for adverse events that are noted.
Goal R.2.9: Implement regimens and monitoring plans. Design and adjust patient-specific
dosing regimens and apply pharmacokinetic principles in consultation with
preceptor/health care team member to make dosing recommendations.
Goal R.2.10: Evaluate patients' progress and redesign regimens and monitoring plans.
Discuss alternative regimens. Evaluate each patient's drug therapy for drug/drug,
drug/food, drug/lab interactions (prospectively and concomitantly)
Goal R.2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1: Provide effective medication and practice-related education, training, or counseling
to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBILITIES
Serve as an integral member of the inpatient medicine team. (R2.1, R2.3)
Make pharmacological and non-pharmacologic recommendations regarding therapy. (R2)
Serve as a drug information resource utilizing evidenced-based medicine as well as current
literature. Perform literature searches as requested. (R1.2, R2, R6)
Counsel patients upon discharge and during hospitalization as necessary to assess
understanding of both pharmacologic and non-pharmacologic therapies. (R2.2, R5)
Interact and communicate effectively with other providers and staff within the hospital. (R2.1,
R2.3, R5)
Provide education to team members through preparing and delivering drug-focused
presentations. (R2, R5)
Seek opportunities to teach and mentor pharmacy students on rotation where applicable.
(R5.1)
Attend Medicine Grand Rounds at 12 noon each Tuesday. Attend other lectures as deemed
pertinent by the preceptor. (R2.1, R2.3)
Other presentations may be performed as assigned. (R5)
Inpatient VA Adult Internal Medicine Experience
Preceptor:
Donna Bingham, Pharm.D
Clinical Pharmacy Coordinator
G. V. (Sonny) Montgomery VAMC
Jackson, MS
Phone: 601-364-1309 (office)
Pager: 601- 929-2718
Fax: 601- 364-1578
Email: donna.bingham@va.gov
Purpose:
To gain knowledge and clinical experience in disease management and
treatment modalities used for acute care of adult patients. To develop and
improve problem-solving and communication skills, to develop effective
patient education techniques and to participate as an active member of a
collaborative health care inpatient medicine team.
Practice Site:
G. V. (Sonny) Montgomery, Department of Veterans Affairs Medical Center,
Jackson, MS
AREAS OF EMPHASIS
1. Participation in collaborative multidisciplinary patient management. (R1.2.1, R2.1.1,
2.3.1)
2. Pathophysiology of chronic and acute disease states commonly encountered within the
inpatient setting. (R2, R6)
3. Patient assessment, including medication and non-medication related factors.(R2)
4. Laboratory monitoring for therapeutic outcomes and potential adverse effects of
medication therapy. (R2.7 – 2.10)
5. Monitoring and interpretation of data related to disease management and medication
safety and effectiveness. (R2.7 – 2.10)
6. Recommendations for initiation and modification in pharmacotherapy based on all
relevant considerations. (R2)
7. Patient education and counseling on both pharmacologic and nonpharmacologic
recommendations and therapy. (R2.11, R5)
8. Medical record documentation of all interventions and care provided. (R2.12)
9. Identification and evaluation of patient compliance, including barriers such as payer
issues or need for medication assistance. (R1.3, R2, R3.2.3)
10. Development of strategies to improve adherence. (R1.3, R2, R3.2.3)
11. Recommendation and administration of appropriate immunizations for this patient
population. (R1.3, R2)
12. Drug literature evaluation including application of evidence-based research and
outcomes to patient specific situations. (R5, R6)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use system.
OBJ R1.1.1
(Comprehension) Explain the organization’s medication-use system and its vulnerabilities
to adverse drug events (ADEs).
Internal Medicine Experience – Sonny Montgomery Veterans Hospital
COMPETENCY BASED LEARNING OBJECTIVES
OBJ R1.1.2
(Analysis) Analyze the structure and process and measure outcomes of the medicationuse system.
OBJ R1.1.3
(Evaluation) Identify opportunities for improvement in the
organization’s medication-use system by comparing the
medication-use system to relevant best practices.
Goal R1.2:
Design and implement quality improvement changes to the organization’s medication-use
system.
OBJ R1.2.1
(Synthesis) Participate in the identification of need for, development of, implementation
of, and evaluation of an evidence-based treatment guideline/protocol related to individual and
population-based patient care.
OBJ R1.2.2
(Synthesis) Design and implement pilot interventions to
change problematic or potentially problematic aspects of the
medication-use system with the objective of improving quality
Goal R1.3:
Prepare and dispense medications following existing standards of practice and the organization’s
policies and procedures.
OBJ R1.3.1
(Evaluation) Interpret the appropriateness of a medication order before preparing or
permitting the distribution of the first dose.
OBJ R1.3.2
(Application) Follow the organization's policies and procedures to maintain the accuracy
of the patient’s medication profile.
OBJ R1.3.3
(Application) Prepare medication using appropriate techniques and following the
organization's policies and procedures.
OBJ R1.3.4
(Application) Dispense medication products following the organization's policies and
procedures.
Goal R1.4:
Demonstrate ownership of and responsibility for the welfare of the patient by performing all
necessary aspects of the medication-use system.
OBJ R1.4.1
(Characterization) Display initiative in preventing, identifying, and resolving pharmacyrelated patient-care problems.
Outcome R2: Provide evidence-based, patient-centered medication therapy management with
interdisciplinary teams.
(Goal R2.1:
As appropriate, establish collaborative professional relationships with members of the health care
team.
OBJ R2.1.1
(Synthesis) Implement a strategy that effectively establishes cooperative, collaborative,
and communicative working relationships with members of interdisciplinary health care teams.
Goal R2.2:
Place practice priority on the delivery of patient-centered care to patients.
OBJ R2.2.1
(Organization) Choose and manage daily activities so that they reflect a priority on the
delivery of appropriate patient-centered care to each patient.
Goal R2.3:
As appropriate, establish collaborative professional pharmacist-patient relationships.
OBJ R2.3.1.
(Synthesis) Formulate a strategy that effectively establishes a patient-centered
pharmacist-patient relationship.
Goal R2.4:
Collect and analyze patient information.
OBJ R2.4.1
(Analysis) Collect and organize all patient-specific information needed by the pharmacist
to prevent, detect, and resolve medication-related problems and to make appropriate evidencebased, patient-centered medication therapy recommendations as part of the interdisciplinary
team.
OBJ R2.4.2
(Analysis) Determine the presence of any of the following medication therapy problems in
a patient's current medication therapy:
1. Medication used with no medical indication
2. Patient has medical conditions for which there is no medication prescribed
3. Medication prescribed inappropriately for a particular medical condition
4. Immunization regimen is incomplete
5. Current medication therapy regimen contains something inappropriate (dose, dosage
form, duration, schedule, route of administration, method of administration)
6. There is therapeutic duplication
7. Medication to which the patient is allergic has been prescribed
8. There are adverse drug or device-related events or potential for such events
Internal Medicine Experience – Sonny Montgomery Veterans Hospital
COMPETENCY BASED LEARNING OBJECTIVES
9. There are clinically significant drug-drug, drug-disease, drug-nutrient, or drug-laboratory
test interactions or potential for such interactions
10. Medical therapy has been interfered with by social, recreational, nonprescription, or
nontraditional drug use by the patient or others
11. Patient not receiving full benefit of prescribed medication therapy
12. There are problems arising from the financial impact of medication therapy on the patient
13. Patient lacks understanding of medication therapy
14. Patient not adhering to medication regimen
OBJ R2.4.3
(Analysis) Using an organized collection of patient-specific information, summarize
patients’ health care needs.
Goal R2.5:
When necessary, make and follow up on patient referrals.
OBJ R2.5.1
(Evaluation) When presented with a patient with health care needs that cannot be met by
the pharmacist, make a referral to the appropriate health care provider based on the patient’s
acuity and the presenting problem.
Goal R2.6:
Design evidence-based therapeutic regimens.
OBJ R2.6.1
(Synthesis) Specify therapeutic goals for a patient incorporating the principles of
evidence-based medicine that integrate patient-specific data, disease and medication-specific
information, ethics, and quality-of-life considerations.
OBJ R2.6.2
(Synthesis) Design a patient-centered regimen that meets the evidence-based
therapeutic goals established for a patient; integrates patient-specific information, disease and
drug information, ethical issues and quality-of-life issues; and considers pharmacoeconomic
principles. .
Goal R2.7:
Design evidence-based monitoring plans.
OBJ R2.7.1
(Synthesis) Design a patient-centered, evidenced-based monitoring plan for a therapeutic
regimen that effectively evaluates achievement of the patient-specific goals.
Goal R2.8:
Recommend or communicate regimens and monitoring plans.
OBJ R2.8.1
(Application) Recommend or communicate a patient-centered, evidence-based
therapeutic regimen and corresponding monitoring plan to other members of the interdisciplinary
team and patients in a way that is systematic, logical, accurate, timely, and secures consensus
from the team and patient.
Goal R2.9:
Implement regimens and monitoring plans.
OBJ R2.9.1
(Application) When appropriate, initiate the patient-centered, evidence-based therapeutic
regimen and monitoring plan for a patient according to the organization's policies and procedures.
OBJ R2.9.2
(Application) Use effective patient education techniques to provide counseling to patients
and caregivers, including information on medication therapy, adverse effects, compliance,
appropriate use, handling, and medication administration.
Goal R2.10:
Evaluate patients’ progress and redesign regimens and monitoring plans.
OBJ R2.10.1 (Evaluation) Accurately assess the patient’s progress toward the therapeutic goal(s).
OBJ R2.10.2 (Synthesis) Redesign a patient-centered, evidence-based therapeutic plan as necessary
based on evaluation of monitoring data and therapeutic outcomes.
Goal R2.11:
Communicate ongoing patient information.
OBJ R2.11.1 (Application) When given a patient who is transitioning from one health care setting to
another, communicate pertinent pharmacotherapeutic information to the receiving health care
professionals.
OBJ R2.11.2 (Application) Ensure that accurate and timely medication-specific information regarding a
specific patient reaches those who need it at the appropriate time.
Goal R2.12:
Document direct patient care activities appropriately.
OBJ R2.12.1 (Analysis) Appropriately select direct patient-care activities for documentation.
OBJ R2.12.2 (Application) Use effective communication practices when documenting a direct patientcare activity.
OBJ R2.12.3 (Comprehension) Explain the characteristics of exemplary documentation systems that
may be used in the organization’s environment.
Internal Medicine Experience – Sonny Montgomery Veterans Hospital
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1:
Exhibit essential personal skills of a practice leader.
OBJ R.3.1.1
(Characterization) Practice self-managed continuing professional development with the
goal of improving the quality of one’s own performance through self-assessment and personal
change.
OBJ R3.1.2
(Characterization) Demonstrate pride in and commitment to the profession through
appearance, personal conduct, and association membership.
OBJ R3.1.3
(Characterization) Act ethically in the conduct of all job-related activities.
Goal R3.2: Contribute to departmental leadership and management activities.
OBJ R3.2.1
(Synthesis) Participate in the pharmacy department's planning processes.
OBJ R3.2.2
(Comprehension) Explain the effect of accreditation, legal, regulatory, and safety
requirements on practice.
OBJ R3.2.3
(Comprehension) Explain the principles of financial management of a pharmacy
department.
OBJ R3.2.4
(Synthesis) Prioritize the work load, organize the work flow, and check the accuracy of
the work of pharmacy technical and clerical personnel or others.
Goal R3.3: Exercise practice leadership.
OBJ R3.3.1
(Synthesis) Use knowledge of an organization's political and decision-making structure
to influence accomplishing a practice area goal.
OBJ R3.3.2
(Comprehension) Explain various leadership philosophies that effectively support direct
patient care and pharmacy practice excellence.
OBJ R3.3.3
(Application) Use group participation skills when leading or working as a member of a
committee or informal work group.
OBJ R3.3.4 (Application) Use knowledge of the principles of change management to achieve organizational,
departmental, and/or team goals
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or counseling to patients,
caregivers, health care professionals, and the public.
OBJ R5.1.1
(Application) Use effective educational techniques in the design OBJ R5.1.2
(Synthesis) Design an assessment strategy that appropriately measures the specified
objectives for education or training and fits the learning situation.
of all educational activities.
OBJ R5.1.3
(Application) Use skill in the four preceptor roles employed in practice-based teaching
(direct instruction, modeling, coaching, and facilitation).
OBJ R5.1.4
(Application) Use skill in case-based teaching.
OBJ R5.1.5
(Application) Use public speaking skills to speak effectively in large and small group
situations.
OBJ R5.1.6
(Application) Use knowledge of audio-visual aids and handouts to enhance the
effectiveness of communications.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
OBJ R6.1.1
(Comprehension) Explain security and patient protections such as access control, data
security, data encryption, HIPAA privacy regulations, as well as ethical and legal issues related to
the use of information technology in pharmacy practice.
OBJ R6.1.2
(Application) Exercise skill in basic use of databases and data analysis software.
OBJ R6.1.3
(Evaluation) Successfully make decisions using electronic data and information from
internal information databases, external online databases, and the Internet.
Internal Medicine Experience – Sonny Montgomery Veterans Hospital
ACTIVITIES AND RESPONSIBILITIES
1. Serve as an integral member of the inpatient medicine team. (R2.1.1, 2.3.1)
2. Make pharmacologic and non-pharmacologic recommendations regarding therapy. (R2)
3. Serve as a drug information resource utilizing evidenced-based medicine as well as
current literature. Perform literature searches as requested. (R1.2.1, R2, R6)
4. Counsel patients upon discharge and during hospitalization as necessary to assess
understanding of both pharmacologic and non-pharmacologic therapies. (R2.11, R5)
5. Assist inpatient medical team with medication reconciliation for each assigned patient
upon admission and discharge. (R2, R5)
6. Interact and communicate effectively with other providers and staff within the hospital.
(R2.1.1, 2.3.1, R5)
7. Assist in teaching of pharmacy students on rotation where applicable. (R5.1.3 – 5.1.4)
8. Provide inservices to the medical center staff as necessary related to medication
therapy. (R5, R6)
9. Attend Medicine Grand Rounds at 12 noon each Tuesday. Attend other lectures as
deemed pertinent by the preceptor. (R2.1.1, 2.3.1)
10. Other presentations may be performed as assigned. (R5)
11. Help to continually expand the credibility and scope of pharmacy services. (R3.3.1)
12. Complete assigned projects prior to end of rotation. (R3, R4)
NEPHROLOGY/RENAL TRANSPLANT EXPERIENCE
Preceptor:
Anna Baldwin, PharmD, BCPS
Clinical Pharmacist - 2 South/Renal Transplant
University of Mississippi Medical Center
Office: 601-815-2285
Cell: 601-754-3010
Pager: 601-929-4008
E-mail: abaldwin@umc.edu
Purpose:
The overall purpose of this elective rotation is two-fold: to gain knowledge and clinical
experience in disease management and treatment modalities used in the inpatient setting, with
a focus on nephrology/renal transplant and to improve problem-solving and communication
skills, develop effective patient education techniques, and participate as an active member of a
multidisciplinary team. The resident will also gain experience in teaching by providing
pharmaceutical information to a variety of health care professionals in different stages of
training to include, but not limited to, medical, pharmacy, dietary & and nursing students,
medical & pharmacy residents, clinical pharmacists, physicians, nurses, dieticians, and nurse
practitioners. Patient education is emphasized on an individual patient basis.
Practice Site:
University of Mississippi Medical Center
2 South
Jackson, Mississippi
Areas of Emphasis:
1. Participation in collaborative multidisciplinary patient management. (R1.2.1, R2.1.1,
2.3.1)
2. Pathophysiology of chronic and acute disease states commonly encountered within the
inpatient setting. (R2, R6)
3. Patient assessment, including medication and non-medication related factors.(R2)
4. Laboratory monitoring for therapeutic outcomes and potential adverse effects of
medication therapy. (R2.7 – 2.10)
5. Monitoring and interpretation of data related to disease management and medication
safety and effectiveness. (R2.7 – 2.10)
6. Recommendations for initiation and modification in pharmacotherapy based on all
relevant considerations. (R2)
7. Patient education and counseling on both pharmacologic and non-pharmacologic
recommendations and therapy. (R2.11, R5)
8. Medical record documentation of all interventions and care provided. (R2.12)
9. Identification and evaluation of patient compliance, including barriers such as payer
issues or need for medication assistance. (R1.3, R2, R3.2.3)
10. Development of strategies to improve adherence. (R1.3, R2, R3.2.3)
11. Recommendation and administration of appropriate immunizations for this patient
population. (R1.3, R2)
12. Drug literature evaluation including application of evidence-based research and
outcomes to patient specific situations. (R5, R6)
Competency-Based Learning Objectives and Goals
Outcome R1:
Manage and improve the medication-use process.
 Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
o R1.1.2 Analyze the structure and process and measure outcomes.
 Goal R1.2:Design and implement quality improvement changes to the organization’s
medication-use system.
o OBJ R1.2.4(Synthesis) Design and implement pilot interventions to change
problematic or potentially problematic aspects of the medication-use system with
the objective of improving quality.
 Goal R1.3:Prepare and dispense medications following existing standards of practice
and the organization’s policies and procedures.
o OBJ R1.3.1 (Evaluation) Interpret the appropriateness of a medication order
before preparing or permitting the distribution of the first dose.
o OBJ R1.3.2 (Application) Follow the organization's policies and procedures to
maintain the accuracy of the patient’s medication profile.
 Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
o OBJ R1.4.1(Characterization) Display initiative in preventing, identifying, and
resolving pharmacy-related patient-care problems.
 Goal R1.5: Provide concise, applicable, comprehensive, and timely responses to
requests for drug information from patients and health care providers.
o OBJ R1.5.1 (Analysis) Discriminate between the requesters’ statement of need
and the actual drug information need by asking for appropriate additional
information.
o OBJ R1.5.2 (Synthesis) Formulate a systematic, efficient, and thorough
procedure for retrieving drug information.
o OBJ R1.5.3 (Analysis) Determine from all retrieved biomedical literature the
appropriate information to evaluate.
o OBJ R1.5.4 (Evaluation) Evaluate the usefulness of biomedical literature
gathered.
o OBJ R1.5.5 (Synthesis) Formulate responses to drug information requests based
on analysis of the literature.
o OBJ R1.5.6 (Synthesis) Provide appropriate responses to drug information
questions that require the pharmacist to draw upon his or her knowledge base.
o OBJ R1.5.7 (Evaluation) Assess the effectiveness of drug information
recommendations.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
 Goal R2.1: As appropriate, establish collaborative professional relationships with
members of the health care team.
o OBJ R2.1.1 (Synthesis) Implement a strategy that effectively establishes
cooperative, collaborative, and communicative working relationships with
members of interdisciplinary health care teams.
 Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
o OBJ R2.2.1 (Organization) Choose and manage daily activities so that they
reflect a priority on the delivery of appropriate patient-centered care to each
patient.
 Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.





o OBJ R2.3.1. (Synthesis) Formulate a strategy that effectively establishes a
patient-centered pharmacist-patient relationship.
Goal R2.4: Collect and analyze patient information.
o OBJ R2.4.1 (Analysis) Collect and organize all patient-specific information
needed by the pharmacist to prevent, detect, and resolve medication-related
problems and to make appropriate evidence-based, patient-centered medication
therapy recommendations as part of the interdisciplinary team.
o OBJ R2.4.2 (Analysis) Determine the presence of any of the following
medication therapy problems in a patient's current medication therapy:
1. Medication used with no medical indication
2. Patient has medical conditions for which there is no medication prescribed
3. Medication prescribed inappropriately for a particular medical condition
4. Immunization regimen is incomplete
5. Current medication therapy regimen contains something inappropriate
(dose, dosage form, duration, schedule, route of administration, method of
administration)
6. There is therapeutic duplication
7. Medication to which the patient is allergic has been prescribed
8. There are adverse drug or device-related events or potential for such
events
9. There are clinically significant drug-drug, drug-disease, drug-nutrient, or
drug-laboratory test interactions or potential for such interactions
10. Medical therapy has been interfered with by social, recreational,
nonprescription, or nontraditional drug use by the patient or others
11. Patient not receiving full benefit of prescribed medication therapy
12. There are problems arising from the financial impact of medication therapy
on the patient
13. Patient lacks understanding of medication therapy
14. Patient not adhering to medication regimen
o OBJ R2.4.3 (Analysis) Using an organized collection of patient-specific
information, summarize patients’ health care needs.
Goal R2.5: When necessary, make and follow up on patient referrals.
o OBJ R2.5.1 (Evaluation) When presented with a patient with health care needs
that cannot be met by the pharmacist, make a referral to the appropriate health
care provider based on the patient’s acuity and the presenting problem.
o OBJ R2.5.2 (Synthesis) Devise a plan for follow-up for a referred patient.
Goal R2.6: Design evidence-based therapeutic regimens.
o OBJ R2.6.1 (Synthesis) Specify therapeutic goals for a patient incorporating the
principles of evidence-based medicine that integrate patient-specific data,
disease and medication-specific information, ethics, and quality-of-life
considerations.
o OBJ R2.6.2 (Synthesis) Design a patient-centered regimen that meets the
evidence-based therapeutic goals established for a patient; integrates patientspecific information, disease and drug information, ethical issues and quality-oflife issues; and considers pharmacoeconomic principles. .
Goal R2.7: Design evidence-based monitoring plans.
o OBJ R2.7.1 (Synthesis) Design a patient-centered, evidenced-based monitoring
plan for a therapeutic regimen that effectively evaluates achievement of the
patient-specific goals.
Goal R2.8: Recommend or communicate regimens and monitoring plans.




o OBJ R2.8.1 (Application) Recommend or communicate a patient-centered,
evidence-based therapeutic regimen and corresponding monitoring plan to other
members of the interdisciplinary team and patients in a way that is systematic,
logical, accurate, timely, and secures consensus from the team and patient.
Goal R2.9: Implement regimens and monitoring plans.
o OBJ R2.9.1(Application) When appropriate, initiate the patient-centered,
evidence-based therapeutic regimen and monitoring plan for a patient according
to the organization's policies and procedures.
o OBJ R2.9.2 (Application) Use effective patient education techniques to provide
counseling to patients and caregivers, including information on medication
therapy, adverse effects, compliance, appropriate use, handling, and medication
administration.
Goal R2.10:Evaluate patients’ progress and redesign regimens and monitoring plans.
o OBJ R2.10.1 (Evaluation) Accurately assess the patient’s progress toward the
therapeutic goal(s).
o OBJ R2.10.2 (Synthesis) Redesign a patient-centered, evidence-based
therapeutic plan as necessary based on evaluation of monitoring data and
therapeutic outcomes.
Goal R2.11: Communicate ongoing patient information.
o OBJ R2.11.2 (Application) Ensure that accurate and timely medication-specific
information regarding a specific patient reaches those who need it at the
appropriate time.
Goal R2.12: Document direct patient care activities appropriately.
o OBJ R2.12.1 (Analysis) Appropriately select direct patient-care activities for
documentation.
o OBJ R2.12.2 (Application) Use effective communication practices when
documenting a direct patient-care activity.
o OBJ R2.12.3 (Comprehension) Explain the characteristics of exemplary
documentation systems that may be used in the organization’s environment.
Outcome R3: Exercise leadership and practice management skills.
 Goal R3.1: Exhibit essential personal skills of a practice leader.
o OBJ R.3.1.1 (Characterization) Practice self-managed continuing professional
development with the goal of improving the quality of one’s own performance
through self-assessment and personal change.
o OBJ R3.1.2 (Characterization) Demonstrate pride in and commitment to the
profession through appearance, personal conduct, and association membership.
o OBJ R3.1.3 (Characterization) Act ethically in the conduct of all job-related
activities.
Outcome R5:
Provide medication and practice-related education/training.
 Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
o OBJ R5.1.1 (Application) Use effective educational techniques in the design of
all educational activities.
o OBJ R5.1.2 (Synthesis) Design an assessment strategy that appropriately
measures the specified objectives for education or training and fits the learning
situation.
o OBJ R5.1.3 (Application) Use skill in the four preceptor roles employed in
practice-based teaching (direct instruction, modeling, coaching, and facilitation).
o OBJ R5.1.4 (Application) Use skill in case-based teaching.
o OBJ R5.1.5 (Application) Use public speaking skills to speak effectively in large
and small group situations.
o OBJ R5.1.6 (Application) Use knowledge of audio-visual aids and handouts to
enhance the effectiveness of communications.
Outcome R6: Utilize medical informatics.
 Goal R6.1: Use information technology to make decisions and reduce error.
o OBJ R6.1.2 (Application) Exercise skill in basic use of databases and data
analysis software.
o OBJ R6.1.3 (Evaluation) Successfully make decisions using electronic data and
information from internal information databases, external online databases, and
the Internet.
Activities and Responsibilities include, but are not limited to:
25. Serve as an integral member of the interdisciplinary nephrology/renal transplant team
(R2.1.1, 2.3.1)
26. Establish a covenant relationship with each patient requiring direct patient care (R2, R5)
27. Identify therapeutic goals for patients (R2)
28. Obtain complete patient assessment by including the following information: reason for
admission, medical history, social/family history, review of systems, physical
examination, home medications, adherence to therapy, need for medication assistance,
and current diagnosis and treatment (R2)
29. Contact community pharmacies to obtain home medication list if necessary (R2, R5)
30. Monitor patient profiles for appropriateness of therapy, complete therapeutic
management, potential drug-drug/food/disease interactions, and adverse drug effects.
This includes daily lab review to ensure patient safety, therapeutic response to therapy,
and to identify needed changes in therapy (R1.2.1, R2)
31. Identifying medication therapy problems and approaches to resolving these problems
(R2)
32. Initiating or optimizing therapeutic regimens for applicable disease states/complications
according to established protocols (R1.2.1, R2, R6)
33. Ensuring access to medication therapies through completion of appropriate paperwork
for patient assistance (R3.3.2, R1.3)
34. Counsel patients and assess understanding of both pharmacologic and nonpharmacologic therapy. Follow-up with communication regarding lab results and any
changes in medication regimens. (R2.11, R5)
35. Documenting direct patient care activities in the medical record (R2.12)
36. Observing patient confidentiality (R3.1.3, 3.2.3)
37. Providing patient-specific and caregiver-specific medication and disease related
education (R2.12, R5)
38. Educate patients on both pharmacologic and non-pharmacologic recommendations
prior to discharge (R2.11, R5)
39. Referring patients to other health care providers as appropriate, including dietician and
social worker (R2.5)
40. Ensuring continuity of care by communicating pertinent information to the provider
responsible for the patient (R2, R2.11, R2.5)
41. Serve as a drug information resource by utilizing evidenced-based medicine as well as
current literature. Perform literature searches as requested. (R6, R5, R2.1.1, 2.3.1)
42. Actively serving as a preceptor and role model for pharmacy student(s) which includes
teaching therapeutic principals, facilitating case discussions, and guiding clinical
activities (R5.1.3, 5.1.4)
43. Interact and communicate effectively with other providers and staff (R5, R2.1.1, 2.3.1)
44. Provide in-services to the nursing staff or medical staff as necessary (R5, R6)
45. Prepare a formal presentation on inpatient topic of choice to be presented at end of
rotation (R5, R6)
46. Help to continually expand the credibility and scope of pharmacy services. (R3.3.1, 3.2)
47. Continue other research, clinical, and service activities that fall outside the rotation as
required by the residency (R3.1.1, R4, E1)
Required Reading
Readings will be assigned during rotation based on topic discussion schedule
Recommended readings:
http://www.kidney.org/professionals/kdoqi/guidelines_commentaries.cfm
NUTRITION SUPPORT EXPERIENCE
PRECEPTOR:
Phil Ayers, Pharm D, BCNSP
Clinical Pharmacist, Nutrition Support/ Intensive Care
Assistance Professor, Department Pharmacy Practice
Mississippi Baptist Medical Center, Jackson, MS
Work Phone: 601-974-6265
Pager: 601- 973-4158
Email: payers@mbhs.org
PURPOSE:
To familiarize the resident with common nutritional therapies,
including patient assessment, enteral and parenteral nutrition,
nutritional considerations with specific diseases and conditions, and
complications of nutritional delivery.
PRACTICE SITE:
University Hospitals and Clinics, Jackson, MS
Mississippi Baptist Medical Center, Jackson, MS
POPULATION SERVED: The UMC Nutrition Support Team is involved with acute care
patients (including critically ill and ward patients). These patients
have a variety of conditions (including traumatic injury, pancreatitis,
GI fistula, Crohn’s disease, bone marrow transplant, gastroparesis.
The Baptist Nutrition Support team is involved with acute care
patients as described above.
Areas of Emphasis and Activities
Emphasis: To consistently provide appropriate patient focused care regarding both nutritional
and pharmacotherapeutic needs of each individual patient. (R2)
Activities: Assess patient information daily and formulate an individualized
therapeutic plan to achieve predetermined outcomes. (R2)
- Perform thorough chart review
- Conduct daily patient interviews
- Perform physical assessment of patient
- Review and evaluate pertinent laboratory data
- Review patient’s bedside chart
- Utilize other sources of information (e.g. medical staff, nursing
staff, pharmacy staff, etc.)
- Calculate/estimate patients’ individualized nutritional needs
- Prepare a treatment plan to meet each patients’ nutritional
needs
- Implement the plan to meet patients’ nutritional needs
Activities: Monitor for potential drug-related and nutritional related
problems and make appropriate interventions. (R2, R1.1.1, 1.1.3)
- Screening of patient medication profiles and nursing MAR
- Screening of laboratory data (particularly for electrolyte
abnormalities)
- Therapeutic drug monitoring (e.g. pharmacokinetics)
- Conducting patient interviews
Nutrition Support Experience
Areas of Emphasis and Activities
-
Assessment of central lines or peripheral for phlebitis and/or
infection
Activities: Ensure accurate and timely medication/nutrition delivery and
administration. (R1.3, R5)
- Communicate daily with Pharmacy Sterile Products staff and
Nursing staff for clarification and mutual understanding of TPN
orders/changes
- Educate Pharmacy Sterile Products staff and Nursing staff
about new orders and the rationale behind them
- Verify correct order entry into pharmacy computer system
- Review patient medication administration records
- Visually check all patients’ intravenous medications for accuracy
of patient, infusion rate, medication/nutrient, and
concentrations/amounts
Emphasis: To develop effective communication skills. (R5, R2.11)
Activities: Communicate medication/nutritional information to
patient/ family members.
- Obtain patient medication histories
- Provide patient/family education
- Perform patient discharge counseling
Activities: Provide timely and appropriate medication/nutritional
information to other health care professionals. (additionally R2.1.1, 2.3.1)
- Communicate with the patient’s primary physicians about
patient’s nutritional status, needs, and order
recommendations/changes
- Provide inservices (e.g. to nurses, physicians, pharmacists, etc.)
Emphasis: To document pharmaceutical care concisely in a timely manner. (R2.12)
Activities: Document patient care interventions
Activities: Document adverse drug events and medication errors
according to departmental policies.
Activities: Demonstrate competency in documenting in the patient
medical record (e.g. daily progress notes)
ACTIVITIES AND RESPONSIBILITIES
Responsibilities
1. Patient monitoring -- the resident will be expected to know each patient's medications and
problem list by utilizing some type of appropriate monitoring form. (R2)
2. Monitor each patient's drug therapy for appropriateness, effectiveness, and toxicity using
laboratory values and clinical assessment of the patient. (R2)
3. Function as a liaison between the departments of pharmacy, nursing, and medicine to
facilitate timely and appropriate pharmacy services. (R2.1.1, 2.3.1, 2.11, R5)
4. Function as a pharmacotherapeutic consultant to other health care professionals using
medical literature retrieval and communication skills. (R5, R6, R2.11, R2)
5. As needed, the resident may be asked to give short presentations or inservices to nursing,
pharmacy, or medical practitioners. (R5, R6, R2.1.1, 2.3.1)
Nutrition Support Experience
Responsibilities
6. Attend medical grand rounds each week, and any other seminar of interest. (R2.1.1, 2.3.1)
7. Attend all pharmacy seminars and presentations (including other students and residents).
(R2.1.1, 2.3.1)
8. Meet with preceptor, as scheduled, for presentation and discussion of patients and topics.
(R5.1.3, 5.1.4)
9. The resident will give formal topic presentations. (R5, R6)
Nutrition Support Team
Patient Workup
Read the chart (orders, progress notes, nurses notes, etc.)
Make note of any changes, new drugs, clinical progress, new developments, etc.
Check laboratory values.
Visually check all IV’s for accuracy of ingredients and infusion rates (and patient name!).
Interview patient (complaints, diarrhea, nausea, vomiting, constipation, hunger, oral intake,
etc.)
Complete the NST monitoring form.
Patient Presentation
Present a one line summary of patient.
Tell what patient is receiving (TPN formula, enteral formula, and diet order).
Tell what TPN/EN provides (kcal/kg/d and g protein/kg/d).
Comment on the last change we made on the patient.
Comment on any changes since last we rounded on that patient.
Comment on patient’s progress since last we rounded.
List today’s laboratory values.
Comment on any miscellaneous information (ins/outs, Tmax, weight changes, etc.)
Describe your plan/recommendation (based upon the above information).
Nutrition Support Experience
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Resident Progression Objectives
Week
Week 1
8)
9)
Week 2
10)
11)
11)
Week 3
12)
13)
14)
6)
7)
8)
Week 4
Objective(s)
Follow all NSS patients in coordination with preceptor
Review assessment of protein and caloric needs of adult and
pediatric patients
Review fluids/electrolytes and acid-base
Order parenteral nutrition and appropriate therapies via CPOE
Follow 2 critical care/surgical patients independently of preceptor,
with overview
Discuss enteral nutrition selection
Order enteral nutrition and appropriate therapies via CPOE
Oversee PY3 and PY4 students assigned to NSS
Follow 4 critical care/surgical patients independently of preceptor,
with overview
Lead topic discussions for PY4 students
Assist PY 4 students with patient presentations
4) Cover all parenteral nutrition patients on the NSS service
independently of preceptor, with overview
GENERAL ONCOLOGY EXPERIENCE
PRECEPTOR:
Shirley Hogan, Pharm.D.
Office Annex #121
Phone: 601-984-2624
Pager: 601-929-3804
Email: shogan@umc.edu
PURPOSE OF ROTATION: To familiarize the resident with the management of
patients receiving chemotherapeutic agents. To develop the clinical skills
necessary to monitor and make appropriate interventions for optimal care
of this unique patient population.
PRACTICE SITE: University of Mississippi Medical Center, Jackson, MS
Hematology and Oncology Department
AREAS OF EMPHASIS
1. Develop an understanding of classification of chemotherapeutic agents. (R1.3, R2,
R6)
2. Become familiar with common side effects of specific chemotherapeutic
agents and appropriate parameters for monitoring. (R1.1.1, 1.1.3, R2, R6)
3. Develop a familiarity with common antiemetic regimens and make appropriate
recommendations to optimize therapy. (R2, R6)
4. Develop an understanding of biological response modifiers and their
appropriate use in the oncology setting. (R2, R6)
5. Become familiar with pathogens commonly encountered in oncology patients
with neutropenia due to chemotherapy. (R2, R6)
6. Function as a drug information provider to the medical team when appropriate
(demonstrating appropriate medical literature retrieval skills and
communication skills). (R6, R5, R2.1.1, 2.3.1, 2.11)
7. Develop effective patient communication skills in order to assist in patient/
parent education. (R2.11, R5)
8. Become familiar with oncology research group protocols, registration of
patients and assignment of treatment schema. (R1.2.1, R2, R6)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
General Oncology Experience continued
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
RESPONSIBILITIES
1.
2.
3.
4.
Meet with preceptor on a daily basis for discussion of patient therapy. (R2, R5.1.3, 5.1.4)
Attendance at weekly oncology patient conferences. (R2.1.1, 2.3.1)
Periodic discussion of assigned reading material with the preceptor. (R6, R2, R5.1.3, 5.1.4)
Attendance on rounds with Adult/Pediatric Hematology/Oncology team as assigned.
(R2.1.1, 2.3.1)
5. Patient/ Parent education as needed. (R2.11, R5)
6. Attendance at resident presentations and pharmacy conferences. (R2.1.1, 2.3.1, R5, R6)
Note: After completion of the general oncology pharmacy rotation, a resident with particular
Interest in oncology pharmacy, may choose to complete a rotation focused on Adult or
Pediatric Oncology. This rotation would build on the experience gained through the general
oncology rotation and focus on those patients in the age group specified.
ORIENTATION / AMBUALTORY CLINICS & DRUG
INFORMATION ORIENTATION
PRECEPTOR:
Michael Todaro, Pharm. D.
Director of Pharmacy
Assistant Professor, Department Pharmacy Practice
Work Phone: 601-984-2055
Cell: 601-540-0620
Fax: 601-984-2063
Email: mtodaro@umc.edu
PRACTICE SITE:
University of Mississippi Health Care
University Hospital and Ambulatory Clinics
Drug Information Center
PURPOSE:
To provide an orientation to the hospital, the Department of Pharmacy
Services, the Department of Pharmacy Practice, Preceptors and Staff. To
provide an overview of institutional practice and aid the resident with
familiarity with the hospital and the pharmacy department to aid in their
function as a vital contributing member of the health care team to provide
exemplary patient care with compassion, dignity, and respect.
TYPE OF EXPERIENCE: Extended experience (July- August)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Orientation Extended Experience
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
AREAS OF EMPHASIS
1. Exposure to the Central Pharmacy/ IV Room, including the Bulk Room and Narcotic Vault.
(R1.3-1.4)
2. Exposure to the Patient Care Area Pharmacists. (R1.3-1.4, R2)
3. Exposure to the Critical Care Satellites (R1.3 – 1.4, R2)
4. Exposure to the Pediatric Satellite and practice areas, including the Neonatal Intensive Care
Satellite. (R1.3-1.4, R2)
5. Exposure to the two outpatient pharmacy services. (R1.3 – 1.4)
6. Exposure to the automation within the department. (R1.3 – 1.4))
7. Exposure to the Drug Information Services and orientation to the Rowland Medical Library.
(R6) Completion of CITI training for research. (R4, E1)
8. Exposure to fluid and electrolytes and parenteral nutrition. (R2)
9. Exposure to the various ambulatory clinic services and orientation to the continuity care
clinic in the Anticoagulation Clinic. (R1-2)
ACTIVITIES
Will be dictated by the area orientation is occurring.
READING ASSIGNMENTS
Department of Pharmacy Services Policy and Procedural Manual
Residency Program Manual
PCAP Orientation Manual
PAIN MEDICINE
Preceptor:
Inactive
Practice Site:
University of Mississippi Medical Center
2500 North State Street, Jackson, MS 39216
Purpose:
To gain knowledge and clinical experience in the recognition and management of
acute and chronic pain conditions. To gain experience in communicating with
other healthcare professionals and patients for the provision of pharmaceutical
information.
Goals
1.
Define pain and its two main types: acute and chronic. (R6)
2.
Understand the pathophysiology of pain, including the anatomy and biochemical
mediators. (R6)
3.
Understand the pharmacology and therapeutic use of analgesic drugs and adjuvants for
specific pain syndromes. (R6, R2)
4.
Understand the rationale for postoperative epidural pain management and the
pharmacological properties of drugs used in epidural anesthesia and analgesia. (R2,
R6)
5.
Understand various anesthetic and neurosurgical approaches and their place in chronic
pain management. (R2, R6)
4.
Demonstrate effective assessment of a pain patient, utilizing the interview process,
numerical scale, visual analog scale and/or McGill Pain Questionnaire. (R2, R5)
Areas of Emphasis
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Discuss specific topics relevant to the area of Pain Medicine. Potential topics for
discussion include modes of opioid delivery, general and regional anesthesia, postpuncture headache, opioid tolerance and dependence and new drug evaluation. (R5,
R6, R2)
Awareness of the non-surgical and surgical modalities utilized to relieve pain. (R2, R6)
Participation in acute and chronic inpatient rounds with the Acute Pain Management
Service. (R2.1.1, 2.3.1)
Attend Pain Management Performance Improvement Committee monthly meetings.
(R3.3.3, 3.3.4)
Provide medication counseling to both hospitalized and ambulatory patients. (R2.11,
R5)
Obtain medication histories (e.g. home medications) from patients and if required,
community pharmacists. (R1.3, R2, R5)
Review medication histories and new prescriptions for drug-drug interactions, drug-food
interactions, and drug-disease interactions. (R1.3, R2)
Obtain and document medication and food allergies of patients. (R1.3, R2, R2.12)
Develop a working knowledge (e.g. dosing, adverse effects) of the non-opioid, opioid,
and adjuvants commonly prescribed to management pain. (R2, R6)
Know the federal and state laws and regulations pertaining to the ordering, dispensing,
administering, monitoring, and procurement of controlled substances. (R3.2.2)
Pain Medicine Continued
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication
use system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice
and the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient
by performing all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy management with
interdisciplinary teams.
Goal R2.1:As appropriate, establish collaborative professional relationships with
members of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3:As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6:Design evidence-based therapeutic regimens.
Goal R2.7:Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10:Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12:Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the
public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
GENERAL PEDIATRIC EXPERIENCE
PRECEPTOR:
Andrew Ostrenga, Pharm.D.
Clinical Pharmacist, Blair E. Batson Hospital for Children
Clinical Assistant Professor, Department of Pharmacy Practice
Work: (601) 815-8391
Pager: (601) 929-4017
Fax: (601) 815-8382
Email: aostrenga@umc.edu
Kim G. Adcock, Pharm.D., CCRC
Assistant Professor, Departments of Pharmacy Practice and Pediatrics
Director, Division of Pediatric Clinical Research, Department of
Pediatrics
Phone: 601-984-2760
Fax: 601-984-2618
Email: kadcock@umc.edu
PURPOSE:
To gain clinical experience and knowledge in a very diverse
and interesting patient population---PEDIATRICS. The
opportunity to experience the routine and not-so routine
disease states that are encountered in the very young to
adolescent age group. The resident can be an integral part
of the multi-disciplinary teams in providing drug information
(ex: dosages, side effects, drug-drug interactions, drug-food
interactions). The resident is given the opportunity to gain
knowledge in several different specialties of pediatrics,
including cardiology, endocrinology, neurology, pulmonology and
gastroenterology.
PRACTICE SITE:
Blair E. Batson Hospital for Children
University of Mississippi Health Care
Jackson, Mississippi
AREAS OF EMPHASIS
1. Assess patient disease state and therapy of such by collecting and organizing
patient data from the medical record and personal interview, if applicable. (R2)
2. Interpretation and evaluation of patient data based on signs and symptoms, etiology,
epidemiology and clinical course. (R2)
3. Knowledge about specific drugs in relation to usual regimen (i.e. dose, form,
schedule, route, and method of administration). (R2, R6)
4. Evaluate therapy in regard to mechanism of action, indication, contraindication(s),
adverse reactions and/or pharmacokinetics (R2)
5. Effectively communicate with patients, caregivers, health-care professionals, or
others so that the patient-specific information needed is collected. (R2.1.1,2.1.3, R5)
6. Provide concise, applicable, and timely responses to requests for drug
information from health care providers and patients. (R6)
General Pediatric Experience Continued
7. Use effective patient education techniques to provide discharge counseling to
caregivers, and when appropriate, patients, including information of drug therapy,
adverse effects, compliance, appropriate use, handling and drug administration.
Documentation of such teaching is made on patient/family education form. (R2.12,
R5)
8. Evaluate pertinent scientific literature relative to the pediatric population and provide
appropriate summary. (R6)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
General Pediatric Experience Continued
ACTIVITIES AND RESPONSIBILITIES
1. Participate in daily work and/or attending rounds with general pediatric team.
(R2.1.1, 2.1.3)
2. Review all patient data—not limited to but includes admission and daily orders,
progress notes of all medical staff and other health care professionals, laboratory
tests (chemistries, cultures, etc.), and any other diagnostic testing relevant to patient
care. (R2.4.1,2.4.2, 2.9.1)
3. Review all drug therapy for appropriateness of dose, drug-drug interactions, drugdisease interactions (9R2)
4. Attend weekly pediatric grand rounds on Wednesdays at noon and pediatric case
conferences on Friday mornings. (R2.1.1, 2.1.3)
5. Attend resident or attending-led teaching sessions on pertinent pediatric subjects
(R2.1.1, 2.1.3, 5.1.4)
6. Provide short pharmacy related in-services to other health-care professionals as
deemed appropriate. (R5)
7. Provide discharge counseling to pediatric patients and/or caregivers, (especially
asthmatics, congenital heart defect patients, or others with difficult medication
regimens. (R2.11,R5)
8. Participate in drug literature evaluation as it pertains to pediatric medicine literature
(R6)
9. Become familiar with strategies employed with care of patients in an acute care
setting (ex: pediatric code situation) (R1.2.1, R2)
10. Effectively recommend dosage adjustments based on pharmacokinetic
parameters specific to the pediatric patient. (R2)
SUGGESTED LITERATURE
1. The Harriet Lane Handbook for Pediatric Dosing
2. Lexi-Comp’s Pediatric Drug Handbook
3. Micromedex and Poisondex---provided
PEDIATRIC INPATIENT HEMATOLOGY/ONCOLOGY EXPERIENCE
PRECEPTOR:
Andrew Ostrenga, Pharm.D.
Clinical Pharmacist, Blair E. Batson Hospital for Children
Clinical Assistant Professor, Department of Pharmacy Practice
Work: (601) 815-8391
Pager: (601) 929-4017
Fax: (601) 815-8382
Email: aostrenga@umc.edu
PURPOSE:
To gain clinical experience and knowledge in the management of pediatric
patients with hematology/oncology diseases. To develop the clinical skills
necessary to monitor and make appropriate interventions for the optimal
care of the patient.
PRACTICE SITE:
Blair E. Batson Hospital for Children
Third Floor Nursing Station
University of Mississippi Health Care
Jackson, Mississippi
AREAS OF EMPHASIS
1. Develop an understanding of classification of chemotherapeutic agents. (R1.3, R2, R6)
2. Become familiar with common side effects of specific chemotherapeutic agents and
appropriate parameters for monitoring. (R1.1.1, 1.1.3, R2, R6)
3. Develop a familiarity with common antiemetic regimens and make appropriate
recommendations to optimize therapy. (R2, R6)
4. Develop an understanding of biological response modifiers and their appropriate use in
the oncology setting. (R2, R6)
5. Become familiar with pathogens commonly encountered in oncology patients with
neutropenia due to chemotherapy. (R2, R6)
6. Function as a medication information provider to the medical team when appropriate
(demonstrating appropriate medical literature retrieval skills and communication skills).
(R6, R5, R2.1.1, 2.3.1, 2.11)
7. Develop effective patient communication skills in order to assist in patient/parent
education. (R2.11, R5)
8. Become familiar with oncology research group protocols, registration of patients and
assignment of treatment schema. (R1.2.1, R2, R6)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBILITIES
1. Participate in daily work and/or attending rounds with pediatric hematology/oncology
team. (R2.1.1, 2.1.3)
2.Review all patient data—not limited to but including admission and daily orders,
progress notes of all medical staff and other health care professionals, laboratory
tests (chemistries, cultures, etc.), and any other diagnostic testing relevant to patient
care. (R2.4.1,2.4.2, 2.9.1)
3. Review all medication therapy for appropriateness of dose, drug-drug interactions,
drug-disease interactions (9R2)
4. Attendance at weekly oncology patient conferences. (R2.1.1, 2.3.1)
5. Attend resident or attending-led teaching sessions on pertinent pediatric topics
(R2.1.1, 2.1.3, 5.1.4)
6. Provide short pharmacy related in-services to other health-care professionals as
deemed appropriate. (R5)
7. Provide discharge counseling to pediatric patients and/or caregivers (R2.11,R5)
8. Participate in mediation literature evaluation as it pertains to pediatric hematology/
oncology literature (R6)
9. Effectively recommend dosage adjustments based on pharmacokinetic parameters
specific to the pediatric patient. (R2)
SUGGESTED LITERATURE
1. The Harriet Lane Handbook for Pediatric Dosing
4. Lexi-Comp’s Pediatric Drug Handbook
5. Micromedex and Poisondex---provided
Resident Progression Objectives
Week
Week 1
Week 2
Week 3
Week 4
Objective(s)
12) Understand basic Pediatric Pharmacokinetic principles
13) Review common Pediatric Oncology disease states and medications
15) Perform pharmacokinetics on assigned patients
16) Understand fundamental supportive care in Pediatric Oncology
9) Lead a discussion with the Pediatric Oncology Team on a complicated medication
or disease state
10) Review common Children’s Oncology Group protocols
5) Independently make pharmacotherapy recommendations to the Pediatric
Oncology Team
GENERAL PEDIATRIC/ PEDIATRIC CRITICAL CARE EXPERIENCE
PRECEPTOR:
Natalie Montgomery, Pharm.D.
Clinical Staff Pharmacist, Pediatric Intensive Care Unit
Assistant Professor, Department Pharmacy Practice
Work: (601) 815-8160
Pager: (601) 929-1630
Fax: (601) 815-8382
Email: nmakamson@umc.edu
PURPOSE:
To gain clinical experience and knowledge in a very diverse
and interesting patient population---PEDIATRICS. The
opportunity to experience the routine and not-so routine
disease states that are encountered in the very young to
adolescent age group. The resident can be an integral part
of the multi-disciplinary teams in providing medication
information (ex: dosages, side effects, drug-drug
interactions, drug-food interactions). The resident is given
the opportunity to gain knowledge in several different
specialties of pediatrics, including cardiology, endocrinology,
neurology, pulmonology and gastroenterology.
PRACTICE SITE:
Blair E. Batson Hospital for Children
Pediatric Intensive Care Unit – First Floor
University Hospital and Clinics
Jackson, Mississippi
AREAS OF EMPHASIS
1. Assess patient disease state and therapy of such by collecting and organizing patient
data from the medical record and personal interview, if applicable. (R1.4.1, R2.2.1,
R2.3.1, R2.4.1, R2.4.2, R2.4.3)
2. Interpretation and evaluation of patient data based on signs and symptoms, etiology,
epidemiology and clinical course. (R2.4.1, R2.4.2, R2.4.3, R2.6.1, R2.6.2, R2.7.1,
R2.8.1, R2.9.1, R2.9.2, R2.10.1, R2.10.2)
3. Knowledge regarding specific mediations in relation to usual regimen (i.e. dose, form,
schedule, route, and method of administration). (R1.3.1, R1.3.2, R1.3.4, R2.6.1,
R2.6.2, R2.7.1, R2.11.1, R2.11.2)
4. Evaluate therapy in regard to mechanism of action, indication, contraindication(s),
adverse reactions and/or pharmacokinetics (R1.3.1, R1.3.4, R2.6.1, R2.6.2, R2.7.1,
R2.8.1, R2.9.1, R2.9.2, R2.10.1, R2.10.2, R2.11.1, R2.11.2)
5. Effectively communicate with patients, caregivers, health-care professionals, or
others so that the patient-specific information needed is collected. (R1.4.1, R2.1.1,
R2.2.1, R2.3.1, R2.8.1, R3.1.1, R3.1.2, R3.1.3, R3.3.1, R3.3.2, R3.3.3, R3.3.4,
R5.1.1, R5.1.2, R5.1.3, R5.1.4, R5.1.5, R5.1.6)
6. Provide concise, applicable, and timely responses to requests for medication
information from health care providers and patients/ caregivers. (R2.2.1, R2.8.1,
R5.1.1, R5.1.2, R5.1.3, R5.1.4, R5.1.5, R5.1.6)
Pediatric and Pediatric Intensive Care Experience
Areas of Emphasis
7. Use effective patient education techniques to provide discharge counseling to
caregivers, and when appropriate, patients, including information of medication
therapy, adverse effects, compliance/ adherence, appropriate use, handling and
medication administration. Documentation of such teaching is made on the
patient/family education form. (R2.2.1, R2.3.1, R2.12.1, R2.12.2, R2.12.3, R5.1.1,
R5.1.2, R5.1.3, R5.1.4, R5.1.5, R5.1.6)
8. Evaluate pertinent scientific literature relative to the pediatric population and provide
appropriate summary. (R6.1.1, R6.1.2, R6.1.3)
ACTIVITIES AND RESPONSIBILITIES
1.Participate in daily work and/or attending rounds with the critical care team in the
Pediatric Intensive Care Unit and Cardiac Critical Care team. (R1.3.1, R1.3.4, R1.4.1,
R2.1.1, R2.2.1, R2.4.1, R2.4.2, R2.4.3, R2.6.1, R2.6.2, R2.7.1, R2.8.1, R2.9.1,
R2.9.2, R2.10.1, R2.10.2, R3.1.1, R3.1.2, R3.1.3)
2. Review all patient data—not limited to but including admission and daily orders,
progress notes of all medical staff and other health care professionals, laboratory
tests (chemistries, cultures, etc.), and any other diagnostic testing relevant to patient
care. (R2.2.1, R2.4.1, R2.4.2, R2.4.3, R2.10.1, R2.10.2)
3. Review all medication therapy for appropriateness of dose, drug-drug interactions,
drug-disease interactions (R2.2.1, R2.4.1, R2.6.1, R2.6.2, R2.7.1, R2.10.1, R2.10.2,
R6.1.1, R6.1.2, R6.1.3)
4. Attend weekly pediatric grand rounds on Wednesdays at noon and pediatric case
conferences on Friday mornings. (R3.1.1, R3.1.2, R3.1.3, R3.3.3)
5. Attend resident or attending-led teaching sessions on pertinent pediatric topics
(R3.1.1, R3.1.2, R3.3.1, R3.3.3)
6. Provide short pharmacy related in-services to other health-care professionals as
deemed appropriate. (R2.1.1, R3.1.1, R3.1.2, R3.3.1, R3.3.3, R5.1.1, R5.1.2, R5.1.3,
R5.1.4, R5.1.5, R5.1.6)
7. Provide discharge counseling to pediatric patients and/or caregivers, (especially
those with asthma, congenital heart defects, or others with difficult medication
regimens.) (R2.2.1, R2.3.1, R2.12.1, R2.12.2, R2.12.3, R5.1.1, R5.1.2, R5.1.3,
R5.1.4, R5.1.5, R5.1.6)
8. Become familiar with strategies employed with care of patients in an acute and/or
intensive care setting (ex: pediatric code situation) (R3.1.3)
9. Effectively recommend dosage adjustments based on pharmacokinetic parameters
specific to the pediatric patient (R1.4.1, R2.8.1, R2.10.1, R2.10.2, R5.1.1, R5.1.2,
R5.1.3, R5.1.4, R5.1.5, R5.1.6)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Goal R1.5: Provide concise, applicable, comprehensive, and timely responses to requests
for drug information from patients and health care providers.
Pediatric and Pediatric Intensive Care Experience
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.11: Communicate ongoing patient information.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
SUGGESTED LITERATURE
1. The Harriet Lane Handbook for Pediatric Dosing
6. Lexi-Comp’s Pediatric Drug Handbook
7. Micromedex and Poisondex---intranet
8. PALS protocols-provided
9. Selected readings from The A.S.P.E.N. Pediatric Nutrition Support Core Curriculum
10. Selected readings from E.L.S.O. Manual
11. Selected readings in regards to congenital heart procedures
Resident Progression Objectives
Week
Week 1
Week 2
Week 3
Week 4
Objective(s)
14) Understand basic Pediatric Pharmacokinetic principles
15) Review common Pediatric disease states and medications
17) Perform pharmacokinetics on assigned patients
18) Understand fundamental pharmacotherapeutic differences between Pediatric
and Adult patients
11) Follow all Pharmacokinetic patients in the Blair E Batson Hospital for Children
12) Lead a discussion with the General Pediatric Team on a complicated medication
or disease state
6) Follow all Pharmacokinetic patients in the Blair E Batson Hospital for Children and
make appropriate interventions independently
7) Independently make pharmacotherapy recommendations to the General
Pediatric Team
PRACTICE MANAGEMENT EXPERIENCE
PRECEPTOR:
Michael Todaro, Pharm D
System Director, Pharmacy Services
Work Phone: 984-2055
Pager: 601- 478-1568
Fax: 601-984-2063
Email: mtodaro@umc.edu
Todd Dear, Pharm D, BCPS
Clinical Coordinator, Pharmacy Services
Work Phone: 984-2949
Fax: 601-984-2063
Email: jdear@umc.edu
PURPOSE:
Department of Pharmacy Services
To become familiar with the organization of a pharmacy department. To become familiar with a
hospital organizational chart. To become familiar with various types of management styles that
can be employed to manage a department. To become familiar with the day-today operation of
a pharmacy department. To become familiar with the hospital committees with which
pharmacy participates. To become familiar with automation in assisting with control and
distribution of medications. To become familiar with interviewing, disciplinary action,
termination of employees. To become familiar with inventory control and formulary
management including participation in Pharmacy & Therapeutics Committee.
Department of Pharmacy Practice
To become familiar with the day-to-day operation of an academic setting. To become familiar
with the types of academic positions available and the requirements of each i.e. tenure versus
non-tenure. To understand the organization of a department and a department within a school
and a school within a university setting. To understand the types of committees that function in
a school of pharmacy. To understand the role of teacher, researcher, mentor and production of
publications. To understand the different management styles that can be used to manage a
department. To understand the different methods of teaching i.e. lecture, problem based
learning or a mixture of both.
PRACTICE SITE:
Pharmacy Administration, University of Mississippi Health Care
University of Mississippi, Department of Pharmacy Practice
EXPERICENCE TYPE: Longitudinal Experience
AREAS OF EMPHASIS
Department of Pharmacy Services
1. Discuss philosophies of the practice of pharmacy. (R3.3)
2. Discuss philosophies of different management styles and when they are the most
effective. (R3.2)
3. Discuss organizational structure of the hospital and the pharmacy department within the
organization. Discuss Strategic Planning and Short and Long Term Goals for the
department. (R3.2)
Practice Management Experience
4. Discuss performance improvement issues – how they are identified; monitored and
reported. (R3.3.3, 3.3.4)
5. Discuss the Joint Commission on Accreditation and Organization Committee reviews
and surveys. (R3.2.2)
AREAS OF EMPHASIS
Department of Pharmacy Services
6. Discuss the drug formulary management including formulary requests, maintaining
formulary items, dissemination of information pertaining to formulary issues. (R1.1., 1.2)
7. Discuss Pharmacy and Therapeutics Committee and the role of the pharmacist involved
in this committee. Discuss drug monographs and medication use evaluations. (R1.1.2,
R1.1.3)
8. Procurement of medications – purchasing, receipt, payment, returns, expired
medications, etc. (R1.1.3, R3.2.3)
9. Discuss financial issues relating to personnel and medication formulary. (R3.2.3)
10. Discuss hiring of personnel – what you look for in an individual; the interview process
and the paperwork that is needed. (R3.2.1)
11. Discuss disciplinary actions up to and including termination of employees – process for
documentation, chain of command for reporting (EEOC, Human Resources, etc); the
grievance process, termination, etc. (R3.2)
12. Discuss drug diversion and the methods used in the hospital to track control of
controlled substances; e.g. automation, controlled substance records, etc. (R3.2.2)
13. Discuss preparation of annual budget and financial performance monitoring activities.
(R3.2.3)
14. Discuss various committees that pharmacy is represented within the hospital
structure.(R3.3.3, 3.3.4)
15. Discuss policy and procedure development, maintenance and review within the hospital
and department. (R1.2.1, 1.2.2,3.2.1, 3.2.2)
16. Discuss possible future directions of hospital pharmacy practice. (R3.3)
17. Discuss reporting relationships and interactions with hospital administration (R3.3)
18. Discuss clinical and operational goals for the department and the personnel. (R3.2)
19. Discuss medication safety issues and programs within the hospital that look at
medication safety (Safety Committee and Medication Management Committee).
Discuss relationship with Risk Management. (R1.1.1, 1.1.2, 1.1.3, 1.2.1)
20. Discuss Compliance issues.(R3.1.3)
21. Discuss ethical issues relating to administration positions and decision making; e.g.
formulary decisions, etc. (R3.1.3)
22. Discuss politics of decision making within the hospital setting. (R3.3)
23. Discuss differences in academic setting and private setting institutions. (R 3.3)
24. Discuss outcomes analysis of programs. (R1.1.2)
25. Discuss initiation of a new program; personnel requests, equipment requests, cost
justifications and pro-formulas. (R3.2.3)
26. Discuss indigent patient assistance opportunities. (R3.2.3)
27. Discuss decisions about pharmacy computer systems and automation – pneumatic tube
systems, automated dispensing machines, etc. (R1.3.4, 3.2.1)
28. Discuss Adverse Drug Reporting within in the department and the hospital. (R1.1.1,
1.1.2, 1.1.3)
29. Discuss Medication Errors and Occurrence Reports – reporting mechanisms, root cause
analyses and process improvement. (R1.1.1, 1.1.2, 1.1.3, 1.2.1)
30. Stress Management Skills; Time Management Skills; Prioritization of Projects (R3.2.40
Practice Management Experience
AREAS OF EMPHASIS
Department of Pharmacy Practice
1. Discuss the organizational structure of a department within a school of pharmacy.
(R3.3)
2. Discuss the management styles that may be utilized in the management and day- today operations of a department within a school of pharmacy. (R3.3)
3. Discuss philosophy of management styles and of pharmacy practice. (R3.2)
4. Discuss professionalism and ethics. (R3.1.3, 3.2.2)
5. Discuss the Strategic Plan and the Short (5 year) and Long Term Goals and Plans.
Review Accreditation Report (R3.2)
6. Discuss how to direct and effect change within a department and curriculum. (R3.2)
7. Discuss tenure track versus non-tenure track faculty positions. (R3.2)
8. Discuss responsibilities and obligations of faculty; e.g. research, publication, teaching,
professional development.(R3.2, 4.1)
9. Discuss options for advancement within a department and within an academic setting.
(R3.2)
10. Discuss development and maintenance of a pharmacy curriculum within a department
and school of pharmacy. (R5.1.2, 5.1.4)
11. Discuss requirements and what a Department Chair would be looking for in a potential
faculty candidate. (R3.2)
12. Discuss evaluation and assessment of performance of faculty members. (R3.2)
13. Discuss relationship of Chairman and faulty on a medical school and teaching hospital
campus. (R3.2)
14. Discuss involvement in professional organizations - locally, state-wide, and nationally.
(R3.1.2, 3.3.1, 3.3.3, 3.3.4)
15. Discuss future of pharmacy relating to academia and direction the profession of
pharmacy is heading. (R3.3)
16. Discuss collaborative practice agreements and disease state management (R1.2.1)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R4:
Demonstrate project management skills.
Goal R4.1: Conduct practice-related investigations using effective project management
skills.
Practice Management Experience
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
ACTIVITIES AND RESPONSIBILITIES
Department of Pharmacy Services
1. Prepare and present a drug monograph for formulary addition to the
Pharmacy and Therapeutics Committee. (R1.1.2, R1.1.3)
2. Develop, monitor and present a Medication Use Evaluation for the
Pharmacy and Therapeutics Committee. (R1.1.2, R1.1.3)
3. Participate in departmental performance improvement activities. (R3.3.3, 3.3.4)
Department of Pharmacy Practice
1. Prepare a sample collaborative practical agreement – Protocol (R1.2.1)
2. Attend at least one (1) curriculum committee meeting. (R.3.3.3)
REQUIRED READINGS
Department of Pharmacy Services
Departmental Policy and Procedure Manual
Department of Pharmacy Practice
1. A Practical Guide to Phett Care, Second edition; 2003. – APhA publication
2. Drug Treatment Protocols; 1999 publication, APhA.
3. Promotion and Tenure Guidelines, University of Mississippi, University, Mississippi
**The above are available for checkout in the Pharmacy Practice Department office or can
be purchased from APhA.
Other persons involved in caring out the goals and objectives for this learning experience:
Todd Dear, Pharm D, Clinical Coordinator
Brad Somers, Pharm D, Clinical Pharmacy Specialist, Special Projects
Traci Allen, Pharm D, Pharmacy Supervisor, ADR and Med Error Reporting
Jim Westmoreland, Pharm D, Supervisor, Automation and Information Services
Gary Teasley, Pharm D, Supervisor, Automation and Information Services
Dr. Leigh Ann Ross, Associate Dean and Chair Pharmacy Practice
PRACTICE MANAGEMENT CHECK LIST
DEPARTMENT PHARMACY SERVICES
______
______
______
Organizational Chart and Description of Department
Management Styles & Philosophy of Pharmacy Management and future of pharmacy
Direct and effect change within a department
______
Interview skills
______
______
______
______
______
Pharmacy Representation on Hospital Committees
Disciplinary actions
Termination of employees
Controlled Substance Management and Handling of Diversion
Compliance Issues
______
______
______
______
Budget Proposals and management
Automation in the department
Initiation of new programs – personnel requests, equipment, staffing, etc.
Pharmacy computer system – maintenance and use
_______
______
Formulary requests, decisions, P&T Committee
______ MUE
______ Drug Monograph
Inventory Management – procurement medications; delivery of medications; borrow loan; returns
and expired medications; payment of bills
Ethical issues pertaining to formulary decisions, distribution, etc.
______
______
______
Medication and Patient Safety issues – Risk Management
Medication Errors and Occurrence Reporting
Adverse Drug Reaction Reporting
______
______
______
Joint ventures with a School of Pharmacy
Future state of Hospital Pharmacy
Politics in a hospital setting
______
______
Performance Improvement Issues
Outcomes analysis of various programs
_____
______
Stress management
Time management and Prioritization
______
JCAHO reviews and surveys
______
Indigent patient services
______
DEPARTMENT OF PHARMACY PRACTICE – As Guest Lectures
______ Philosophy of management styles
______
______
______
______
______
______
______
______
______
______
______
______
______
Organizational structure of department, school, university
Tenure versus Non-tenure positions
Interviewing, hiring, disciplinary action, evaluation assessment & termination employees
Professionalism and Ethics and Plagiarism
Relationship to Department of Pharmacy in hospital
Direct and effect change within a department
Responsibilities of teaching, research, publication, committees, professional development
Options for advancement in academia
Curriculum development and review
Future direction of pharmacy & academia – strategic plans; 5 year goals
Involvement in professional organizations
Involvement in legislative sessions and politics as relates to pharmacy practice – locally &
nationally
Collaborative practice agreements and disease state management
Practice Management Checklist
Department of Pharmacy Services
Session 1
Organizational Chart and Description of Department
________ Management Styles and Philosophy of Pharmacy Management and Future of
Pharmacy
________ Direct and effect change within a department
________ Pharmacy Representation on Hospital Committees
Session 2
________ Disciplinary Actions
________ Termination of Employees
________ Controlled Substance Management and Handling Diversion
________ Compliance Issues
Session 3
_______ Budget Proposals and Management
_______ Automation in the Department
_______ Initiation of new programs – personnel requests, equipment, staffing, etc
_______ Pharmacy computer Systems – maintenance and use
_______ Indigent patient services
Session 4
_______ Formulary Requests, decision, P&T Committee
MUE and Monographs
______ Inventory Management – procurement , delivery; borrow loan; returns; expired
medications; payment of bills
______ Ethical issues pertaining to formulary decisions, distribution, etc
Session 5
_______ Medication and Patient Safety Issues – Risk Management
_______ Medication Errors and Occurrence Reporting
_______ Adverse Drug Reaction Reporting
_______ Performance Improvement Issues
_______ Outcomes analysis of various programs
Session 6
______ Joint ventures with School of Pharmacy
______ Future State of Hospital Pharmacy
______ Politics in hospital setting
Session 7
_______ Stress management
_______ Time management and Prioritization
_______ Interview Skills
Adult Psychiatry Rotation
Preceptor:
Brian Wood, PharmD
Patient Care Area Pharmacist - Psychiatry
University of Mississippi Medical Center
Clinical Assistant Professor,
University of Mississippi School of Pharmacy
Email: bwood@umc.edu
Purpose:
The purpose of this rotation is to gain knowledge and clinical
experience in psychiatric disease management, to develop
patient education techniques, to improve communication
between health care professionals and patients, and to
participate as part of a health care team.
Practice Site:
University of Mississippi Medical Center
Adult Medical Psychiatry Unit – 7 East
Adult Psychiatry Unit – 7 West
2500 North State St
Jackson, MS 39216
Telephone: (601) 984-4707
Hours: 0700 – 1530, Monday-Friday
Areas of Emphasis
1. Participation in multidisciplinary medical team. (R2.1.1, 2.1.3)
2. Pathophysiology of common psychiatric disorders. (R2, R6)
3. Presentation of common psychiatric disorders. (R2, R6)
4. Diagnoses of common psychiatric disorders. (R2, R6)
5. Pharmacological treatment of common psychiatric disorders. (R2, R6)
6. Non-pharmacological treatment of common psychiatric disorders. (R2)
7. Assess patients for therapeutic and adverse effects of medications. (R1.1.1, R2)
8. Laboratory monitoring for adverse effects of medication therapy. (R1.1.1, 2.4.2, 2.10)
9. Patient counseling regarding pharmacological therapies. (R2.11, R5)
10. Recommendations for changes to patient’s pharmacotherapy. (R2)
Competency-Based Learning Objectives
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Activities and Responsibilities
1.
2.
3.
4.
5.
6.
7.
8.
Serve as an integral member of the healthcare team. (R2.1.1, 2.3.1)
Make pharmacological recommendations regarding therapy. (R2)
Serve as a drug information resource. (R6)
Contact community pharmacies to obtain medication history when needed. (R2, R5)
Provide medication discharge counseling. (R2.11, 2.12, R5)
Attend psychiatry grand rounds. (R2.1.1, 2.3.1)
Provide inservices to nursing or medical staff as necessary. (R5)
Interact and communicate effectively with patients and other healthcare
providers.(R2.11,R5)
9. Gain an understanding of medications used to treat psychiatric disorders. (R6)
10. Gain an understanding of the diagnoses and classification of psychiatric disorders. (R2)
11. Interact with physicians to make sure that patients have prescriptions for all discharge
medications. (R2.1.2, 2.1.3, 2.9, 2.11)
12. Assist in teaching of pharmacy students on rotation where applicable. (R5)
13. Complete a series of self-directed reading topics on psychiatric illnesses. (R3.2.4, 3.3)
14. Observe electroconvulsive therapy (ECT). (R2)
15. Participate in social worker led group therapy. (R3.3.3, 3.3.4)
Required Reading or Information Resource
1.
2.
3.
4.
5.
Diagnostic and Statistical Manual (DSM-IV-TR) or other current version
Kaplan and Sadock’s Comprehensive Textbook of Psychiatry
Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)
Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study
Additional scientific literature as needed
Renal Failure/ Dialysis Clinic Experience
PRECEPTOR:
Deborah S. Minor, Pharm.D.
Professor - Medicine and Pharmacy Practice
Division of General Internal Medicine/Hypertension
Phone: 601-984-6888, 601-790-4376 (H), 601-506-7303 (C)
Fax: 601-984-6853
Email: dminor@umc.edu
PURPOSE:
To gain knowledge and clinical experience in the ambulatory care setting
using a multidisciplinary team approach to disease management and
treatment of patients with renal failure. To gain knowledge and clinical
experience in development of problem-solving and communication skills,
with an emphasis on effective patient assessment and education
techniques. The resident will participate as an active member of a
collaborative health care team, primarily dealing with renal failure and
dialysis. The resident will be responsible for providing both direct patient
care.
PRACTICE SITE:
University of Mississippi Health Care, Jackson, Mississippi
Jackson Medical Mall – Renal Dialysis Clinic
Hours: 0730- 1700, Monday – Friday
ROTATION TYPE: Longitudinal or monthly
AREAS OF EMPHASIS WITH ACTIVITIES AND RESPONSIBILITIES
1. Training in the appropriate management and assessment of the renal failure/ dialysis
patient. (R2 and R5 inclusive)
a. Specifically related to phosphate binders; antihypertensives; vitamin
supplementation and deficiencies(particularly vitamin D supplementation and
guidelines, management of anemia with ESAs and intravenous iron
supplementation (R2 and R5 inclusive)
b. Antibiotic selection in the renal failure patient and effects of dialysis on serum
concentrations. (R2 and R5 inclusive)
2. Management of commonly encountered ambulatory care disease states to include but
not limited to: chronic kidney disease, anemia, diabetes, and hypertension. (R2.1-2.12
inclusive, R5.1.1)
3. Assessment, management and documentation of medication intolerances and adverse
medication reactions in the ambulatory care patient. (R1.1.2, R1.1.3)
a. Assist with assessment, management and documentation of medication
intolerances and adverse drug reactions in all patients. (R1.1.2, R1.1.3)
4. Assessment of medication adherence and all obstacles that influence adherence
including access to medications. (R2.1-2.12 inclusive, R5.1.1)
a. Continually assess medication adherence and all obstacles that influence
adherence including access to medications for all patients. (R2.1-2.12 inclusive,
R5.1.1)
5. Assessment of indications for and appropriate administration of seasonal and
nonseasonal vaccinations, including all required documentations. (R1.1.2, R1.3.3,
R1.3.4, R2.1-2.12 inclusive, R5.1.1)
6. Serve as an integral member of the clinic team. Assist with all necessary clinical and
operational aspects of daily functions as requested by clinic providers (physician, nurse,
practitioner, and pharmacist). Interact and communicate effectively with providers and
staff within the clinic. (R1.1.2, R1.1.3, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3,
R3.3.1-3.3.3, R5.1.1)
a. If possible, participate in monthly Interdisciplinary Team Assessment (RN, Tech,
RD, LMSW, MD, NP) (R1.1.2, R1.1.3, R1.3.4, R1.4.1, R2.1-2.12 inclusive,
R3.1.1-3.1.3, R3.3.1-3.3.3, R5.1.1)
b. Participate in rounds weekly and make recommendations to patient’s medication
regimen (R1.1.2, R1.1.3, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3,
R3.3.1-3.3.3, R5.1.1)
7. Make pharmacologic and nonpharmacologic recommendations regarding therapy based
on all relevant considerations. Counsel patients and assess understanding of both
pharmacologic and nonpharmacologic therapy and disease states. Follow-up with
communication regarding lab results and any changes in medication regimens. This
shall include management of commonly encountered ambulatory care disease states to
include but not limited to: hypertension, diabetes, dyslipidemia, and chronic kidney
disease. (R2.1-2.12 inclusive, R5.1.1)
a. Monitor patient’s laboratory values, including phosphate, PTH, calcium, and
provide recommendations to the medical team (R2.1-2.12 inclusive, R5.1.1)
b. Check for medications without indications and indications without a prescribed
therapy and communicate information to physician
c. Renally adjust all necessary medications (R2.1-2.12 inclusive, R5.1.1)
d. Check for drug-drug interactions, vitamins and herbals interactions.
e. Provide alternative treatment options to maximize patient’s medication regimen.
f. Recommend alternate dosage formulations with fewer side effects or more
convenient for the patient as needed
g. Counsel patients who are taking warfarin to follow-up on a monthly basis with
Anticoagulation clinic, and assess their compliance weekly
h. Counsel patients on smoking cessation and provide referral to ACT Clinic as
needed
8. Serve as a drug information resource for the clinic utilizing evidenced-based medicine
as well as current literature. Perform literature searches as requested. Educate other
health care providers in both formal and informal settings (by daily interactions,
documentation in patient records, and providing formal topic presentations). (R3.1.13.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
9. Provide patient education regarding disease states, pharmacological interventions and
lifestyle intervention. (R1.1, R2.1-2.12 inclusive, R5.1.1, R5.1.5, R5.1.6, R6.1.1, R6.1.3)
a. Help identify and maintain patient education resources within the clinic (R1.1,
R2.1-2.12 inclusive, R5.1.1, R5.1.5, R5.1.6, R6.1.1, R6.1.3)
b. Provide patient education specifically related to phosphate binders;
antihypertensives; vitamin supplementation and deficiencies(particularly vitamin
D supplementation and guidelines, management of anemia with ESAs and
intravenous iron supplementation (R2, R5, R6 inclusive)
c. Answer patients questions related to their medications, vitamins or herbals. (R2,
R5 and R6 inclusive)
d. Provide medication pill boxes or organizers to assist patients with adherence and
review how to fill these medications. (R2, R5, R6)
10. Educate other health care providers in both formal and informal settings (by daily
interactions, documentation in patient records, providing formal topic presentations).
(R3.1.1-3.1.3, R5.1.1-5.1.6 inclusive, R6.1.1, R6.1.3)
a. Documentation of all encounters and interventions in the permanent medical
record (R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1,
R6.1.1, R6.1.3)
b. Help in maintaining the accuracy of all patients’ medication profiles and clinical
records. (R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1,
R6.1.1, R6.1.3)
c. Provide drug information for the medical team, including nurses, dietician,
physician, and social worker
11. Participate in community activities including health fairs, educational sessions, and
other outreach efforts. (R2.4.2, R2.4.3, R3.1, R5.1.1, R5.1.5, R5.1.6)
12. Participate in journal reviews and other ongoing internal and external educational efforts
as the opportunity arises. (R3.1.1-3.1.3, R5.1.1, R5.1.3-5.1.6 inclusive)
13. Assist with all medication assistance program activities including patient eligibility
determination, medication selection, ordering, and dispensing. (R1.3.4, R1.4.1, R2.12.12 inclusive, R5.1.1)
a. Interact with providers to ensure patients have prescriptions and refills on all
medications, including assistance with patient and pharmacy calls, enrollment in
medication assistance programs or communication with third party sources.
(R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1)
14. Assist with all necessary clinical and operational aspects of daily functions. (R1.1.2,
R1.1.3, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R3.1.1-3.1.3, R3.3.1-3.3.3, R5.1.1)
a. Interview patients, obtaining a complete medication history, including changes in
therapy, efficacy, adverse effects, drug interaction and allergies. Assist with
maintaining the accuracy of all patients’ medication profiles and clinical records.
(R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1, R6.1.1,
R6.1.3)
b. Ask patients to bring their medications and call nursing homes to obtain current
medications list, and update patient’s medication list on their chart on a monthly
basis (R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1, R2.1-2.12 inclusive, R5.1.1,
R6.1.1, R6.1.3)
15. Exercise leadership and initiative in a collaborative environment. (R3.1.1, R3.1.2,
R3.1.3, R3.3.1-3.3.3)
a. Maintain a positive attitude, the highest ethical standards, and a mutual respect
for all those encountered in the clinic. Practice leadership and initiative in a
collaborative environment. (R3.1.1, R3.1.2, R3.1.3, R3.3.1-3.3.3)
16. Review patient records prior to providing care and document all encounters and
interventions in the permanent medical record. (R1.1.2, R1.1.3, R1.3.2, R1.3.4, R1.4.1,
R2.1-2.12 inclusive, R5.1.1, R6.1.1, R6.1.3)
17. Attend all internal and external activities and programs that would be expected as part
of the clinic health care team or professional pharmacy involvement (for example,
weekly Grand Rounds and pharmacy meetings). A schedule will be provided at the
beginning of each monthly rotational experience. (R3.1 inclusive, R5.1.1)
18. Participate in quality assessment and improvement initiatives ongoing in the unit. (R1
and R2 inclusive)
19. Complete all assigned projects prior to the end of the rotation. (R3)
COMPETENCY-BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.11: Communicate ongoing patient information.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
REQUIRED/ SUGGESTED READINGS
1. Chronic Renal Failure Guidelines
2. Comparisons of Phosphate Binders
3. JNC 7 or latest version – blood pressure management especially in renal failure
4. Vitamin supplementation in the Renal Failure Patient – particularly Vitamin D guidelines
5. Anemia Management and protocols – ESAs and IV iron supplementation
6. Antibiotics in chronic dialysis – unit formulary
7. Others as determined by preceptor
Renal Failure/ Dialysis Clinic
Catherine Wells, DNP, ACNP-BC, CNN-NP, Instructor and Clinic Director
Dr. Albert Dreisbach, Division of Nephrology
Dr Seyed Hamrahian, Division of Nephrology
Nurses, Dieticians, Social Workers and Other Clinic Staff
MAJOR SCHOLARLY RESEARCH EXPERIENCE
PRECEPTOR:
Research Project Mentor
PURPOSE:
1. To expose the resident firsthand to the mechanics of research methodology.
2. To provide the resident experience in directing and conducting an original project from
beginning to end.
3. To teach a resident how to write and submit a manuscript for presentation at a national or
regional meeting and for publication in a refereed pharmaceutical or medical journal or
prepare a poster for presentation.
4. To promote research that evaluates some aspect of pharmacy practice.
5. To develop new and innovative approaches to managing medication and biological
therapies for improving patient care.
PRACTICE SITE:
University of Mississippi Medical Center
TYPE OF EXPERIENCE: Longitudinal
AREAS OF EMPHASIS:
Each resident is required to complete a major scholarly research project directed at enhancing
personal and professional growth. This project may be in the form of original research, a
problem solving exercise, or development, enhancement or evaluation of some aspect of
pharmacy services. It is anticipated and encouraged that the residency project will consist of
one major project.
All projects shall be directed toward useful outcomes and should not merely be an academic
exercise for the sole purpose of satisfying this requirement. The purpose of the project is to
develop the resident’s problem solving skills and to expose the resident to research methods,
while addressing an issue or area in need of study or research, development, or evaluation.
Each resident should select a Research Mentor to serve as the project advisor or primary
investigator throughout the year. The project selection will be reviewed by the Residency
Director and the Residency Committee.
Residents are encouraged to consider several factors when selecting a project. The project
should be one of personal interest to the resident and of value in the provision of
pharmaceutical care or to the department in provision of services. Finally, the resident project
should be selected with the intent of completing the project in one year and submitting results
for publication in an appropriate professional journal if applicable.
Each resident will present his/her research project at the Regional Residency Conference held
in the spring of each year. Practice sessions will be held within the department in preparation
for the conference.
Major Scholarly Research Experience
Following completion of the major project, each resident will submit a final manuscript to the
Research Mentor and the Program Director and place a copy in the appropriate section of the
notebook. The manuscript style should follow guidelines and requirements for submission of
manuscripts based on the requirements of the professional journal. Each resident will prepare
a final report of the project:
1.
Include the final manuscript with statistical information and data collected with
final analysis
2.
A copy of the slides presented at SERC
3.
Assessment or evaluation of the Research Mentor and the overall research
experience – can be separate or on the same page
4.
Perform a self assessment and preceptor assessment evaluation
5.
One copy of the above is placed in your notebook and one copy is provided to
the Program Director.
6.
All research data and information must be left with your Research Mentor for
storage for 6 years as mandated by the Institutional Review Board (IRB)
7.
The resident will close out the project with the IRB at the completion of the
project and include the closure letter from the IRB in the final report that is
submitted to the Program Director and place one copy in your notebook if
necessary.
The resident should make every effort to complete their project according to the timetable
outlined below. Failure to meet deadlines for the interim steps should be discussed with the
Research Mentor, Research Coordinator and the Residency Director. If the resident fails to
successfully complete the residency project before the twelve month training period ends, a
short extension not to exceed 6 months may be granted by the Residency Director, Research
Mentor and Residency Committee. If this extension exceeds the twelve month period, the time
spent completing the residency requirements will be uncompensated. The residency
certificate will be withheld until all requirements, including the major project, are
successfully completed.
Major Scholarly Project Goals
1. To expose the resident firsthand to the mechanics of research methodology. (R4.1.1, all of
Goal E1)
2. To provide the resident experience in directing and conducting an original project from
beginning to end. (R41.1 and all of E1)
3. To teach a resident how to write and submit a manuscript for presentation at a national or
regional meeting and for publication in a refereed pharmaceutical or medical journal or
prepare a poster for presentation. (E1.1.7 and E1.1.8)
4. To promote research that evaluates some aspect of pharmacy practice. (R4 and all of E1)
5. To develop new and innovative approaches to managing medication and biological
therapies for improving patient care. (R4 and all of E1)
Major Scholarly Research Experience
Project Guidelines (Goals R4 and E1 for all activities listed below in items 1-12)
1. Complete the CITI training for conducting research on the IRB Website. This should be
completed during the orientation period in Drug Information.
2. Project should focus on practice – related activities and issues.
3. No commitments shall be made without approval from the Residency Committee.
4. If needed, outside funding should be sought and is often available in limited amounts from
pharmaceutical manufacturers or state pharmacy organizations. If outside funding is not
available, departmental research funds may be sought to support proposed projects.
5. Discuss potential research projects with several preceptors/ pharmacists to assist in
formulating a workable idea.
6. Select one preceptor to serve as the Research Mentor to assist with the project throughout
the residency. Other project associated preceptors may be solicited if needed.
7. The IRB website will have instructions for electronic submission of all paperwork.
8. Prepare a formal proposal using the standard format. Examples are available from previous
residents and will be provided upon request.
9. Projects may commence only after the Residency Committee and the IRB have obtained
final approval, if necessary.
10. Discuss with the statistician early during the planning phase to ensure that the information
is collected and entered into the spreadsheet as needed to expedite this process.
11. A final written paper, signed by the Research Mentor shall be submitted to the Residency
Director and a copy placed in the notebook upon completion of the project,
12. A final close out report must be filed electronically with the IRB and receipt of the closure
letter from IRB should be included in final report, if necessary.
Time Table for Major Scholarly Research
Identify at least 3-4 areas of interest………………………………July
Project identification and development ………………………….. August
Project Proposal & Revisions ……………………………………. September
IRB review, if needed ………………………………………………1st week October
First progress report………………………………………………….Mid December
Biographical data for SERC…………………………………………January
Abstract for SERC…………………………………………………….February
Second progress report……………………………………………...1st of March
Practice presentations………………………………………………. March/ April
Southeastern Residency Conference………………………………April/ May
Final Presentation…………………………………………………….May/June
Final Report and Closure…………………………………………….Mid June
Major Scholarly Research Experience
Project Proposal and Format
In preparing for the presentation of the major research project proposal, certain information
should be included. The following format is suggested:
1. A cover page including title of project, the resident’s name, and name of Research Mentor.
2. State the purpose of the project clearly and concisely.
3. A background section that states the reason your project is needed and includes a concise
review of the literature on the topic. A bibliography should be attached.
4. The Methodology section should explain the “how” of your project and should include,
where appropriate the design of your project.
5. An analysis section should address how the results will be analyzed including statistical
treatment to be employed. This section should provide a measurement for the completion
of the project.
6. Finally, include a section on cost and funding to show estimates of the cost of your project
and potential outside funding. Cost should include supplies, materials, services, and
manpower other than the resident’s time.
Competency Based Assessment
Outcome R4:
Demonstrate project management skills.
Goal R4.1:Conduct practice-related investigations using effective project management skills.
OBJ R4.1.1 (Synthesis) Initiate, design, implement, and write up a practice-related
investigation which, at all steps in the process, reflects the skillful application of
project management skills.
Outcome E1:
Conduct pharmacy practice research.
Goal E1.1: Design, execute, and report results of investigations of pharmacy practice-related
issues.
OBJ E1.1.1 (Analysis) Identify potential practice-related issues that need to be
studied.
OBJ E1.1.2 (Application) Use a systematic procedure for performing a comprehensive
literature search.
OBJ E1.1.3 (Analysis) Draw appropriate conclusions based on a summary of a
comprehensive literature search.
OBJ E1.1.4 (Synthesis) Generate a research question(s) to be answered by an
investigation.
OBJ E1.1.5 (Synthesis) Develop specific aims and design study methods that will
answer the question(s) identified.
OBJ E1.1.6 (Application) Use a systematic procedure to collect and analyze data.
OBJ E1.1.7 (Evaluation) Draw valid conclusions through evaluation of the data.
OBJ E1.1.8 (Synthesis) Use effective communication skills to report orally and in
writing the results and recommendations of an investigation into a pharmacy
practice-related issue.
Goal E1.2
Participate in clinical, humanistic and economic outcomes analyses.
OBJ E1.2.1 (Evaluation) Contribute to a prospective clinical, humanistic and/or
economic outcomes analysis.
OBJ E1.2.2 (Evaluation) Contribute to a retrospective clinical, humanistic, and/or
economic outcomes analysis.
SERVICE (STAFFING) EXPERIENCE
PRECEPTOR:
Bridgett H. Chisolm, Pharm. D.
Barry Phillips, Pharm D
Supervisors, Central Pharmacy
Pharmacy Staff in Central Pharmacy
Work Phone:601-984-2807
Pager: 601-929-1226
Fax: 601-984-2063
Email: bchisolm@umc.edu
Todd Dear, Pharm D
Clinical Coordinator
PCAP Pharmacists
Work Phone: 601-984-2949
Pager: 601-929-4007
Fax: 601-984-2063
Email: jear@umc.edu and zsomers@umc.edu
Cindy Dumas, Pharm D
Supervisor, Pediatric Satellite
Pharmacists, Pediatric Satellite
Phone: 601-815-8383
Email: cdumas@umc.edu
PURPOSE: To gain experience in the area of medication distribution and clinical activities. To
become familiar with policies and procedures for order entry, dispensing,
automation, compounding, and sterile product preparation. To gain an
understanding of the management and control of controlled substances within
the department as well as within the hospital. To become proficient in handling
problems that may arise with medication orders. To gain an understanding of
dispensing and record keeping for investigational medication studies. To
understand the day to day operations of a centralized and decentralized
medication distribution system. To become an integral part of the Central
Pharmacy Team and Patient Care Area Pharmacist (PCAPs).
PRACTICE SITE:
University of Mississippi Health Care, Jackson, Mississippi
Only Level 1 Trauma Center in Mississippi
Central Pharmacy to include Sterile Product Area
Patient Care Areas
TYPE OF EXPERIENCE: Longitudinal
Service Experience
AREAS OF EMPHASIS
1. Communication with health care providers pertaining to medication orders to
provide clarification. (R1.3,2.1 – 2.3)
2. Drug literature evaluation as pertains to medication order entry. (R6)
3. Recommending pharmacological management taking into consideration drug interactions,
side effects, and disease state management based on evidence based medicine. (R2)
4. Become familiar with The Joint Commission (TJC) standards and national patient safety
goals. (R1, 3.1.3, 3.2.2)
5. Medication formulary process – procurement of needed items, alternate therapy provided,
non-formulary requests, communication with other health care professionals pertaining to
delays in therapy. (R1)
6. Management of Adverse Drug Reaction (ADR) in patients. Also participate in reporting of
ADR’s. (R1.1.1, 1.1.3)
7. Documentation of specific interventions in the medical record and the computer system,
including clinical interventions. (R1.3,2.12)
8. Participate in performance improvement in the pharmacy department. (R1.2.2)
9. Become familiar with the operation of the pneumatic tube system and the automated
medication dispensing devices. Be able to use and trouble shoot problems. (R1.3)
10. Compound sterile and non-sterile products. (R1.3)
11. Be familiar with proper process to restock and seal hospital crash carts. (R1.3)
12. Be able to check work of pharmacy technicians – pulling doses; manual charge entry; prepacking of medication dosages. (R1.3.3 – R1.4.1, 3.2.4)
13. Prepare medication for delivery to the units. (R1.3)
14. Be able to sign out controlled substances – be familiar with the required paperwork; sign
out controlled substances to the units; accept returns; advise nurses of what to do in the event
of a controlled substance discrepancy. (R1.3)
15. Be able to process orders in the computer system. (R1.3)
16. Be able to prepare a pediatric code sheet if requested. (R1.3)
17. Provide drug information to a variety of health care professionals.(R6)
18. Be able to address issues concerning MedSelect equipment. (R1.3)
19. Become familiar with clinical reports and the daily activities of the Patient Care Area
Pharmacist (PCAP). (R1.3, R2)
20. Understand the workflow of the Department of Pharmacy Services. (R1.3, 3.2.4, 3.3.4)
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Service or Staffing Experience
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
ACTIVITIES AND RESPONSIBILITIES
1. Serve as a drug information resource utilizing evidence based medicine. (R6)
2. Assist in therapeutic management of patients, including monitoring and modifying
medication therapy. (R2)
3. Assist in initiation of drug therapy - assess drug- drug, drug-food, and drug –disease
interactions. (R2)
4. Provide discharge counseling to patients upon request. (R2.11, R5)
5. Learn to assess and handle phone calls as needed. (R5)
6. Provide inservices to the pharmacy staff as necessary related to medications or pharmacy
related issues. (R5)
7. Assist in continually expanding the credibility and scope of clinical pharmacy services in the
hospital. (R3.2)
8. Assist in teaching pharmacy students on rotation, Technicians, new employees both
professional and non-professional. (R5)
9. Interact and communicate effectively with health care professionals. (R2.1.1, 2.1.3, R5)
10. Gain an understanding of the medications used within the hospital setting. (R6)
11. Provide pharmacokinetic consultation as requested. (R6, R2)
12. Participate in hospital wide committees that relate to medication distribution. (R3.3.3,3.3.4)
13. Become familiar with the automated dispensing machines and their usefulness in the
hospital as well as methods to deal with problems and name discrepancies associated with the
machines. Also become familiar with other technology that enhances drug delivery to the
patient such as the pneumatic tube system. (R1.3)
14. Properly dispense medications in investigational drug studies – maintain proper
paperwork, ensure proper delivery, randomization if necessary, etc. (R1.3)
15. Document clinical interventions in the computer system as needed.(R2.12)
16. Medication order entry. (R1.3)
Service Experience
17. Participation in TJC surveys within the pharmacy department. (R3.2.2)
18. Be able to compound topical, oral, and suppository formulations. (R1.3)
19. Be able to compound sterile products such as special ophthalmic preparations and other
hospital specific protocols. (R1.3)
20. Restock and seal crash carts. (R1.3)
21. Check the work and oversee the activities of the pharmacy technicians. (R1.3.3 – R1.4.1,
3.2.4)
22. Process and evaluate Patient Care Area reports and intervene when necessary. (R1.3,
R2)
REQUIRED READINGS
Sterile Product Compounding Manual.
Central Compounding Manual.
Pharmacy Department Policy and Procedure Manual – Section on Dispensing Medication and
on Controlled Substance – Intranet.
Video on Proper Sterile Technique – provided.
Handbook for Computer Order Entry – provided.
See Activities Listed on the following pages for Central Pharmacy and Patient Care Area
Pharmacists daily activities and duties.
Activities for Staffing in Central Pharmacy
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From 7:30am-3pm, technicians make deliveries every 30 minutes. The “first dose” table
and the IV room window has to be signed off by a pharmacist before each delivery.
Once you have verified a floor’s MedSelect fill, sign the bottom of the “pull” sheet and
place it back in the bin. Once signed, the technicians will deliver.
Once you have verified a floors cart fill, place your initials at the top of the first page,
place the sheets in the proper bin located above the first dose check station and sign
the cart fill log. Once your signature is on the log, the technicians will deliver.
URC (University Rehab Center)– Technicians can make deliveries throughout the day, if
needed, for missing and STAT doses. There is a scheduled delivery at 3:00pm for all
other doses.
In addition to verifying MedSelect, Cartfill and first doses, all orders must be verified in
Epic.

7:00 – Morning MedSelect and URC cart fill (only on weekdays) is pulled by the technicians.
Once completed, all pulls need to be verified by a pharmacist. This is done by scanning the
items through the check stations located in front of the carousels. Everything should be pulled
and verified before 10:00. Also, the morning IV room update is run. This update should be
signed off by a pharmacist before being delivered to the floor
10:00 – Morning cart fill is pulled by the technicians. Once completed, all doses need to be
verified by a pharmacist in the same manner as above.
11:00 – Evening IV room update is run. Once completed, must be verified by a pharmacist.
12:00 – Noon cart fill is pulled by the technicians.
1:00 – Afternoon MedSelect is pulled by the technicians.
2:00 – Cart fill is delivered to the floors by the technicians.
3:00 – Scheduled delivery to URC.
Activities for Staffing as a PCAP Pharmacist
(PCAP – Patient Care Area Pharmacist)
Daily Activities
1. Introduce yourself to the nurses for the floors you will be covering and let them know
how to contact you (leave a sheet of paper with name/office number/pager number) and
that you are here to assist them in any way possible. At the end of your shift – let them
know that you are leaving.
a. A good time to introduce yourself is during the morning Nurse Report (7am) for
that unit
b. Throughout the day check on the nurses to see if they need anything or if they
need help with anything – this is really appreciated by the nursing staff.
c. Also, introduce yourself to the Respiratory Therapist covering the units – let them
know that if something is missing on the Diebold profile or the MAR (Medication
Administration Profile) that they need to contact you to make corrections – they
do not need to do overrides unless absolutely necessary.
2. Review Reports/Patient Data/Consults/TPNS
a. Pharmacy Consults (found under consult messages in your EPIC In Basket)
i. Be sure to properly document when pharmacy is consulted on a patient
(leave a progress note, etc)
ii. Order any necessary labs, communicate with providers, nurses, patients –
anything that is necessary to fulfill the consult
b. Anticoagulation Report (warfarin, heparin, argatroban, enoxaparin)
i. Monitor/order labs, complete i-vent(s) as appropriate; update Rx Warfarin
Last Reviewed Section on Coag Report in EPIC
ii. Provide patient counseling for all warfarin patients and those going home
on Lovenox®
iii. Contact providers with recommendations/concerns
iv. Please review protocols for warfarin/heparin/argatroban regarding
MINIMAL monitoring policies
c. Kinetics Report
i. Monitor/order labs, complete i-vent(s) as appropriate; update Rx Kinetics
Last Reviewed Section on Kinetics Report in EPIC
ii. Contact providers with recommendations/concerns
iii. Please review Pharmacokinetics Protocol to assist you.
d. TPNs
i. Complete assigned TPN(s) for the weekend
1. Review labs, write progress note, order/re-order TPN/PPN, order
follow-up labs; communicate with provider, patient, dietician as
appropriate.
2. Be sure to submit all TPN/PPN orders by 2pm (earlier if possible)
3. TIP: check for labs right when you get to the floor in the morning,
so, if they have not been drawn, there will be time to draw them
before you need to do your TPN
e. Medication Profiles
i. Review profiles for duplicate therapies, renal dosing, proper dosing, drug
interactions, erroneous entries, etc. (“housekeeping”)
ii. Also, check to make sure height and weight have been documented for
this encounter (hospital admission – it will list it in the header)
iii. Contact providers to clarify any issues
f. Renal Function
i. Review renal function and make sure medications are dosed appropriately
while review medication profiles
g. IV to PO switch
i. Switch IV medications to PO when possible
ii. Please review the IV to PO protocol to assist you.
3. Other Activities
a. Be familiar with the formulary process – physicians will submit a non-formulary
medication order in EPIC – you must review and make sure the request is
appropriate
b. Automatic Therapeutic Interchange policy (under Policies & Procedures)
c. Vaccine process
i. Once nurse completes vaccine screening and vaccinating is appropriate,
nurse must place vaccine medication order per protocol into EPIC
d. Assist with Medication Reconciliation
i. When time allows, review home medications for new admits
e. Assist with issues related to the Diebold Automated Dispensing Machines
(ADMs)
f. Enter all clinical interventions – create an i-vent
g. Participate in Code Blue situations – especially on the floors you cover and if not
busy then you can assist other PCAPs with codes in their areas.
h. Serve as a drug information source for the nurses and medical staff. Provide
intravenous stability, compatibility, and infusion rate information to the nursing
staff
i. Provide discharge counseling for patients to be discharged from your units (if
time allows)
j. Rounding with team activities – this will be just during the week when you are on
a service with a PCAP as preceptor – This will NOT be done during the
WEEKEND Service Experience
k. Assisting in any way possible to benefit the patients.
l. The best way to get in touch with a doctor on the weekend (or anytime)
is to page him/her; it is easier to ask the physician to change the order rather
than asking the nurse to ask the physician to change the order.
ALWAYS ask other pharmacists if you have any questions at all! We are all here to help you
have the best learning experience as possible. There will be things that come up that you are
not familiar with on a daily basis while staffing – do NOT be afraid to ask!!!
Last updated 6/28/12
Adult Special Care Clinic
Preceptor:
Billy Brown, Pharm D
Clinical Pharmacist, VA Hospital
Email: billy.brown2@va.gov
Purpose:
To expose the resident to the management of patients with HIV infection.
To be exposed to the management of the HIV virus, chronic illnesses,
complications and opportunistic infections.
Practice Area:
Adult Special Care Clinics at VA and UMMC
GV Sonny Montgomery VA Medical Center and
University of Mississippi Medical Center
Jackson, MS
Areas of Emphasis
1. Limited physical assessment of the patient (R2.4.1)
2. Understanding of acute and chronic care pharmacology and monitoring therapeutic effect.
(R2.7)
3. Communication with health care providers and patient education techniques.(R2.2.1,2.2.3,
R5)
4.Drug literature evaluation as pertains to medicine & pharmacy literature. (R6)
5.Recommending pharmacological management taking into consideration drug interactions,
side effects, and disease state management based on evidence based medicine. (R1.2.1,
R2)
6. Participation in clinical case conferences. (R2.2.1, 2.2.3, 5.1.4)
7. Participation in JCAHO surveys and medication use reviews(R3.2.2)
8. Management of the adult and pediatric patient with a broad spectrum of infectious
diseases, some of which are listed more specifically below. (R2.4.1,2.4.2, 2.6, 2.7, 2.9,
2.10, 2.11)
9. Management of the HIV infected patient (R2.4.1,2.4.2, 2.6, 2.7, 2.9, 2.10, 2.11)
10. Management of adult and pediatric patients with nosocomial infections (R2.4.1,2.4.2, 2.6,
2.7, 2.9, 2.10, 2.11)
11. Management of acute disease states to include but not limited to: pneumonia, sinusitis, skin
and soft tissue infections, urinary tract infections, animal bites, hepatitis, trauma with
secondary infections, presumed infections in immunocompromised patients. (R2.4.1,2.4.2,
2.6, 2.7, 2.9, 2.10, 2.11)
12. Management of non-acute disease states as perceived by the patient to include but not
limited to: STD’s, flu-like symptoms, otitis medica, rashes, etc. (R2.4.1,2.4.2, 2.6, 2.7, 2.9,
2.10, 2.11)
13. Management of Adverse Drug Reaction (ADR) in the acute patient. Also participating in
ADR reporting. (R1.1.1, 1.1.3)
14. Management of specific drug induced diseases (Beyond the ADRs) (R2.4.1,2.4.2, 2.6, 2.7,
2.9, 2.10, 2.11)
15. Management of patients with chronic or indolent diseases (lyme disease, chronic fatigue,
osteomyelitis, endocarditis) (R2.4.1,2.4.2, 2.6, 2.7, 2.9, 2.10, 2.11)
16. Management of the patient with tuberculosis (R2.4.1,2.4.2, 2.6, 2.7, 2.9, 2.10, 2.11)
17. Management of patients that have an exposure to blood and body fluids (R2.4.1,2.4.2, 2.6,
2.7, 2.9, 2.10, 2.11)
Adult Special Care Clinic
ACTIVITIES AND RESPONSIBILITIES
18. Administration techniques for oral, subcutaneous, intravenous, intramuscular, and topical
medications. (R1.3)
19. Assist with access to medications for patients that are unable to procure them (R1.3)
20. Documentation of specific interventions in the medical record. (R5)
21. Participate in performance improvement in the pharmacy department (R1.2)
22. Provide patient education pertaining to disease state and pharmacological management.
Documentation of this education intervention on the Patient/ Family Education Form.
(R2.12, R5)
COMPETENCY BASED LEARNING OBJECTIVES FOR PHARMACY PRACTICE:
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
REQUIRED READINGS:
Readings should be directed based on cases and therapeutic problems observed during
experience. These can be assigned by the preceptor.
SPECIAL INTEREST EXPERIENCE
PRECEPTOR:
Program Director or Designee
PURPOSE:
To allow the resident to experience areas or practice that they may not want to complete an
entire month. This will allow the resident exposure to a variety of practice settings and sites to
enhance their experiences and guide them in future practice areas. This is a filler description to
hold for the schedule until the resident determines their last learning experience.
PRACTICE SITE:
Multiple locations to expand experiences
AREAS OF EMPHASIS:
1. The goals and objectives of the residency program will be assessed.
2. The resident will actively participate in the experiences throughout the month.
3. Projects may be assigned.
4. Readings and learning experiences will be assigned based on the learning experience.
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1: Manage and improve the medication-use process.
Goal R1.1:
Identify opportunities for improvement of the organization’s medication-use system.
Goal R1.2:
Design and implement quality improvement changes to the organization’s medicationuse system.
Goal R1.3:
Prepare and dispense medications following existing standards of practice and the
organization’s policies and procedures.
Goal R1.4:
Demonstrate ownership of and responsibility for the welfare of the patient by performing
all necessary aspects of the medication-use system.
Outcome R2: Provide evidence-based, patient-centered medication therapy management with
interdisciplinary teams.
Goal R2.1:
As appropriate, establish collaborative professional relationships with members of the
health care team.
Goal R2.2:
Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3:
As appropriate, establish collaborative professional pharmacist-patient relationships.
Goal R2.4:
Collect and analyze patient information.
Goal R2.5:
When necessary, make and follow up on patient referrals.
Goal R2.6:
Design evidence-based therapeutic regimens.
Goal R2.7:
Design evidence-based monitoring plans.
Goal R2.8:
Recommend or communicate regimens and monitoring plans.
Goal R2.9:
Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1:
Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5: Provide medication and practice-related education/training.
Goal R5.1
Provide effective medication and practice-related education, training, or counseling to
patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Women’s Health Elective Experience
Preceptor:
INACTIVE
Pager:
Phone:
Fax: 601- 815-7590
Email:
Practice Site:
Winfred Wiser Women’s and Infant’s Hospital
5th Floor Wiser
University of Mississippi Medical Center
Jackson, Mississippi
Purpose
1. To gain knowledge and clinical experience in the field of women’s health.
2. To understand the pathophysiology and treatment of common benign and oncologic
disorders.
3. To understand the normal physiologic and pharmacokinetic changes associated with
pregnancy and their relevance.
Areas of Emphasis
1. To gain an understanding of gynecological oncology including cervical, ovarian, and
endometrial cancers. (R1.2.1,R2, R6)
2. Management of ectopic and molar pregnancies. (R1.2.1, R2, R6)
3. Appropriate use of medications in the peri-operative period. (R1.2.1, R2, R6)
4. To understand benign gynecologic conditions including endometriosis, abnormal vaginal
bleeding, and fibroids. (R1.2.1, R2, R6)
5. An understanding of the risk of venous thromboembolic disease (VTE) in the setting of
cancer and the importance of appropriate prophylaxis. (R1.2.1, R2, R6)
6. Management of patients with VTE. (R1.2.1, R2)
7. Treatment of pelvic inflammation disease and STDs. (R1.2.1, R2)
8. An understanding of the appropriate chemotherapeutic agents used to treat cervical,
ovarian, and endometrial cancers. (R1.2.1, R2, R6)
9. Management of acute and chronic pain. (R1.2.1, R2, R6)
10. Treatment of surgical site infections and intra-abdominal infections. (R1.2.1, R2, R6)
11. Recognize pharmacokinetic differences in pregnant patients and their clinical
significance. (R1.2.1, R2)
12. An understanding of the “All or None” phenomenon with respect to timing of drug
exposure during pregnancy. (R1.2.1, R2, R6)
13. To understand the concept of placental transfer. (R1.2.1, R2, R6)
14. Management of the high-risk pregnant patient. (R1.2.1, R2, R6)
15. Management of pregnancy related complication such as pregnancy-induced
hypertension and gestational diabetes. (R1.2.1, R2, R6)
16. To understand the appropriate pharmacologic management of pregnant patients with
the following disorders: asthma, diabetes, epilepsy, STDs, and hypertension. (R1.2.1,
R2, R6)
17. Understand the pathophysiology and treatment of menopause. (R1.2.1, R2, R6)
Women’s Health Elective Experience
18. Provide patient education on the risks and benefits of hormone replacement therapy
(HRT). (R1.2.1, R2, R6)
19. Provide patient education upon hospital discharge. (R2.11, R5)
Learning Experience Goals & Objectives
1. Take personal responsibility for attaining excellence in one’s own ability to provide
pharmaceutical care. (R3.1.1)
2. Display initiative in preventing, identifying, and resolving pharmacy-related patient-care
problems. Proactively identify potential problems, which may result in suboptimal
patient outcomes. (R1.1.1, 1.1.3, R2)
3. Organize all written or oral communication in a logical manner at the level appropriate
for the audience. Prepare all communications so that they reflect a positive image of a
pharmacy professional. (R5)
4. Use correct grammar, punctuation, spelling, style, and formatting conventions in
preparing all written communications. (R5)
5. Collect and organize all patient-specific information needed by the pharmacist to
prevent, detect, and resolve medication-related problems and to make appropriate
medication therapy recommendations. (R2)
6. Determine the presence of any of the following medication therapy problems in a
patient’s current medication therapy: (R2)
1. Medication used with no medical indication
2. Patient has medical conditions for which there is no medication prescribed
3. Medication prescribed inappropriately for a particular medical condition
4. Immunization record is incomplete
5. Current medication therapy regimen contains something inappropriate (dose,
dosage form, duration, schedule, route of administration, method of
administration)
6. There is therapeutic duplication
7. Medication to which the patient is allergic has been prescribed
8. There are adverse drug or device-related events or potential for such events
9. There are clinically significant drug-drug, drug-disease, drug-nutrient, or druglaboratory test interactions or potential for such interactions
10. Medical therapy has been interfered with by social, recreational, nonprescription,
or nontraditional drug use the patient or others.
11. Patient not receiving full benefit of prescribed medication therapy
12. There are problems arising form the financial impact of medication therapy on the
patient
13. Patient lacks understanding of medication therapy
14. Patient not adhering to medication regimen (R2)
7. Specify therapeutic goals for a patient, design a regimen that meets those goals based
on evidence-based medicine, and develop a monitoring plan for the therapeutic regimen
that effectively evaluates achievement of patient-specific goals. (R2.7-2.10)
8. Redesign therapeutic regimens and corresponding monitoring plans based on patient
response. (R2.10)
9. Complete patient monitoring forms in a clear and understandable manner. Assess
patient’s response to therapeutic regimen daily and record in form of a SOAP note.
(R2.12)
Women’s Health Experience
Learning Experience Goals and Objectives
10. Recommend or communicate a therapeutic regimen and corresponding monitoring plan
to prescribers and patients in a way that is systematic and logical. (R2.1.1, 2.1.3)
11. Modify a pharmacotherapeutics plan as necessary based on evaluation of monitored
data. (R2.10)
12. Demonstrate proficiency at solving pharmacokinetic problems for aminoglycosides,
vancomycin, phenytoin, digoxin, and theophylline. (R2)
13. Recommend appropriate dosing regimens based on serum concentrations and
calculated pharmacokinetic parameters. (R2)
14. Participate in patient care rounds. (R2.1.1, 2.1.3)
15. Meet with the preceptor to discuss patient cases. (R5.1.4)
16. Provide concise, applicable, comprehensive, and timely responses to requests for drug
information from patients, the medical team or preceptor. Formulate responses to drug
information requests based on analysis of the literature. (R6)
17. Provide effective education to patients/caregivers regarding the patient’s medications.
Include pertinent information regarding: (R5)
1. Indication
2. Adverse effects
3. Importance of compliance
4. Proper administration technique
5. Handling/storage of medications
6. Appropriate follow-up (lab tests, etc)
7. What to do in case of missed dose(s)
8. Duration of therapy
9. Other drug-specific information as needed
Daily Activities and Responsibilities
1. Provide drug information using evidence-based medicine. (R6)
2. Participate daily in patient care rounds. (R2)
3. Assist in therapeutic management of patients, monitor therapy and modify therapy as
necessary. (R2)
4. Attend weekly high-risk pregnancy grand rounds. (R2.1.1, 2.3.1)
5. Provide patient education upon hospital discharge. (R2.11, R5)
6. Provide nursing and medicine inservice as needed concerning pharmacy-related issues.
(R5)
7. Contact pharmaceutical care clinic at the Jackson Medical Mall on select patients to
ensure continuity of care. (R2.5)
8. Attend weekly gynecology grand rounds. (R2.1.1, 2.3.1)
Women’s Health Elective Experience
Possible Reading Topics
1. Diabetes disease
2. Dyslipidemia
3. Hypertension
4. Anemia
5. Thyroid disorders
6. Contraception
7. Ectopic Pregnancy
8. Osteoporosis
9. PID/STDs
10. UTI/pyelonephritis
11. Epilepsy in Women
12. Premature infants
*
Indicates required readings
11. Polycystic ovary
12. Constipation
13. Pain management
14. Incontinence
15. Endometriosis
16. Migraines
17. DVT
18. Gestational DM
19. Cancer*
20. HRT*
21. Pregnancy & Lactation
22. Preterm Labor
******
Other topics as indicated
COMPETENCY BASED LEARNING OBJECTIVES
Outcome R1:
Manage and improve the medication-use process.
Goal R1.1: Identify opportunities for improvement of the organization’s medication-use
system.
Goal R1.2: Design and implement quality improvement changes to the organization’s
medication-use system.
Goal R1.3: Prepare and dispense medications following existing standards of practice and
the organization’s policies and procedures.
Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by
performing all necessary aspects of the medication-use system.
Outcome R2:
Provide evidence-based, patient-centered medication therapy
management with interdisciplinary teams.
Goal R2.1: As appropriate, establish collaborative professional relationships with members
of the health care team.
Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.
Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient
relationships.
Goal R2.4: Collect and analyze patient information.
Goal R2.5: When necessary, make and follow up on patient referrals.
Goal R2.6: Design evidence-based therapeutic regimens.
Goal R2.7: Design evidence-based monitoring plans.
Goal R2.8: Recommend or communicate regimens and monitoring plans.
Goal R2.9: Implement regimens and monitoring plans.
Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.
Goal R2.12: Document direct patient care activities appropriately.
Outcome R3: Exercise leadership and practice management skills.
Goal R3.1: Exhibit essential personal skills of a practice leader.
Goal R3.2: Contribute to departmental leadership and management activities.
Goal R3.3: Exercise practice leadership.
Outcome R5:
Provide medication and practice-related education/training.
Goal R5.1 Provide effective medication and practice-related education, training, or
counseling to patients, caregivers, health care professionals, and the public.
Outcome R6: Utilize medical informatics.
Goal R6.1: Use information technology to make decisions and reduce error.
Residency Assessment
Process
Resident Assessment Process
The Residency Learning System (RLS) model supports three types of assessment:
1. Preceptor assessment of the resident’s attainment of goals and objectives
2. Resident’s self assessment of their attainment of goals and objectives
3. Resident’s assessment of the preceptor and the learning experience.
The assessment of resident performance by both the resident and preceptor is directly linked
to the RLS goals and objectives. The self assessment is linked to the ability to judge one’s
performance against criteria and be able to modify their practice as needed to make
improvements. The Resi-Trak™ is the system ASHP has provided for the tracking of
assessments.
In July 2007, ASHP developed and released the Resi-Trak™ system for monitoring and
evaluating residents. UMMC will participate in this assessment system which will electronically
process all assessments by the resident, preceptor and be monitored by the Director. In this
case, reports will be printed only as needed if the system has a failure or problem.
Continuous feedback to and communication with the resident shall be provided by the
preceptor during each training segment. During a concentrated experience, that is an
experience that is two weeks in duration, one Snapshot or Criteria Based Critique will be
completed. During a month long learning experience, at least two snapshots or criteria based
assessments will be completed. During a quarterly assessment of a longitudinal experience, at
least two snapshots or criteria based assessments will be completed. These snapshots are to
be included in the final assessment of the resident’s performance during a learning experience.
Snapshots should be completed as close to the event that is to be assessed for valuable
feedback to be provided. The resident and preceptor can select snapshots or criteria based
assessments together.
A summative assessment located on Resi-Trak™ will be completed by the preceptor and a self
assessment by the resident and sent to the Residency Director for review. The assessments
must be completed by at least 10 days after the experience is completed and submitted to the
Residency Director for review. A Preceptor and Learning Experience Assessment will be
completed by the resident at the end of a monthly learning experience and at least quarterly for
longitudinal experiences.
The assessments are made by the preceptor and a self assessment by the resident for each
experience and snapshot. The resident will complete an assessment of the preceptor and the
learning experience. Each of these assessments will be reviewed by both the resident and the
preceptor. Then the assessments will be forwarded to the Residency Director for review. Once
all assessments have been signed by preceptor, resident and Director, the assessments will
be printed and placed in the assessment section of the notebook each quarter. A final
accumulative report will be printed at the end of the residency and placed in the notebooks.
When completing the assessments, goals and objectives that are to be assessed are those
that have a designation TE (TE = Teach and Evaluate) or TE+ (Taught and evaluated multiple
times). See Appendix F. Those goals and objectives that are designated as T (Teach only) do
not require an assessment but should be identified as having been taught at some point during
the residency program experiences to assure goal attainment. The resident and the preceptor
are to mark only Needs Improvement (NI) or Satisfactory Progress (SP). Once the resident has
received three Satisfactory Progress designations for a goal and objective, the Director will
mark that goal as Achieved (Ach). Once a goal has been achieved, the resident and preceptor
do not have to address that goal unless there are deficiencies identified. Then the deficiencies
for that goal should be addressed with the resident in the written assessment as well as with
the program Director. If toward the end of the program all goals are achieved, the resident and
preceptor must write comments regarding the resident’s performance in the comments section
of the Resi-Trak™ assessment.
When significant deficiencies are noted during a learning experience, the resident may not
successfully complete the experience. In such cases, appropriate remedial action will be
undertaken after discussion with the Residency Director. If the resident does not successfully
complete the remediation, the Residency Committee will review the assessments and
determine the next course of action.
The upcoming preceptors and the resident can view the assessments on Resi-Trak™ prior to
beginning the experience to identify strengths or areas that need to be addressed. The
Program Director should discuss any deficiencies that might be identified by either the resident
or the preceptor.
Each quarter, a quarterly assessment will be conducted by the Residency Committee. This
assessment will review any learning experience assessments, review resident progress with
special projects, research and residency requirements as well as the residency outcomes for
the resident. The Committee will discuss with the resident their progress and identify methods
to enhance learning as well as to strengthen areas for improvement. The Director will then
complete a written quarterly evaluation assessment that reflects the discussion and findings of
the Committee. The Residency Director will then take this assessment and with the resident
revise the Residency Plan as needed to address areas of strength, areas for improvement and
the resident’s overall goals for the residency program.
The following section will provide the forms that are to be completed for the assessments only
in the event that ResiTrak™ is unavailable. Otherwise the information will be reflected on ResiTrak™.
Appendix A
Organizational Chart
Systems Director of
Pharmacy
Michael Todaro
Administrative Assistant
III
Judy Taylor
Pharmacy Supv
Central Pharmacy
BarryPhillips / Bridgett
Chisolm
Business Manager
Stacy Conn
Assistant Pharmacy
Buyer-1
Susan St. John
Central Pharmacy
Admin Assist
Central Pharmacy
Pharmacists-15
QA Assistant
Tryane Owens
QA Assistant
Narcotics
Barbara Qualls
Pharmacy Buyer
Tommy Ball
Pharmacy Supv
Ambulatory
Steven Dancer
Pharmacist Supv
Drug Technology
Jim Westmorland
Outpatient Pharmacy
Jackson Medical Mall
Pharmacists- 2
Technicians-3
Pharmacy Supv
Pharmacy Automation
Gary Teasly
Pavilion Pharmacy
Pharmacist-2
Pharmacy technician-2
QA Assistant
David Winder
Pharmacy Residents
Pharmacy Supv
Batson and Wiser
Cindy Dumas
Pediatric Pharmacy
Pharmacists-11
Tech I -6
NICU Pharmacy
Pharmacists-2.5
Technicians-2
PGY1 - 6
Pharmacy Supv
Quality Assurence
Traci Allen
Director Of Pharmacy
UHC Holms County
Theresa Crum
QA Assistant-1
Pharmacist-1
Technician-1
Adult Hospital PCAPS
Pharmacists- 10
Pharmaceutical Care Clinic
Pharmacist-2 (0.5 FTE x 2)
Assistant Pharmacy
Buyer-3
Meds and Threads
Pharmacist -2
Secretary-1
Pharmacy Tech -1.5
IV room technicians
Pharmacy technicians -5
Pharmacy technitions-23
Center for Bleeding Disorders
Nurse Pract -1
Social Worker II- 1
RN-1
Admin Assist II -1
Pharmacy Supv
ICU Tower
Scott McKenzie
Systems Clinical
Manager
Todd Dear
Ambulatry Clinics
Clinical Pharmacy
Specialist
Internal Med-1
Clinical Pharmacy
Specialist (3)
ED, Nutrition Support
Pharmacists-7
Techs-4
Pharmacy Supv
Drug Information Center
Invest. Studies
Buddy Ogletree
Investigational Studies
QA Assistant-1
Appendix B
Residency Program
Requirements
Check off Form
ANNUAL PGY-1 RESIDENCY REQUIREMENTS
PHARMACY PRACTICE RESIDENT: _______________, Pharm D
1. Residency Notebook
 Must be kept up-to-date.
 Reviewed quarterly.
2. Newsletter
 Complete at least two articles to be in the Drug
Information Hospital Newsletter under supervision of
Drug Information Supervisor.
 Write one article for MSHP or MPHA journal.
1st
quarter
2nd
quarter
3rd
quarter
Drug Information
Newsletter required
4th
quarter
MSHP publication
3. Publication - Optional
 Under the supervision of a preceptor (as a coauthor), complete and publish at least one additional
article in a peer-reviewed journal.
4. Major Research Project
 Under the supervision of Program Director, the
Residency Committee, and the resident’s research
advisor; conduct research project worthy of
publication.
 Results should be submitted to Program Director,
Research Mentor, and the IRB.
 Results will be presented at the Regional Residency
Conference.
5. Medication Use Evaluation & Drug Monograph
 Under the supervision of Dr. Todd Dear and Dr Brad
Somers, formulate a medication use evaluation and
drug monograph.
 Present the MUE/ drug monograph to the Pharmacy
and Therapeutics Committee at the University of
Mississippi Medical Center.
6. Presentations
 Prepare and present at least 4 Powerpoint
presentations during the year – Regional Residency
Conference will serve as 1 of the 4 presentations.
 Additional presentations may be required at the
request of the preceptor.
7. Precepting Students
 Facilitate disease state management discussions.
 Participate in the evaluation process.
MUE
Regional
Residency
Conf.
Monograph
New Drug
Update
1.
Date of
2.
Additional
Presentations 3.
DSM
Discussions
Evaluations
8. Problem-Based Learning
 Observe PBL with a pharmacy faculty member.
9. Journal Club
 Attend regularly scheduled journal club sessions
 Serve as the primary presenter for at least 1 journal
club session.
10. Therapeutic Pearls
• Attend scheduled Therapeutic Pearl sessions.
• Present a pearl at each session.
11. Community Service
 Participate in at least 4 heath-related outreach
projects including but not limited to health fairs.
12. Select Mentors
• Research Mentor
• Professional Mentor
1.
3.
2.
4.
1. Research Mentor
________________________________
2. Professional Mentor
________________________________
13. Physical Assessment Checklist completed
14. Monthly Activity Report
 Complete a monthly activity report within a timely
manner.
 Forward this report to the Program Director and the
Pharmacy Department Director.
July
Oct
Jan
Apr
Aug
Nov
Feb
May
Sept
Dec
Mar
June
*This list is not inclusive of responsibilities expected by preceptors of individual learning
experiences. This reflects major overall requirements for successful completion of the
program.
PHYSICAL SKILLS ASSESSMENT CHECKLIST
Resident Name: _____________________________________
Date Submitted: ___________________
Below is a checklist that identifies those physical assessment skills a Doctor of Pharmacy should possess at the end of the
experiential program. This checklist should be kept in the resident portfolio and reviewed with each preceptor at the beginning of
each rotation. The preceptor should assist the resident in completing the checklist.
Skill
Vital Signs
Blood Pressure
Pulse
Temperature (otic, oral)
Physical Examination
Ophthalmologic
Otoscopic
Nasopharyngeal
Heart Sounds
Breath Sounds
Neurologic
Bowel Sounds
Mental Status Exam
Administration Techniques
Subcutaneous Injection
Intramuscular Injection
Topicals
Nasal sprays
Nasal drops
Eye drops
Eye ointments
Autoinjectors (Epi-Pen)
Insulin pens
Metered dose inhalers
Dry powder inhalers
Device Management
Peak Flow Meter
Spacers
Self-Glucose Monitors
Monofilament Test
Satisfactory
Completion
()
Preceptor Signature
Physical Skills
Instructor Signature (If
other than Preceptor)
Date
Appendix C
Resident Job Description
Census Code _______________
Occupational Code __________
Grade _______________
Salary _______________
THE UNIVERSITY OF MISSISSIPPI HEALTH CARE
JOB DESCRIPTION
JOB TITLE:
Pharmacy Resident
DEPARTMENT:
Pharmacy
REPORTS TO:
Director of Residency Program
POSITION SUMMARY:
To provide pharmaceutical care that meets or exceeds established standards. Accomplished
through the ability to conceptualize, integrate, and transform accumulated experiences and
knowledge into optimal drug therapy outcomes. Providing both clinical and distributive pharmacy
services. Performs these functions and other duties as assigned under the general supervision of
the Director of the Residency Program.
Essential Duties and Responsibilities:
Distributive Activities
1. Compounds, labels and/or dispenses accurately and in a timely manner.
2. Performs computer order-entry in an accurate and timely manner.
3. Obtains and enters patient height, weight, allergies and diagnosis into the pharmacy
computer system.
4. Follows departmental policy when an order for a non-formulary medication is received.
5. Checks medication carts and code carts accurately as assigned.
6. Properly maintains all legally required records.
7. Recognizes drug supply problems and assists in obtaining and maintaining adequate
drug stock.
8. Reviews patient profiles and ensures accuracy of medication administration record.
9. Verifies appropriate and accurate drug distribution tasks performed by supportive staff.
Clinical Activities
1. Designs, recommends, monitors and evaluates patient specific pharmacotherapy.
2. Performs therapeutic drug monitoring, uses pharmacokinetics to evaluate drug regimens
and recommends changes in medication regimens to improve patient outcomes.
3. Participates in the health system’s process for assessing, managing, and reporting
medication errors.
4. Participates in the health system’s process for documenting and evaluating adverse drug
reactions.
5. Assists with formulary and medication use evaluation activities.
6. Provides concise, applicable, and timely responses to requests for drug information from
healthcare providers and patients.
7. Documents patient/family education properly with respect to current
medications/devices.
8. Provides discharge counseling for patients and documents sessions appropriately.
Educational Activities
1.
2.
3.
Contributes to the training of pharmacy students, other health-care professionals and
supportive personnel.
Delivers effective education and training to patients and the public.
Designs and executes investigations of pharmacy practice-related issues.
Job location, working environment, or hazard variables:
MINIMUM EDUCATION, EXPERIENCE AND LICENSURE/CERTIFICATION/SPECIAL
TRAINING REQUIREMENT:
MINIMUM EDUCATION:
Pharm.D. from an accredited School of Pharmacy
LICENSURE:
Must be licensed or eligible for licensure as a pharmacist in the
State of Mississippi.
EXPERIENCE:
No experience required.
APPROVED BY:
__________________________________
Employee Signature
_____________________________________
Evaluator
____________
Date
____________
Date
_____________________________________
Department Head
_____________
Date
_____________________________________
Hospital Administration (if applicable)
_____________
Date
Appendix D
Pre- Assessment Document
And
Assessment of Knowledge
ACADEMIC APPOINTMENT PHARMACY RESIDENCY
ASSESSMENT FOR RESIDENCY TRAINING
PHARMACY PRACTICE RESIDENCY
Name_________________________
Date______________________
The following questions are intended for the incoming resident to conduct a self-assessment prior to
beginning the residency year. The responses assist in planning experiences for the resident in the coming
year. Please answer the following and return to Michael Todaro.
1. State your short term goals (within the next 5 years).
2. Describe your current practice interests (ambulatory clinics, institutional pharmacy (hospital),
academia, pharmaceutical industry, and/ or combinations, etc).
3. List your strengths both personal and in pharmaceutical care skills.
4. List the areas of improvement that you would like to address during the residency.
5. List at least 3 goals you would like to accomplish during your residency program.
6. Describe the frequency of the preceptor interaction you feel to be ideal. Where do you see
the preceptor fitting into your professional development and maturity?
7. What is your personal strategy for life-long continuing education?
8. What role will professional organizations have in your career?
9. What is your personal strategy for time management and meeting deadlines?
10. What areas of residency training would you like to concentrate during the residency (list in order of
importance)? (See enclosed ASHP Objectives for your program – read over these before beginning
the residency)
11. Do you have any of the following and what is the date of expiration?
BLS certification ______________________________________
ACLS certification_____________________________________
Attended a cardiac arrest situation________________________
Immunization Certification_______________________________
Physical Assessment Class or Experience__________________
Drug Information Rotation_______________________________
12. Have you been involved in research projects prior to the residency? If so, how much
experience do you have and with what type of research?
13. How much work experience do you have in the following:
Hospital Pharmacy: _______________________________
Community Pharmacy: _____________________________
Other practice settings: _____________________________
14. For the next set of questions, rank your answer from 1-5 for each item
(Scale: 1 - no experience and 5 - much experience; very comfortable)
Time Management Skills_____________________
Supervisory Skills___________________________
Written Communication___________________
Oral Presentations____________________ Number presentations:_____)
PowerPoint Slide Program____________________
Medication Use Evaluation (MUE)______________
Drug Monographs___________________________
P&T Presentations___________________________
Micromedex Information Service_______________
Poisondex Information Service_________________
Iowa Drug Information Service_________________
Internet Searches ___________________________
Microsoft Word______________________________
Microsoft Excel______________________________
Statistics ___________________________________
Journal Article Review_________________________
15. Using the same rank system (1 is no experience and 5 is very comfortable), regarding the
following staffing or service in an institutional Pharmacy Department, how much experience
do you have with the following:
IV fluid / TPN preparation_______________________________
Chemotherapy Compounding __________________________
Prepacking IV and IVPB’s______________________________
Computer order entry_________________________________
Electronic Medical Record_____________________________
Cart fill and delivery of med carts________________________
Medication Cart Checks_______________________________
Automated Dispensing Machines________________________
(Pyxis, Omnicell, Medselect, etc)
Compounding ointments/creams, solutions_________________
Dispensing/Maintaining Controlled Substance Records________
Ordering / stocking medications __________________________
Nonformulary items____________________________________
Critical Care Satellites _________________________________
Pediatric Patients _____________________________________
Pharmacokinetics _____________________________________
Nutrition Support Services_______________________________
Fluid & Electrolyte Imbalances ____________________________
Retail Pharmacy Dispensing _____________________________
Pricing of medications in the institution______________________
340B Pricing medications ________________________________
Dealing with 3rd party payors______________________________
Medicaid / Third Party Prior Approvals ______________________
Patient Assistance Programs ______________________________
Thank you for your time in completing this self-assessment, it will be valuable in planning
your experiences.
Please return to me with the other required documents as soon as possible.
Michael Todaro
Director of Pharmacy
Residency Program Director
Appendix E
Presentation Critique
Resident Presentation
√ Check One
Evaluation Form
I am a…
□ Pharmacist
Presenter’s Name:_____________________________________□ Technician
□ Student/ Resident
□ Other_____________
Presentation Title:_____________________________________
Excellent
Presentation
Speaking style (volume, clarity)
Organization, points well made
Non-verbal (e.g., eye contact)
Slides – Readability, quality
Resident enthusiasm/participation
Appropriate length
Ability to respond to questions
Content
Content and knowledge of topic
Content & appropriateness of A/V
Ability to improve the audience’s
understanding of topic presented
Comments/Suggestions:
Check One Please
Good
Average
Fair
Poor
Appendix F
RLS Goals and Objectives
To Be
Taught and Taught and
Evaluated
University of Mississippi Medical Center RLS Goal and Assessment Assignments
PGY-1 Pharmacy Practice
Emphasis
TE/TE+
Goal
Practice
Management
Longitudinal
Experience Core
Research
Longitudinal
Experience Core
Service
Longitudinal Core
Direct Patient
Care –
Inpatient and
Ambulatory
Care -Core &
Elective
Required outcomes and educational
goals and objectives for PGY1 programs
Outcome R1: Manage and improve the medication-use process.
Goal
R1.1
Goal
R1.2
Goal
R1.3
Identify opportunities for improvement of
the organization’s medication-use system.
OBJ R1.1.1(Comprehension) Explain the
organization’s medication-use system and
its vulnerabilities to adverse drug events
(ADEs).
OBJ R1.1.2(Analysis) Analyze the
structure and process and measure
outcomes of the medication-use system.
OBJ R1.1.3(Evaluation) Identify
opportunities for improvement in the
organization’s medication-use system by
comparing the medication-use system to
relevant best practices.
Design and implement quality improvement
changes to the organization’s medicationuse system.
OBJ R1.2.1(Synthesis) Participate in the
identification of, need for, development of,
implementation of, and evaluation of an
evidence-based treatment
guideline/protocol related to individual and
population-based patient care.
OBJ R1.2.2(Synthesis) Design and
implement pilot interventions to change
problematic or potentially problematic
aspects of the medication-use system with
the objective of improving quality.
Prepare and dispense medications
following existing standards of practice and
the organization’s policies and procedures.
OBJ R1.3.1(Evaluation) Interpret the
appropriateness of a medication order
before preparing or permitting the
T/ TE
T
T
T
T
T
T
T
T
T
T/ TE
T/ TE
T/ TE
T/ TE
T
T
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T
T/ TE
T/ TE
Goal
R1.4
distribution of the first dose.
OBJ R1.3.2(Application) Follow the
organization's policies and procedures to
maintain the accuracy of the patient’s
medication profile.
OBJ R1.3.3(Application) Prepare
medication using appropriate techniques
and following the organization's policies
and procedures.
OBJ R1.3.4(Application) Dispense
medication products following the
organization's policies and procedures.
Demonstrate ownership of and
responsibility for the welfare of the patient
by performing all necessary aspects of the
medication-use system.
OBJ R1.4.1(Characterization) Display
initiative in preventing, identifying, and
resolving pharmacy-related patient-care
problems.
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
T/ TE
Outcome R2: Provide evidence-based, patient-centered
medication therapy management with interdisciplinary teams.
Goal
As appropriate, establish collaborative
TE+
R2.1
professional relationships with members of
the health care team.
OBJ R2.1.1(Synthesis) Implement a
TE+
strategy that effectively establishes
cooperative, collaborative, and
communicative working relationships with
members of interdisciplinary health care
teams.
Goal
Place practice priority on the delivery of
TE+
R2.2
patient-centered care to patients.
OBJ R2.2.1(Organization) Choose and
TE+
manage daily activities so that they reflect
a priority on the delivery of appropriate
patient-centered care to each patient.
Goal
As appropriate, establish collaborative
TE+
R2.3
professional pharmacist-patient
relationships.
OBJ R2.3.1.(Synthesis) Formulate a
TE+
strategy that effectively establishes a
patient-centered pharmacist-patient
relationship
Goal
Collect and analyze patient information.
TE+
R2.4
OBJ R2.4.1(Analysis) Collect and
TE+
organize all patient-specific information
needed by the pharmacist to prevent,
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
detect, and resolve medication-related
problems and to make appropriate
evidence-based, patient-centered
medication therapy recommendations as
part of the interdisciplinary team.
OBJ R2.4.2(Analysis) Determine the
presence of any of the following
medication therapy problems in a patient's
current medication therapy:
1.Medication used with no medical
indication
2.Patient has medical conditions for which
there is no medication prescribed
3Medication prescribed inappropriately for
a particular medical condition
4.Immunization regimen is incomplete
5. Current medication therapy regimen
contains something inappropriate (dose,
dosage form, duration, schedule, route of
administration, method of administration)
6.There is therapeutic duplication
7.Medication to which the patient is allergic
has been prescribed
8.There are adverse drug or device-related
events or potential for such events
9.There are clinically significant drug-drug,
drug-disease, drug-nutrient, or druglaboratory test interactions or potential for
such interactions
10.Medical therapy has been interfered
with by social, recreational,
nonprescription, or nontraditional drug use
by the patient or others
11.Patient not receiving full benefit of
prescribed medication therapy
12.There are problems arising from the
financial impact of medication therapy on
the patient
13.Patient lacks understanding of
medication therapy
14.Patient not adhering to medication
regimen
Goal
R2.5
TE+
TE+
TE+
TE+
OBJ R2.4.3(Analysis) Using an
organized collection of patient-specific
information, summarize patients’
health care needs.
TE+
TE+
TE+
TE+
When necessary, make and follow up on
patient referrals.
OBJ R2.5.1(Evaluation) When presented
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
Goal
R2.6
Goal
R2.7
Goal
R2.8
Goal
R2.9
with a patient with health care needs that
cannot be met by the pharmacist, make a
referral to the appropriate health care
provider based on the patient’s acuity and
the presenting problem.
OBJ R2.5.2(Synthesis) Devise a plan for
follow-up for a referred patient.
Design evidence-based therapeutics
regimens.
OBJ R2.6.1(Synthesis) Specify
therapeutic goals for a patient
incorporating the principles of evidencebased medicine that integrate patientspecific data, disease and medicationspecific information, ethics, and quality-oflife considerations.
OBJ R2.6.2(Synthesis) Design a patientcentered regimen that meets the evidencebased therapeutic goals established for a
patient; integrates patient-specific
information, disease and drug information,
ethical issues and quality-of-life issues;
and considers pharmacoeconomic
principles.
Design evidence-based monitoring plans.
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
OBJ R2.7.1(Synthesis) Design a patientcentered, evidenced-based monitoring
plan for a therapeutic regimen that
effectively evaluates achievement of the
patient-specific goals.
Recommend or communicate regimens
and monitoring plans.
OBJ R2.8.1(Application) Recommend or
communicate a patient-centered,
evidence-based therapeutic regimen and
corresponding monitoring plan to other
members of the interdisciplinary team and
patients in a way that is systematic, logical,
accurate, timely, and secures consensus
from the team and patient.
Implement regimens and monitoring plans.
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
OBJ R2.9.1(Application) When
appropriate, initiate the patient-centered,
evidence-based therapeutic regimen and
monitoring plan for a patient according to
the organization's policies and procedures.
OBJ R2.9.2(Application) Use effective
patient education techniques to provide
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
Goal
R2.10
Goal
R2.11
Goal
R2.12
counseling to patients and caregivers,
including information on medication
therapy, adverse effects, compliance,
appropriate use, handling, and medication
administration.
Evaluate patients’ progress and redesign
regimens and monitoring plans.
OBJ R2.10.1(Evaluation) Accurately
assess the patient’s progress toward the
therapeutic goal(s).
OBJ R2.10.2(Synthesis) Redesign a
patient-centered, evidence-based
therapeutic plan as necessary based on
evaluation of monitoring data and
therapeutic outcomes.
Communicate ongoing patient information.
OBJ R2.11.1(Application) When given a
patient who is transitioning from one health
care setting to another, communicate
pertinent pharmacotherapeutic information
to the receiving health care professionals.
OBJ R2.11.2(Application) Ensure that
accurate and timely medication-specific
information regarding a specific patient
reaches those who need it at the
appropriate time.
Document direct patient care activities
appropriately.
OBJ R2.12.1(Analysis) Appropriately
select direct patient-care activities for
documentation.
OBJ R2.12.2(Application) Use effective
communication practices when
documenting a direct patient-care activity.
OBJ R2.12.3(Comprehension) Explain the
characteristics of exemplary
documentation systems that may be used
in the organization’s environment.
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
T
T
T
T
TE+
TE+
TE+
TE+
T
Outcome R3: Exercise leadership and practice management
skills.
Goal
Exhibit essential personal skills of a
TE+
R3.1
practice leader.
OBJ R.3.1.1(Characterization) Practice
self-managed continuing professional
development with the goal of improving the
quality of one’s own performance through
self-assessment and personal change.
Goal
R3.2
Goal
R3.3
OBJ R3.1.2(Characterization)
Demonstrate pride in and commitment to
the profession through appearance,
personal conduct, and association
membership
OBJ R3.1.3(Characterization) Act ethically
in the conduct of all job-related activities.
Contribute to departmental leadership and
management activities.
OBJ R3.2.1(Synthesis) Participate in the
pharmacy department's planning
processes.
OBJ R3.2.2(Comprehension) Explain the
effect of accreditation, legal, regulatory,
and safety requirements on practice.
OBJ R3.2.3(Comprehension) Explain the
principles of financial management of a
pharmacy department.
OBJ R3.2.4(Synthesis) Prioritize the work
load, organize the work flow, and check the
accuracy of the work of pharmacy technical
and clerical personnel or others.
Exercise practice leadership.
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
TE+
T/ TE+
TE+
T
T
T
T
T
T
T
T
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T
OBJ R3.3.1(Synthesis) Use knowledge of
an organization's political and
decision-making structure to influence
accomplishing a practice area goal.
OBJ R3.3.2(Comprehension) Explain
various leadership philosophies that
effectively support direct patient care and
pharmacy practice excellence.
OBJ R3.3.3(Application) Use group
participation skills when leading or working
as a member of a committee or informal
work group.
OBJ R3.3.4(Application) Use knowledge of
the principles of change management to
achieve organizational, departmental,
and/or team goals.
T
T
T
T
T
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T
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Outcome R4: Demonstrate project management skills.
Goal
R4.1
Conduct practice-related investigations
using effective project management skills.
OBJ R4.1.1(Synthesis) Initiate, design,
implement, and write up a practice-related
investigation which, at all steps in the
process, reflects the skillful application of
project management skills.
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Outcome R5: Provide medication and practice-related
education/training
Goal
Provide effective medication and practiceTE+
R5.1
related education, training, or counseling to
patients, caregivers, health care
professionals, and the public.
OBJ R5.1.1(Application) Use effective
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educational techniques in the design of all
educational activities.
OBJ R5.1.2(Synthesis) Design an
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assessment strategy that appropriately
measures the specified objectives for
education or training and fits the learning
situation.
OBJ R5.1.3(Application) Use skill in the
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four preceptor roles employed in practicebased teaching (direct instruction,
modeling, coaching, and facilitation).
OBJ R5.1.4(Application) Use skill in caseTE+
based teaching.
OBJ R5.1.5(Application) Use public
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speaking skills to speak effectively in large
and small group situations.
OBJ R5.1.6(Application) Use knowledge of TE+
audio-visual aids and handouts to enhance
the effectiveness of communications.
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T/ TE+
T/ TE+
T/ TE+
T/ TE+
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T
T
T
T
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Outcome R6: Utilize medical informatics.
Goal
R6.1
Use information technology to make
decisions and reduce error.
OBJ R6.1.1(Comprehension) Explain
security and patient protections such as
access control, data security, data
encryption, HIPAA privacy regulations, as
well as ethical and legal issues related to
the use of information technology in
pharmacy practice.
OBJ R6.1.2(Application) Exercise skill in
basic use of databases and data analysis
software.
OBJ R6.1.3(Evaluation) Successfully
make decisions using electronic data and
information from internal information
databases, external online databases, and
the Internet.
Elective outcomes and educational goals
and objectives for PGY1 programs
Outcome E1:Conduct pharmacy practice
research.
Goal
Design, execute, and report results of
E1.1
investigations of pharmacy practice-related
issues.
OBJ E1.1.1(Analysis) Identify potential
practice-related issues that need to be
studied.
OBJ E1.1.2(Application) Use a systematic
procedure for performing a comprehensive
literature search.
OBJ E1.1.3(Analysis) Draw appropriate
conclusions based on a summary of a
comprehensive literature search
OBJ E1.1.4(Synthesis) Generate a
research question(s) to be answered by an
investigation.
OBJ E1.1.5(Synthesis) Develop specific
aims and design study methods that will
answer the question(s) identified.
OBJ E1.1.6(Application) Use a systematic
procedure to collect and analyze data
OBJ E1.1.7(Evaluation) Draw valid
conclusions through evaluation of the data.
OBJ E1.1.8(Synthesis) Use effective
communication skills to report orally and in
writing the results and recommendations of
an investigation into a pharmacy practicerelated issue.
Goal
Participate in clinical, humanistic and
E1.2
economic outcomes analyses.
OBJ E1.2.1(Evaluation) Contribute to a
prospective clinical, humanistic and/or
economic outcomes analysis.
OBJ E1.2.2(Evaluation) Contribute to a
retrospective clinical, humanistic, and/or
economic outcomes analysis.
Revised 6/08
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