Staats Pharmacy & Health Education Center
WVRHEP Program–Winding Roads Health Consortium
Ambulatory Care Rotation
Course Overview
The Ambulatory Care rotation is a four (4) week required experiential rotation. Students will gain practical experience providing pharmaceutical care and disease state management in an outpatient setting. Students will identify and resolve drug related problems; identify therapeutic goals; monitor therapeutic outcomes and adverse effects; provide drug information to health care professionals; and perform patient counseling on medications and disease states.
In order to achieve the maximum benefit and best experience from this rotation, students are encouraged to:
· Be self-motivated
· Ask questions
· Get involved
· Interact with and get to know our staff, patients and local health care providers
· Make themselves at home at the pharmacy as if this were their professional place of practice
Community Service & IDS
Twenty (20) percent (approximately one day/week) of the student’s time (unless categorized as “secondary”) at the RHEP site is to be spent participating in:
1. Interdisciplinary Sessions (IDS)
2. Community Service
Disease State Management/Screening Programs at Staats Pharmacy
q Diabetes
q Hyperlipidemia
q Osteoporosis
q Hypertension
Activities:
Students must be prepared to perform/participate in the following should the opportunity arise:
o Patient counseling / education / recommendations
o Staff education
o Drug information requests from staff, providers & patients
o Written assignments or projects such as newsletters, patient education materials, manuals or other written reports as applicable (to target patients, staff or health care providers for print or Internet web site)
o Participation in community health fairs or screenings (when applicable)
o Rounds at Roane General Hospital with physician
o Learn about Lab Testing, CLIA, OSHA & Blood Borne Pathogens Rules
Disease State Management Skills and Activities Checklist
Student’s preceptor is to initial the following when completed:
q Diabetes
§ Assist with PEIA Face to Face Diabetes Program
§ Be familiar with the current ADA Clinical Practice Recommendations (available in store & online: www.diabetes.org)
§ Blood glucose monitoring
· Know recommendations (ACE vs ADA recommendations) for target blood glucose levels
· Perform blood glucose monitoring
· Teach patients how to use a blood glucose monitor
§ A1c testing (using DCA 2000 instrument)
· Learn how & why to perform this test & know the recommended target level (ACE vs ADA recommendations)
§ Identify patients at risk for diabetes
· Give ADA diabetes risk test to patients in waiting area (document results)
· Do random blood pressure and blood sugar screening of patients in waiting area (document results)
§ Diabetes Self-Management Education (DSME)
· Assist with education sessions & documentation/charting (if the opportunity arises)
· Be available to answer questions/concerns of patients
§ Diabetes Foot Care program
· Learn about importance of diabetes foot care
· Assist with patient education & fitting of shoes (if the opportunity arises)
· Medicare billing of therapeutic footwear (David to sign)
q Hyperlipidemia
o Be familiar with the NCEP ATP III Guidelines
o Cholesterol testing
§ Learn how to perform a lipid panel using the Cholestech instrument
§ Perform lipid panels using the Cholestech instrument
o Learn how to do a 10-year cardiac risk assessment
§ Manual
§ Cholestech
o Patient education
§ Counsel patients on test results & make recommendations
q Osteoporosis
o Be familiar with the diagnosis, prevention & treatment of osteoporosis. Great web site: National Osteoporosis Foundation (www.nof.org)
o Learn how to perform a bone mineral density test
o Perform a bone mineral density test, interpret the results and counsel patient
q Hypertension
o Be familiar with the JNC VII guidelines
o Learn how to properly take blood pressures
o Learn about the different blood pressure monitors available, their accuracy, ease of use, cost and patient selection
o Counsel patients about their readings; chart their readings; make recommendations based on their readings
q Drug-Nutrient Depletion Program
o Familiarize yourself with this program
o Distribute patient info sheets and counsel patients about them
Projects:
Each student must select a minimum of 1 major project and 2 minor projects to complete during this rotation. Some examples are listed below:
Major Projects
q Review & update Staats Pharmacy’s Bloodborne Pathogens policy & procedure and OSHA regulations. Give staff education update.
q Health screening
· Specify ___________________________________________________
q Revise diabetes patient assessment/history form
q Revise diabetes self-management training flow sheet
q Research reimbursement for lipid panels, A1c & bone density screening by various insurance companies
q Patient follow-up calls (eg rx’s for antibiotics, new patients, pediatrics, multiple meds, blood glucose meters, etc.)
q Project of interest to student with preceptor approval
· Specify ___________________________________________________
Minor Projects
q Blood glucose monitoring policy & procedure (See APhA sample p&p)
q A1c testing policy & procedure
q Bone density screening policy & procedure
q Lipid panel policy & procedure (revise current procedure)
q Radio ad for therapeutic footwear
q Food models
§ re-label food models that are missing serving size stickers
§ label food models with nutritional info
§ make chart to use with generic portion size food models (also label on underside)
q Develop & implement a system for distributing patient education fliers to patients taking statins and TZD’s
q Counsel patients at time of dispensing statins about importance of compliance, having LFT’s done & taking CoQ 10.
q Give patient ed sheets with rx’s for Actos & Avandia; counsel patients
§ Monitor HIPPA compliance in the store; make suggestions and update staff if needed
§ In-store display on health observance for the current month
§ Patient education article on a health observance for the current month
§ Project of interest to student with preceptor approval
• Specify ___________________________________________________