Community Introductory Pharmacy Practice Experience (IPPE) Manual - Spring 2021 - University of Minnesota College of Pharmacy Office of ...
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Community Introductory Pharmacy Practice Experience (IPPE) Manual - Spring 2021 University of Minnesota College of Pharmacy Office of Experiential Education 5-110 Weaver – Densford Hall 308 Harvard Street S.E. Minneapolis, Minnesota 55455
Table of Contents
Introduction 2
Office of Experiential Education Contact Information 2
Course Goals & Objectives 3
Student Assessment 3
Preceptor Introduction Letter and Learning Intention 4
Activity 1: Community Pharmacy Roles and Responsibilities 6
Activity 2: Community Pharmacy Services 7
Activity 3: Controlled Substance Management 8
Activity 4: Systems and Financial Management Activity 9
Activity 5: OTC Care Plans 11
Activity 6: Patient Safety Activity 18
Activity 7: OTC Section Tour 19
Activity 8: OTC Product Line Extension Activity 20
1Introduction
The Spring PD1 Community Introductory Pharmacy Practice Experience (IPPE) is
intended to provide students with an initial introduction to community pharmacy practice,
with a focus on over-the-counter (OTC) medications and self-care, and pharmacy
operations. This 40-hour block will occur mid-spring semester with students assigned to
a community pharmacy preceptor to complete these activities on-site. This experience
is intended to complement the fall IPPE block, which is focused on patient counseling
and prescription dispensing.
Elements of this workbook:
● Course goals and overview
● Entrustable professional activities (EPAs) used by preceptors to assess student
performance
● Activities to be completed to direct student learning
In addition to the information found in this workbook, you will find general expectations
and policies for experiential education in the Experiential Education Manual located on
Canvas.
If you find you are unable to complete the activities and/or meet the learning goals
described in this manual at your site for any reason, please contact your course
directors to discuss solutions.
Office of Experiential Education Contact Information
Caitlin Frail, PharmD, MS, BCACP 612- 626-9280
IPPE1-Community Co-Course Director 7-174 WDH
ckfrail@umn.edu
Jason Varin, PharmD 612-626-8734
IPPE1-Community Co-Course Director 5-110 WDH
varin@umn.edu
Andy Traynor, PharmD, BCPS 612-625-0077
Assistant Dean of Experiential Education 5-110 WDH
tray0015@umn.edu
Raquel Rodriguez, BS Pharm, PhD 612-626-1163
Director of Experiential Education 1-130 WDH
2rodre001@umn.edu
Katie Oja, PharmD 218-726-6039
Associate Program Director of Experiential 107 LSci (Duluth Campus)
Education koja@d.umn.edu
Mary McGuiggan, PharmD, BCGP 612-624-1596
Director of Preceptor Development 5-110 WDH
mcgui036@umn.edu
Course Goals & Objectives
Community IPPE is an introductory experience and all activities are the responsibility of
the student pharmacist, and are expected to be completed with the guidance, direction
and supervision of your preceptor. This experience is designed to provide you with
practice and exposure to the foundational professional skills and experiences related to
community pharmacy.
Student Assessment
Preceptors will assess student performance through an evaluation form in CORE.
Assessment is conducted using five EPAs, which are used throughout the experiential
education curriculum, and a statement on professionalism. The left column of the table
includes questions preceptors are asked to complete about student performance. The
right column includes the expected performance level for students to achieve during
Community IPPE. Preceptors are able to rate students on a performance ranging from
one through five, with one being observation only and five being the student is able to
teach others. All expected performance levels are set at one or two, which require direct
supervision for all activities. For more background on EPAs, please refer to the
Experiential Education Manual.
EPA Levels:
● Level One: I trust the learner, with specific direction and direct supervision. The
learner requires significant correction for performance improvement.
● Level Two: I trust the learner, with direct supervision and frequent correction.
The learner accepts feedback for performance improvement.
● Level Three: I trust the learner, with limited correction. The learner is self-
directed and seeks guidance as necessary.
3● Level Four: I trust the learner, with limited correction as an independent
practitioner (upon graduation).
● Level Five: I trust that the learner has mastered the ability as an independent
practitioner (upon licensure). The learner is qualified to give meaningful feedback
to other learners.
Preceptor Evaluation Questions
Entrustable Professional Activity Expected performance level description
1 Collect information to identify a Level 2: I trust the learner, with direct supervision
patient’s medication therapy problems and frequent correction. The learner accepts
and health-related needs feedback for performance improvement.
2 Analyze information to determine the Level 2: I trust the learner, with direct supervision
effects of medication therapy, identify and frequent correction. The learner accepts
medication therapy problems feedback for performance improvement.
(indicated, effective, safe, and
convenient), and prioritize health-
related needs.
3 Serve as the first contact of care in Level 2: I trust the learner, with direct supervision
assisting with self-care and/or triage to and frequent correction. The learner accepts
an escalated care setting. feedback for performance improvement.
4 Oversee the pharmacy operations for Level 1: I trust the learner, with specific direction
an assigned work shift. and direct supervision. The learner requires
significant correction for performance
improvement.
5 Minimize adverse drug events and Level 2: I trust the learner, with direct supervision
medication errors. and frequent correction. The learner accepts
feedback for performance improvement.
6 I trust the learner to, independently and Yes
without additional guidance,
consistently exhibit professional
behavior. [Yes or No]
BEFORE IPPE BEGINS
Preceptor Introduction Letter and Learning Intention
4Write a letter to your preceptor to introduce yourself professionally and state your
learning intention for the experience. Think about what you would like to gain,
considering what will be most valuable to you based on your goals and past
experiences. Consider the following in developing your one page letter:
● Outside of the stated learning outcomes, what do you professionally and
personally hope to gain from this experience, and why? How will this benefit you
as a student and as a professional?
● How will you work to ensure you achieve these learning outcomes?
● Briefly describe your reasons for attending pharmacy school, prior experience in
pharmacy, and experience in your first year of school to introduce yourself and
provide context for your learning intention reflection.
Only reveal information to your preceptor you are comfortable sharing. Please use your
own judgement, but do include your pharmacy experience and learning intention as this
will help your preceptor to better understand your level of exposure to pharmacy
practice and interests. It also helps the preceptor to prepare and plan for your
experience. Please feel free to reach out to us individually about ways to modify this
assignment if you have concerns. Upload the letter to Canvas by two Mondays before
your rotation week starts, and provide your letter to your preceptor.
5Activity 1
Community Pharmacy Roles and Responsibilities
(EPA 4: Oversee the pharmacy operations for an assigned work shift.)
● Observe the activity at your site and interview the individuals at your site. Answer
these questions about the: 1) the Pharmacist in Charge(PIC), 2) staff
pharmacists, 3) pharmacy technicians, and 4) other support staff:
○ What are the roles and responsibilities of each team member?
○ What are their primary tasks? How do they spend most of their time?
○ What activities/responsibilities are unique to each position? For instance,
what does the PIC do that the staff pharmacist may not? What do the
technicians do that the PIC may not?
○ Which activity/responsibility do they enjoy the most? Why?
○ Which activity/responsibility do they dislike the most? Why?
● How do team members work together? How does the pharmacy team
communicate with each other?
● Who does the pharmacy team need to communicate with outside of the
pharmacy on a regular basis and why? What does this look like?
● What are the activities that occur before opening each day? Before closing the
pharmacy each day? Participate in the pre-opening and post-closing process at
least once, if possible.
6Activity 2
Community Pharmacy Services
(EPA 4: Oversee the pharmacy operations for an assigned work shift.)
● Beyond typical prescription dispensing, what patient care services are available
at your site? (e.g. medication therapy management, immunizations, point-of-care
testing)
● What are the goals of providing these services?
● What are considerations that go into offering new services? What would be the
first step to implementing or growing this service?
● What policies or manuals are available to guide these services? Review these, if
available.
7Activity 3
Controlled Substance Management
(EPA 4: Oversee the pharmacy operations for an assigned work shift.)
● How are controlled substances ordered at your site?
● How is controlled substances inventory managed at your site?
● Ask if your pharmacy uses the Minnesota Prescription Monitoring Program
(PDMP). What may prompt them to access the system (new patient, suspicion of
fraud and or abuse, etc?
● How do they access and analyze data in the system? How does the PMP
contribute to their decision to dispense a controlled substance?
● If they do not use the PMP, ask what barriers may exist to them using it, and do
they use other resources in its place?
8Activity 4
Systems and Financial Management Activity
(EPA 4: Oversee the pharmacy operations for an assigned work shift.)
Define the following terms and what they mean in community pharmacy operations.
copay
coinsurance
deductible
donut hole
prior
authorization
AWP
AAC
MAC
FIFO
Inventory shrink
Inventory days
supply
Medicaid
Medicare
PMAP
MPAPs
(Manufacturer
Patient Assistance
Programs)
Third Party
Reimbursement
Formulary/
Non Formulary
Activity 5
9OTC Care Plans
(EPA 1: Collect information to identify a patient’s medication therapy problems and
health-related needs. EPA 2: Analyze information to determine the effects of medication
therapy, identify medication therapy problems (indicated, effective, safe, and
convenient), and prioritize health-related needs. EPA 3: Serve as the first contact of
care in assisting with self-care and/or triage to an escalated care setting.)
Complete two care plans for self-care cases that are identified at your site.
Care Plan 1
REASON FOR ENCOUNTER:
SUBJECTIVE Background (Description and history of the present illness or medical
condition including previous approaches to treatment and responses; include other
medical problems, medication experience per patient, drug allergies, current meds, any
relevant social drug use, etc.)
Immunizations (patient reported and documented):
Medication Allergies/ADRs (medication, reaction, date):
Alerts (e.g. sight, hearing, mobility, literacy, disability):
Current Medication List:
10INDICATION MEDICATIONS DOSAGE START ADHERENCE OR
INSTRUCTIONS DATE OTHER NOTES
(DRUG
PRODUCT, (DOSE, ROUTE,
STRENGTH, FREQUENCY,
DOSAGE DURATION)
FORM)
11OBJECTIVE Background (pertinent laboratory values, physical assessment
measurements, etc.)
ASSESSMENT (INCLUDE GOALS, DTPS, OPTIONS, ETC. FOR EACH CONDITION
ASSESSED: include indication, goals of therapy, drug therapy problems, and
therapeutic options):
INDICATION (CONDITION 1) _________________________
GOALS OF THERAPY (CONDITION 1) (improvement or normalization of
signs/symptoms/laboratory tests or reduction of risk; must have a short- and long-term
effectiveness goal, unless indication does not warrant both: include parameter, value,
time frame.)
1.
2.
DRUG THERAPY PROBLEMS to be resolved (CONDITION 1) (Select one of the seven
major categories, and elaborate with the cause. Tie DTP to condition/drug)
1.
Therapeutic Options (to resolve the drug therapy problem(s)) (CONDITION 1) [List at
least two: these can be classes or agents, or non-drug therapeutic options if applicable]
**Repeat above assessment for condition 2, 3, 4, etc. as appropriate**
12PLAN
Pharmacotherapy (Includes new and continuing drug therapies and
changes/discontinuations with rationale)
INDICATION MEDICATIONS INSTRUCTIONS NOTES/ RATIONALE
FOR USE
(DRUG CHANGES (FOR HEALTH
PRODUCT, (DOSE, ROUTE, CARE
STRENGTH, FREQUENCY, (FOR PATIENTS) PROVIDERS)
DOSAGE FORM) DURATION)
13Other interventions to optimize drug therapy
Follow-up Evaluation (include date, format (e.g. phone call or office visit) and what
specific monitoring parameters and information will be evaluated to assess
effectiveness and safety at the next contact).
Care Plan 2
REASON FOR ENCOUNTER:
SUBJECTIVE Background (Description and history of the present illness or medical
condition including previous approaches to treatment and responses; include other
medical problems, medication experience per patient, drug allergies, current meds, any
relevant social drug use, etc.)
Immunizations (patient reported and documented):
Medication Allergies/ADRs (medication, reaction, date):
Alerts (e.g. sight, hearing, mobility, literacy, disability):
Current Medication List:
14INDICATION MEDICATIONS DOSAGE START ADHERENCE
INSTRUCTIONS DATE OR OTHER
(DRUG NOTES
PRODUCT, (DOSE, ROUTE,
STRENGTH, FREQUENCY,
DOSAGE DURATION)
FORM)
15OBJECTIVE Background (pertinent laboratory values, physical assessment
measurements, etc.)
ASSESSMENT (INCLUDE GOALS, DTPS, OPTIONS, ETC. FOR EACH CONDITION
ASSESSED: include indication, goals of therapy, drug therapy problems, and
therapeutic options):
INDICATION (CONDITION 1) _________________________
GOALS OF THERAPY (CONDITION 1) (improvement or normalization of
signs/symptoms/laboratory tests or reduction of risk; must have a short- and long-term
effectiveness goal, unless indication does not warrant both: include parameter, value,
time frame.)
1.
2.
DRUG THERAPY PROBLEMS to be resolved (CONDITION 1) (Select one of the seven
major categories, and elaborate with the cause. Tie DTP to condition/drug)
1.
Therapeutic Options (to resolve the drug therapy problem(s)) (CONDITION 1) [List at
least two: these can be classes or agents, or non-drug therapeutic options if applicable]
**Repeat above assessment for condition 2, 3, 4, etc. as appropriate**
PLAN
Pharmacotherapy (Includes new and continuing drug therapies and
changes/discontinuations with rationale)
INDICATION MEDICATIONS INSTRUCTIONS NOTES/ RATIONALE
FOR USE CHANGES
(DRUG (FOR
PRODUCT, (DOSE, ROUTE, (FOR HEALTH
STRENGTH, FREQUENCY, PATIENTS)
DURATION)
16DOSAGE CARE
FORM) PROVIDERS)
Other interventions to optimize drug therapy
Follow-up Evaluation (include date, format (e.g. phone call or office visit) and what
specific monitoring parameters and information will be evaluated to assess
effectiveness and safety at the next contact):
1718
Activity 6
Patient Safety Activity
(EPA 5: Minimize adverse drug events and medication errors. EPA 4: Oversee the
pharmacy operations for an assigned work shift.)
● Review materials from Phar 6710 patient safety discussion.
● What are some of the ways your site works to prevent medication errors?
● What is an example of an error that someone at your site was involved with?
How did it happen? How did they work to make sure it did not happen again?
● How are medications organized into sections at your site? How are lookalike
soundalike (LASA) products stored at your site?
● Find the following products on the shelf at your site. What opportunities do you
see for potential dispensing errors with these products?
buproprion alprazolam
buspirone amlodipine
cyclosporine carbamazepine
dobutamine clonidine
glipizide fluoxetine
hydralazine humalog
nifedipine phenobarbital
prednisone saxagliptin
risperidone tramadol
tolbutamide zyprexa
19Activity 7
OTC Section Tour (EPA 3: Serve as the first contact of care in assisting with self-care
and/or triage to an escalated care setting.)
● Consider why are pharmacists increasingly important in guiding self-care
decisions?
● Orient yourself to the OTC section at your site. Work with your preceptor on ways
to best do this safely during COVID19. You might consider taking a picture of the
shelf to refer back to in answering these questions.
● Review the products available in each of the following sections, as available:
Ophthalmic Vitamins Dermatology
Otic Analgesics Complementary therapy
and herbal products
Cough and cold Foot care Self-monitoring products
and home test kits (e.g.
pregnancy tests,
glucometers)
Gastrointestinal Oral care Non-vitamin food
supplements
● What are some of the key products in each of these categories?
● What are the questions you imagine patients have when they are searching for a
product for each of these self-care conditions?
● What are some of the key issues you would consider when helping a patient
select a product for each of these categories?
20Activity 8
OTC Product Line Extensions
(EPA 3: Serve as the first contact of care in assisting with self-care and/or triage to an
escalated care setting. EPA 5: Minimize adverse drug events and medication errors.)
● Review this short resource on OTC product line extensions.
● Why do product line extensions occur?
● What are the potential concerns with OTC product line extensions?
● Search the OTC shelves to identify two OTC product line extension examples.
Product 1 Product 2
What is the name of
the product?
What is the expected
primary ingredient of
the product?
What are the actual
ingredients of the
product?
What are some of the
concerns you might
have with a patient
searching for or using
this product?
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