Intern Pharmacist Training Programme - Department of Pharmacy - January - December 2018
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Department of Pharmacy Intern Pharmacist Training Programme January – December 2018
Contents
1 Rationale 3
2 Aims 3
3 Philosophy 3
4 Workbook 4
5 Personnel 5
5.1 Preceptor .................................................................................................................. 5
5.2 Buddy ....................................................................................................................... 5
5.3 Supervising pharmacist or technician ........................................................................... 5
5.4 Intern training programme co-ordinator ....................................................................... 5
6 Glossary of terms and abbreviations Error! Bookmark not defined.
7 Timetable for the year 7
8 Induction 9
8.1 Timetable ............................................................................................................... 10
8.5 Clinical Induction Activities ........................................................................................ 14
9 Hauora Maori…………………………………………………………………………………………………………. 15
10 Home Base Ward…………………………………………………………………………………………………….16
11 Clinical Rotations……………………………………………………………………………………………………17
12 Oncology………………………………………………………………………………………………………………….19
13 Dispensary ……………………………………………………………………………………………………….... 23
14 Medicines Information……………………………………………………………………………………………29
15 Project…………………………………………………………………………………………………………………….34
16 Community Placement……………………………………………………………………………………………35
17 Teaching Sessions…………………………………………………………………………………………………..37
18 CE Sessions……………………………………………………………………………………………………………..38
21 Rationale
The Auckland District Health Board Intern pharmacist training programme has been developed to support
the pharmacy intern in achieving the Competence Standards and passing the Assessment Centre specified
by The Pharmaceutical Society of New Zealand Inc. (PSNZ Inc.) in their Intern Training Programme.
2 Aims
To provide a comprehensive overview of all aspects of pharmacy, with the emphasis on hospital
pharmacy skills.
To ensure the Intern pharmacists have the opportunity to apply the knowledge gained at university and
acquire the skills and attitudes required of a competent, registered pharmacist
To provide opportunities for Intern pharmacists to meet the PSNZ Inc. Training Programme
requirements and achieve the competencies required for registration as a pharmacist
To instil the practice of life-long learning and the need for on-going maintenance of competence with
the interns
3 Philosophy
The training programme is largely self-directed with the Intern pharmacists expected to take responsibility
for their learning and development. This approach will build the foundations of lifelong learners and
develop the interns as reflective practitioners. The programme is intended to produce pharmacists who are
self-directed problem solvers for whom the patient is their focus, who can work well within teams
(pharmacy and wider health care teams), are confident in their own abilities, while knowing their
limitations and are able to ask for help when required. They will be able to work as competent hospital
pharmacist once registered; ideally motivated and encouraged to stay within hospital pharmacy practice.
The teaching methods used to achieve this will be student centred with a significant amount of self-
directed problem and case based learning. The aim is to help Interns “learn through doing”
Interns will work together for some of their rotations in order to support, challenge and learn from each
other. Supervising pharmacy staff will support and guide the interns as they learn to apply their
knowledge and develop the competencies required of a practising pharmacist. Many of the pharmacists
and technicians within the pharmacy department will be involved in the training programme as this
provides a valuable opportunity for the interns to learn from wide range of colleagues.
34 Workbook
This workbook has two main overall functions - to outline the training programme for the year and to assist
in the documentation and assessment of progress. It is intended to be used flexibly to complement and
assist in the completion of the PSNZ Competency Standards.
More specifically this workbook has been developed
To assist in the integration of monthly learning goals with rotations by relating the competency
standards to learning outcomes and activities within each rotation within the programme (see grid
below)
To enable interns to clearly state their learning goals at beginning of each rotation to their supervising
pharmacist
To specify the activities to be undertaken, and goals and milestones to be achieved
As a way of collecting evidence for achievement of competence
To enable feedback from pharmacists to preceptors to be a specific, accurate assessment of interns
achievements and areas for improvement
To allow supervising pharmacists to see what has already been achieved and to help them to tailor
their training to build on (rather than duplicate) the intern’s existing experience
to track the interns progress and assist their preceptor in assessing their progress against the
competencies
Competency Standards
O1: Health and Medicine
M2: Communication and
compulosry for interns)
M1: Professionalism in
O2: Publci Health care
O4: Leadership and
Management (not
Administration of
O3: Supply and
Rotation
Organisational
Collaboration
Management
Pharmacy .
Medicines
Dispensary (inc
Manufacturing)
Wards
MI
Community
PAPU / Onc /Haem
Project
The Competency Standards are formally assessed during a number of appraisals during the year
45 Personnel
5.1 Preceptor
A preceptor is a pharmacist who has been registered for more than 3 years and is a trained (or currently
training) Workplace Assessor (Open Polytechnic qualification).
The responsibilities of the preceptor are to
work with the intern on individual components of the PSNZ Intern Training Programme
monitor and assess the progress of their individual intern, with feedback from other staff members
involved with the intern
ensure the intern is meeting the competence standards required
meet regularly with the intern and other pharmacy staff involved in their training to co-ordinate their
training programme
to act as a mentor and be a support for the intern throughout the intern year
5.2 Buddy
A buddy is a recently registered pharmacist, who will help the intern learn some of the social and practical
aspects of the department.
The role of the buddy is to
look after the intern for the first few weeks of their new job and help them with the practical and social
aspects of fitting into the department
empathise with what it is like to be a new intern
be there to answer questions, help the intern find out how the place works, who people are, where
things are e.g. toilets, canteen, shopping, banking, leisure activities
be friendly and patient, they will appreciate some company when going to lunch, and some
introductions to other staff members
answer questions when they can and refer on to the most appropriate person if they can’t. It’s
important that the intern is not made to feel a nuisance.
Intern Preceptor Buddy (for the first 2-3weeks)
Hannah Ashmore-Price Natasha Pool Rosalie Chang
Connor Colombus Ziyen Lam Seung Jay Yeo
5.3 Supervising pharmacist or technician
A supervising pharmacist or technician will work closely with you during each rotation. Who this is will vary
with each rotation but will in general be a senior, experienced pharmacist or technician, to teach, coach
and oversee your development.
You will meet with them at the beginning of your rotation and communicate to them your learning
outcomes and priorities for the time you are with them. They will then feedback to you and your preceptor
about your progress and development at the end of the rotation.
5.4 Intern training programme co-ordinator
This is Sian Dawson, Clinical Lead Pharmacist, Education, Training and Practice Research who has overall
responsibility for the Intern pharmacist training programme and is your Line Manager.
56 Timetable 2018
Week beg. Connor Hannah Important dates
8-Jan Induction Induction
15-Jan Induction Induction
22-Jan Induction Induction
29-Jan Disp Disp Anniversary Day
5 -Feb Disp Disp Waitangi Day
12-Feb Home base ward/Disp Home base ward/Disp
19- Feb Home base ward/Disp Home base ward/Disp ? Assignment 1 due this week
26-Feb Home base ward/Disp Home base ward/Disp PSNZ Training Days (W)
5-Mar Home base ward/Disp Home base ward/Disp PSNZ Training Days (C)
12-Mar Home base ward/Disp Home base ward/Disp PSNZ Training Days (A)
19 -Mar Home base ward/Disp Home base ward/Disp PSNZ Training Days (A)
26-Mar Med Safety / HBW Med Safety/ HBW PSNZ Training Days (W) Easter Fri
2-Apr MI MI Easter Mon
9-Apr MI MI
16-Apr MI MI ? Assignment 2 / Appraisal 1 due this week
23-Apr MI MI Anzac Day
30-Apr Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
7-May Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
14-May Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
21-May Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
28-May Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
4-June Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs) Queen’s Birthday
11-June Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs) ? Assignment 3 due this week
18-June Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
25-June Clinical / HBW/Oper (2hrs) Clinical / HBW/Oper (2hrs)
2-July Community ACH ?? MCQ
9-July Community GCC
16-July Community PAPU / Oncology Team ? Appraisal 2 due this week
23-July Community PAPU / Oncology Team
30-July ACH Annual Leave PSNZ Training Days (W)
6-Aug GCC Intern training days PSNZ Training Days (A)
13-Aug HBW / Student supervision HBW / Student supervision PSNZ Training Days (A)
20-Aug Annual Leave Community PSNZ Training Days (W)
27-Aug Intern training days Community PSNZ Training Days (C)
3-Sept PAPU / Oncology Team Community
10-Sept PAPU / Oncology Team Community ?? MCQ (if failed July)
17-Sept Mental Health /HBW / Disp Mental Health /HBW / Disp
24-Sept Mental Health /HBW / Disp Mental Health /HBW / Disp
1-Oct Mental Health /HBW / Disp Mental Health /HBW / Disp
8-Oct ? Assignment 4 & 5 due this week
15-Oct ? Appraisal 3 due this week
22- Oct
29-Oct Labour Day
5-Nov Assessment centre Nov 6 or13
12-Nov
19-Nov Final Placement Final Placement
26-Nov
3-Dec
10-Dec
17-Dec
24-Dec Public Hols 25 & 26
31-Dec Public Hols 1 & 2
66.1 Notes about the Timetable
Intern time 11am – 1.30pm
During the course of a week it is likely that an Intern will need some time to either meet with their
Preceptor or Project supervisor, undertake some project work or complete essential EVOLVE paperwork.
To facilitate these activities, a period of time from 11am to 1.30pm daily will be available as “Intern time”.
Please note this includes the ½ hour lunch break.
It is not time which should be taken automatically – if there are no pressing activities or meetings the
Intern should continue in their operational or clinical area. Equally if the department is busy or short-
staffed the Intern should negotiate to take the time another day if possible.
Ideally the Intern will inform their ward or operational supervisor of their weekly commitments, during the
previous week so as to help with rostering requirements and planned teaching activities.
General Guidelines
1) Wednesday teaching sessions
These are 2 hrs long so ideally no other "Intern time" should be taken that day unless essential
(project data collection or a meeting that has to happen).
• 8 - 8.30 Morning rotation
• 8.30 - 10.30 Teaching session
• 10.30 - 1.00pm Morning rotation (may need to incl. break)
• 1 - 1.30pm - Lunch
• 1.30 - 4.30 Afternoon rotation
2) CE sessions
These are 1 hr long so suggest
• 8-9 CE
• 9 - 12 Morning rotation
• 12 - 1.30 Lunch and 1 hr Intern time
• 1.30 - 4.30 Afternoon rotation
3) Project Time
There will need to be more flexibility whilst the Intern is collecting project data and possibly at other
times of their project. The Interns need to negotiate in advance with both the clinical and operational
supervisors.
Annual Leave
It’s important to have a break within this busy year, and a week’s leave is pencilled in for July but may be
moved depending on Intern preference and departmental needs. Leave may also be taken at other times
and must be applied for as per departmental policy.
77 Induction
The induction period is a time of transition, the purpose of which is to help you settle in and adjust to
working life. This will involve you meeting the pharmacy staff, starting to learn the systems of work in the
hospital and pharmacy department and generally get a feel for what it means to be an Intern pharmacist in
a hospital. There will be lots of opportunities to take part in work activities as well as observe.
Induction Checklist
To help us ensure that you have a broad induction you will be provided with an Induction checklist
(provided separately) which needs to be signed off and dated by the appropriate supervisor after meeting
with them or after achieving the stated activity. Once the checklist is complete please return to Sian
Dawson.
Clinical Induction Checklist
In addition to this checklist there is a specific clinical induction checklist (page 14) which lists a number of
activities to be achieved during your first 3 weeks. They are linked to some of the tutorials and are
designed to provide you with some basic knowledge and skills before you start on the wards. They are
referred to as Visits A to E on the timetable, with the detail of each visit provided on the checklist. These
ward visits are in addition to visiting the wards with the five clinical pharmacy teams
8Induction day programme for Monday 8th January 2018
Time Venue Topic Speaker
8.00 Pharmacy Welcome Kim Brackley, Clinical
Mtg room HR Paperwork Lead Pharmacist,
Identity badges Education, Training and
Tour of dept Practice Research
9.00 Pharmacy Induction Checklist & Welcome Pack Kim Brackley
Mtg room
10.00 Staff Morning tea Rosie Chang, Seung Jae Yeo,
Cafeteria Meet buddies, preceptors, Home Base Natasha Pool, Ziyen Lam, Mena
A-Daim, Helen Kim, Annie Chen
ward mentors
10.30 Pharmacy General welcome to Pharmacy Dept. Abbey Butler,
Mtg room Service Clinical Director,
Pharmacy and Meds
Management
11.00 Pharmacy Overview of Pharmacy Technician & Dianne Gulliver
Mtg room Assistant roles Lead Pharmacy Technician
Education, Training and
Medicines Management
11.30 Pharmacy Overview of Supply & Logistics Naomi Wood
Mtg room Services Clinical Lead Pharmacist,
Medicines Supply &
Logistics
12.00 Lunch with buddies Rosie and SJ
12.30 Room 61008 Intern Training Programme from an Rosie Chang
Intern Perspective
13.00 Pharmacy Health and Safety Divya Puli
Dept. Venue – Pharmacy Dept. Technician, H&S Rep
13.30 Tour of hospital Kim Brackley
14.00 PAPU mtg The ADHB Intern training programme Kim Brackley
room Overview
Expectations
16.00 PAPU mtg Overview of Aseptic Services and Joanne Beachman,
room Business Support Clinical Lead Pharmacist,
Aseptic Services &
Business Support
9Week beginning 8 January 2018
Date Time Connor Hannah
First Day (see separate timetable)
Mon 8 Jan
ADHB System log-ins (Kiosk/ Ko-Awatea / Workforce Central)
8–9 Linda Lam, Clinical Tutor (Clinical area)
Dispensary Overview and Introduction, Jayshree Daya, Dispensary Manager,
9 - 10
(Dispensary)
Ward visit A with Helen Kim Ward visit A with Mena A-Daim
10 – 12
Tues 9 Jan (HBW tutor) (HBW tutor)
12 – 12.30 Lunch
1 – 2.30 Ward visit with Paul Gelber, Advanced Clinical Pharmacist
Introduction to Dispensary Validation Scheme, Jayshree Daya, Dispensary Manager,
3 – 4.30
Pharmacy Meeting room
Tutorial “Interpersonal Skills / Learning Style”
8 – 12.00 Kim Brackley, Clinical Lead Pharmacist, Education, Training and Practice Research
Room 92020 (meet in Clinical area)
12 – 12.30 Lunch
Weds 10 Jan
12.30 –
e-Pharmacy training, Jayshree Daya, Dispensary Manager,(meet in dispensary)
3.30
3.30 – 4.30 Meet with Preceptor
8-9 Paperwork
9.00 – 10.00 Ward visit with Jay Gong, Senior Pharmacist
Tea break and watch Safety Management System online video tutorial (Datix)
10 – 11 (ADHB Intranet site ‘D’ Datix Training Resources’How to report an incident’)
11 -12 Intro to MI Resources, , Kristin Chapman, MI Manger, Medicines Information office
Thurs 11 Jan
12 -12.30 Lunch
12.30 – 2.00 Dispensary
2.30 – 4.30 Ward visit B with Anna Hill (and visit to Discharge Lounge)
Tutorial “Pharmaceutical Care, Part 1” Linda Lam
8 -10 PAPU Meeting room (meet in clinical area)
Ward visit E with Helen Kim Ward visit E with Mena A-Daim
10.30-12.30
Fri 12 Jan
(HBW tutor) (HBW tutor)
12.30 - 1 Lunch
1 – 4.30 Dispensary
10Week beginning 15 January 2018
Date Time Connor Hannah
8 – 9.15 Dispensary
Tutorial “Medicines Reconciliation” Jo Marcroft, Lead Pharmacist, Med Safety, Room
9.30 -11.30 61008 (Meet in Clinical area)
12 – 12.30 Lunch
12.30 – 1.30 Dispensary
Mon 15 Jan Ward visit C with Ziyen Ward visit C with Angelene
1.30 – 3.30
Personal Safety and Pharmacy Security, Chris Gray (ADHB Security)
3.30 - 4 Pharmacy Meeting room
Introduction to Antimicrobial Stewardship (AMS), Eamon Duffy, AMS Pharmacist,
4 – 4.30
Pharmacy Meeting room
8.30 – 12.00 Greenlane Clinical Centre Pharmacy, Level 5 Retail Pharmacy,ACH
Tony Sie, Manager Ashwin Choy, Manager
12.30 – 1.00 Lunch
Tues 16 Jan 1.00 – 1.30 Meeting with Preceptor or Paperwork
1.30 - 4.30 Dispensary
8 - 8.30 Catch shuttle to Greenlane
Pre Assessment Clinic (PAC) at GCC with Grace Chan, PAC Pharmacist
9 - 11 (go to Reception E, Room 26 at GCC)
Weds 17 Jan 11.30 –
Paperwork
12.30
12.30 -1.00 Lunch
1–3 Dispensary
3.30 – 4.30 Informatics Introduction, Kath Dean or Chris Lodge, Informatics Pharmacists
8-9 Dispensary
Tutorial “ Communication & Patient Counselling” Angelene van der Westhuizen,
9 -11
Teacher Practitioner, (meet in clinical area)
11 -12.30 Ward visit D with Lucy Sheed
12.30 -1.00 Lunch
Thurs 18 Jan 1.00 – 1.30 Introduction to Clinical Trials, Michelle Ure, Senior Pharmacist, Clinical Trials Office
Meet with Preetika Vareed, Procurement Pharmacist & Ziyen Lam, Formulary
1.30 – 2.30
Pharmacist, Pharmacy Meeting room
3.00 – 4.30 Dispensary
8.00 – 10.00
Dispensary
10.30 – 12 Ward visit with Lejla Brkic, Advanced Clinical Pharmacist, Adult Acute Care
12- 12.30 Lunch
12.30 – 1.30 Meet with Rob Ticehurst, Clinical Lead Pharmacist, Medicines Governance &
Fri 19 Jan
Informatics, Pharmacy Meeting room
1.30 -3.00 Ward Visit with Kaajal Djkstra, Advanced Clinical Pharmacist, Paeds.
3.00 – 4.30 Dispensary
11Week beginning 22 January 2018
Date Time Connor Hannah
8–9 Dispensary
Clinical Systems Training, Training Room 2, L15, Support Building, ACH
9 - 12
(same training as Drs but you don’t need to stay for the dictation section)
12.30 - 1.30 Lunch / Paperwork
Mon 22 Jan Tutorial “Pharmaceutical Care, Part 2” Linda Lam, PAPU Meeting room
1.30 – 3.30
4 – 4.30 Catch up with Sian, Pharmacy Meeting room
8 - 10 Pharmacy Aseptic Production unit, (PAPU)
Ruta Padalkar, PAPU Team Leader Production
(including Intrathecal Policy Non-involvement sign off)
10.30 – Visit Oncology / Haematology team
12.30 Laura Clunie, Senior Pharmacist, Oncology (meet in Clinical area)
12.30 - 1 Lunch
Tues 23 Jan
1 – 2.30 Dispensary
Ward visit E with Helen Kim Ward visit E with Mena A-Daim
3 – 4.30
(HBW tutor) (HBW tutor)
Distribution
8 – 12.00
Dallas Murie, Senior Technician, Distribution area, Level 6 Pharmacy
Weds 24 Jan 12 – 12.30 Lunch
Meet with Steve Drackett, Acting Clinical Lead, Clinical Pharmacy Services
12.30 - 1
Room 61008 (Meet in Clinical area)
12.30 - 4 Distribution
8.00 – 9.00 Pharmacist CE session
9 – 12.00 Distribution
Thurs 25 Jan 12.00 -12.30 Lunch
12.30- 4.30 Distribution
Greenlane Clinical Centre Pharmacy,
8.30 – 12.00 Level 5 Retail Pharmacy, ACH
Tony Sie, Manager
Ashwin Choy, Manager
12.30 – 1.00 Lunch
Fri 26 Jan 1 – 1.30 Paperwork / SOPS
1.30 – 3.00 Ward visit with Carla Corbet, Advanced Clinical Pharmacist, Mental Health
3.30 – 4.30 Disensary
127.1 Clinical Induction Activities
Comple
Date &
Ward
Sign
Activity
ted
Skill
Visit
Hospital Describe how a patient’s journey in hospital is managed, from the
Processes admission process through to discharge
Discuss and describe the roles of different grades of Drs and nurses
Roles of Hcp and other health care professionals eg. occupational therapists,
physiotherapists, speech and language therapists, dieticians
Describe the medicines and patient information sources available on
Info
the ward and demonstrate how to use them
Reference Viewer & NZ Formulary
A Pharmac Internet site
Pharmacy Intranet Site
MI Intranet site
Medication Safety Intranet Site
Medication Administration Guidelines
Policies and Procedures
RMO handbook online
Concerto Interns won’t have had training in
3M these so just show them where to
CHiPs / CMS find them and what they are
useful for
Describe the layout of the clinical notes, where to find the relevant
information & the function of relevant clinical forms e.g.
A to D planner
Nursing Observations
Drug chart
Notes Insulin, warfarin, fluid charts
B Medicine Reconciliation form
Demographic data
Referral paperwork (GP letter, copy of nursing home medication
chart, transfer summary from another hospital)
Operation / Procedure notes
Describe the medication supply and management systems within the
Supply
hospital (imprest and dispensary, HML, S29.)
Medicines Observe a pharmacist completing a Medicine Reconciliation Refer to
C
Reconciliation Clinical SOP & Med Rec Tutorial
Observe a pharmacist providing counselling. Refer to Clinical SOP and
D Counselling
Counselling tutorial
Review and discuss medication charts with supervising pharmacist.
E Chart Review
Refer to Pharmaceutical Care Tutorial
138 Hauora Maori
Cultural competence is an integral part of professional pharmacy practice and is included in Domain M1 of
the Pharmacy Competence Standards (2014). ADHB serves a multicultural population and you will have
plenty of opportunities to practice pharmacy in a culturally appropriate way with a range of patients.
As the indigenous people of NZ, understanding and contributing to the wellbeing of Maori has been
highlighted amongst many health professions as particularly relevant.
Competency M1.5 (Understand Hauora Maori) describes optimal behaviours such as
M1.5.1 Understands and describes the relevance of Te Tiriti o Waitangi
M1.5.2 Understands Maori perspectives of health
M1.5.4 Pronounces Te Reo Maori correctly, in particular proper nouns, understands
common or relevant words and can use them when appropriate
To support you in demonstrating competence in this Domain, a number of opportunities have been
included or suggested, in the Intern Training Programme. However it is important to note that cultural
competence does not occur as an isolated activity, but is incorporated into all aspects of practice.
Activity
ADHB Mandatory
Treaty of Waitangi Elearn course (via Ko Awatea Learn)
Training
ADHB Mandatory
Understanding Tikanga Best Practice Elearn course (via Ko Awatea Learn)
Training
Teaching session ‘Maori Health Beliefs” ,
Case Study Complete a Pharmaceutical Care Plan for Maori patient
Maori Language Promote the use of Maori words within the pharmacy department.
Consider linking in with Maori Language week
Rangatahi
programme Spend time with students from the Rangatahi programme when they are on
(Maori & Pacific final placement in pharmacy.
year school students
on placement in the
Provide an overview of life as a pharmacy student
hospital)
Reading Maori Experiences and Perceptions of Gout and its treatment. Leanne Te Karu,
Linda Bryant, C. Raina Elley
Journal of Primary Healthcare Vol 5 No 3 Sept 2013
149 Home Based Ward
Aim
To provide you with the opportunity to practice as a ward pharmacist in a supervised and stable
environment.
Initially you will have limited responsibility and will be concentrating on developing your basic skills and
knowledge. You will be assessed regularly and expected to collate evidence to demonstrate your
competence. The level of responsibility will increase as appropriate
Process
Assigned a ward (likely surgical or medical)
Supervised by the ward pharmacist (known as the Clinical Mentor)
Initially, visit the ward with the pharmacist every day for 6 weeks for ~ 2 – 3 hrs / day
Ideally continue to visit the ward for 1 to 2 hrs / day whilst doing other rotations
During your Final Placement (Oct, Nov and Dec) you will gradually assume full responsibility for the
ward
Duties
Medicine Reconciliation
Screen / Review Charts
Review Clinical Notes
Access and interpret lab results and nursing observations
Annotate charts
Organise supply
Deal with queries from nursing and medical staff, researching the information if required
Document activities in the clinical notes
Counsel patients
Produce Yellow cards
Assessment
Assessments will be undertaken to feed into the three Appraisals required by EVOLVE
A final “Clinical Sign-Off” will be required in Oct during the final placement, before you are allowed to take
full responsibility for the ward.
1510 Clinical Rotations
You will spend time with a number of the Clinical teams, developing your knowledge in a range of clinical
areas.
You will not be able to visit the entire range of specialities within the hospital, but each rotation will have a
set of learning objectives which reflect the core clinical skills and knowledge appropriate for that team.
Listed below are some clinical topics which you should aim to become familiar with by the end of your
Intern year. Some will be covered during formal Wednesday teaching sessions (those in bold), whilst other
topics will be covered during your clinical rotations. It is your responsibility to learn about any topics which
have not been covered elsewhere – ideally using your patients as a starting point.
Surgery
o Thromboprophylaxis / Anticoagulation
o Nausea & vomiting
o Stopping and starting regular meds around surgery
o NBM and the need to change routes
o Antibiotics
o Pain control
o Principles of Renal medicine
o Principles of Liver medicine
General Medicine/ OPH
o Chronic Obstructive Pulmonary Disease (COPD)
o Asthma
o Diabetes
o Cardiology
o IHD / MI / Cardiovascular Risk
o Hypertension
o Heart Failure
o Stroke
o AF/ Anticoagulation
o Thyroid dysfunction
o Gastro related conditions
o Osteoporosis
o Gout
o Anaemia
o Using drugs in the elderly
o Constipation
o Preventing falls
Paediatrics / Women’s Health
o Pharmacokinetic/pharmacodynamic handling of drugs in children
o Off-label prescribing in children
o Formulation issues
o Calculation issues
o Cardiology – hypertension, heart failure
o Drugs in Pregnancy
o Drugs in Breastfeeding
16Oncology / Haematology
o Principles of Oncology
Mental Health
o Schizophrenia
o Bipolar disorder
o Depression
1711 Oncology Pharmacy
Training in this area consists of a two week rotation within the Pharmacy Aseptic Production Unit and the
Oncology and Haematology team. This will involve spending time
• With the Screening Pharmacists
• With staff who are preparing and checking the chemotherapy
• In Haematology Day Stay
• In Oncology Day Stay
Staff involved
Within this rotation you will have one person with overall responsibility for your development,
although this person will not be with you all the time. They will
co-ordinate and plan your programme
liaise with the other pharmacists and technicians contributing to your training
meet with you regularly (at least once a week) to discuss and assess your progress in all areas
You will then have a number of supervising pharmacists and technicians who will sign you off as you
successfully achieve the learning outcomes relevant to the area they are teaching you in.
1812.1 Learning outcomes for operational work in the cytotoxic unit
achieved
Learning outcome Methods Assessment Supervising
(What will you be able to do by the end of the (Tasks/activities to achieve the learning (How are you going to assess whether the pharm/tech
Date
rotation) outcome e.g. case study/reading) learning outcomes have been achieved) signature
Describe the key technical features of Orientation with senior technician Discussion of the standards, air flow
the isolator(s) and clean rooms and Read references & SOPs and pressures in different rooms
name the standards which apply to with senior technician
sterile manufacturing
Explain the procedures and recording Read SOPs Discussion of the standards & the
of environmental monitoring in the Observation of daily monitoring by importance of environmental
manufacturing unit and name the technicians monitoring with senior technician
standards which apply to environmental Assist in recording associated with Discussion of what to do in the
monitoring and sterile manufacturing this event of microbial growth
Completion of records
Demonstrate correct handling of Read SOPs Observation of handling of cytotoxic
cytotoxic materials including how to Orientation with senior technician materials
deal with a spill Practice handling of cytotoxic Discuss how to deal with a spill,
materials content and location of spill kits
Mock demonstration of how to deal
with different types of spills in
various areas
Demonstrate correct disposal of Read SOPs Observation of disposal of cytotoxic
cytotoxic materials Orientation with senior technician materials
Practice disposal of cytotoxic
materials
Describe the filing and order systems Discussion with / observation of Discussion of the filing systems /
used within oncology(Baxter pre-fills, assistants orders with senior technician
bulk fluids, blue book, SO12, HSL
orders)achieved
Supervising
Learning outcome Methods Assessment pharm/tech
Date
signature
Explain the hazards associated with Read SOPs Discussion of the hazards of
cytotoxic drugs and the potential risks Orientation with senior technician cytotoxic drugs and methods to do
to the operators (including pregnancy) Practice disposal of cytotoxic to minimise risk to operators with
materials senior technician
Discussion of what to do regarding
pregnancy
Work according to the correct Read orientation pack Observation of ability to gown up
processes within the manufacturing Read SOPs and enter the manufacturing unit
unit Orientation by senior technician and their movement around the
Explanation from cyto unit staff rooms by senior technician
Observation of workflow Correct prioritisation of items to be
Assist pharmacists, technicians and made
assistants within the compounding Assessment sheet
area Part vials stored correctly
Process prescriptions Explanation by pharmacist or Assessment sheet
technician Verbal assessment by pharmacist /
Production of worksheets and labels senior technician
Dispensing of pre-filled and oral Correct return of items if necessary
products Named-patient Baxter order cut-off
Preparing a named-patient Baxter times
order (including urgent orders and
out-of-hours orders)
Describe the resources available to Explanation by pharmacist of Determine storage and expiry for an
determine stability and compatibility of resources available usual items and concentration
usual items and concentrations Looking up references available Explain the reasons for their choice
when unusual items are presented to pharmacist
2012.2 Learning outcomes for clinical work in the cytotoxic pharmacy
achieved
Supervising
Learning outcome Methods Assessment pharm/tech
Date
signature
Calculate body surface area using Calculate BSA using available Double check of calculations by
patient's height and weight and sources pharmacist
creatinine clearance Calculate CrCl using available
sources
Describe the various administration Discussion with pharmacist Discussion with pharmacist
routes for utilised chemotherapy Reading references
Explain the criteria used for screening Observation of screening and Check by screening pharmacist
prescriptions explanation by pharmacist Discussion with screening
Practical screening of simple pharmacist
chemotherapy prescriptions with Compile a checklist of parameters
pharmacist to cover / consider when screening
2112 Dispensary and medication supply systems
Over the course of the year you will develop your dispensary based skills. This will include all aspects of
the supply of medicines to patients i.e. imprest supply to wards and manufactured and individually
supplied items. As the dispensary is physically removed from the wards you will be encouraged to
remember the bigger picture in that there is a patient at the end of line and we provide a service to
patients and fellow health care professionals.
As well as your technical dispensing skills and knowledge you will be developing other skills such as your
ability to prioritise and multi- task and make reasoned decisions with confidence and under pressure.
You will have a number of specific responsibilities to undertake each day, towards the end of the year
this is likely to extend to running the dispensary for a period of time. You will need to develop your
leadership, teamwork and delegation skills to assist you in this. As teamwork is an essential element of
the dispensary you will be buddied with a dispensary technician to help you learn the technicians’ roles
so that you understand all aspects of the dispensing process. As a pharmacist you are the expert on
medicines – in practical terms this also includes a detailed knowledge of the medicines supply systems
requirements (local and legal e.g. formulary, Pharmac).
The problem solving approach you will be using on the wards will extend to the dispensary and you will
be expected to complete prescription interventions during your rotations. These must be discussed with
the senior pharmacist present in the dispensary at the time of the intervention. You’d be expected to try
to work things out for yourself first and refer the problem on to an appropriate person if you need help.
As well as learning to deal with the pharmaceutical issues you will be developing your sense of
responsibility and accountability for following through with the problems until resolution. You will be
expected to arrange a meeting with the Dispensary manager at the start of each rotation to discuss the
plan for the rotation.
General responsibilities
During all dispensary rotations, interns, in addition to other members of staff are expected to perform
certain tasks including
Putting away medicines
Filing of charts
Ensuring plentiful supply of brown bags / boxes / bottles
Answering of telephones
Ensuring dispensary is kept tidy
Completion of these tasks will contribute towards achieving competency standards
© Auckland District Health Board 2008 22Placement 1 (Feb & March)
ADHB Dispensing, Screening and Checking validations need to be commenced during Placement 1 to meet the requirements for Assignment 1 and 2.
Competence
Activity ADHB Training Comments EVOLVE
Standards
Dispensing
Follow workplace dispensing criteria Dispensing Self-Check Pre-requisites O1.4 Deliver Quality Assignment 1
when dispensing a prescription item Dispensing Validations for: • Read SOP 313 and 314 and Safe Services
Produce comprehensible and complete • Non-Imprest dispensing • Read SOP 318,319,324 CD Assignment 2
labels • Self-Med SOP 303,304,306,307,310 O3.2 Dispense • Part of Task 1
Maintain a logical, safe and disciplined • Leave • Must have completed e-Pharmacy Medicines (producing a
dispensing process • Transplant training label)
Fulfil legal requirements and • Controlled Drugs • Majority of
professional conventions regarding • PCT Task 2
maintenance of medicine, patient and (packing)
dispensing records
Minimise dispensing errors
Follow CD prioritisation, delivery and
collection processes
Screening
Check and obtain information to make Screening Self- Checklist and Charts to be screened M1.6 Make Effective Assignment 2
prescriptions complete, legal and Validation • Non-complex Gen Med, Gen Surg, OPH Decisions • Part of Task 1
authentic Charts . (Screening)
O3.1 Assess • Initial part of
Prioritise prescriptions Pre-requisites Prescriptions Task 2
Annotate prescriptions for dispensing as • Read SOP 103 (Selection)
well as any discussions if chart is held as • Knowledge of the HMC, Formulary,
a query funding issues, ADHB restrictions Prescription
• Knowledge of ADHB specific processes Interventions for
Communicate handover and query e.g. Transplant dispensing monthly portfolio
information with ward and ward
pharmacist
© Auckland District Health Board 2008 23Placement 1 (continued)
Competence
Activity ADHB Training Comments EVOLVE
Standards
Checking
Maintain a logical, safe and disciplined Checking Validation Read SOP 311, 313,314,317, 323 O3.2.1 Assignment 2
checking procedure O3.2.2 Task 3
Follow prioritisation processes on the O3.2.3
checking bench
Organisation / Management
Comply with the “owes” process and SOP 324 M1.2 Comply with
contribute to the maintenance of Ethical and Legal
effective stock control requirements
Receive, respond and resolve queries M1.6 Make Effective
from hospital staff either at the Decisions
reception or via telephone, referring on M2.1 Communicate
as needed. Effectively
Log and track prescriptions in the SOP313 M2.2 Establish and
inpatient register. Maintain Collaborate
Follow work place procedures with SOP313 Working relationships
regards to delivery of drugs to wards O1.4 Deliver Quality
and clinical areas. (Lamson, scheduled and Safe Services
assistant delivery, GCC and off-site,
courier)
Comply with department procedure for SOP313
recording of “near miss” and dispensing
errors.
© Auckland District Health Board 2008 24Placement 2 (April – June)
Competence
Activity ADHB Training Comments EVOLVE
Standards
Compound Pharmaceutical Products
Participate in the technician roster for Extemporaneous compounding training O3.3 Compound Evidence of 6
extemporaneous production and validation Pharmaceutical products submitted
Products via Monthly
portfolio
Screening
As before Logs to be completed with the requisite Align complexity of charts screened M1.6 Make Prescription
number of items as per ADHB Validation with clinical team rotations and Effective Decisions Interventions for
Scheme. training O3.1 Assess monthly portfolio
Prescriptions
Once validation achieved, logs are not
required but a second screen is
mandatory. (Laminated cards to be
used to identify items screened by
interns)
Checking
As before Logs to be completed with the requisite Align complexity of charts checked O3.2.1
number of items as per ADHB Validation with clinical team rotations and O3.2.2
Scheme. training O3.2.3
Once validation achieved, logs are not
required but a second check is
mandatory. (Laminated cards to be
used to identify items checked by
interns)
© Auckland District Health Board 2008 25Placement 2 (continued)
Competence
Activity ADHB Training Comments EVOLVE
Standards
Blister Packs
Blister Pack Screening and Checking Blister pack training and validation Read SOP 312
Understand the requirements to be
fulfilled when screening a chart for
blister packing Understand the
blister pack dispensing process in
order to perform a check
Dispensing
Consolidate all activities performed in Dispensing validation complete Screening and Checking to be As before
Placement 1 prioritised over dispensing
Organisation / Management
Develop and consolidate all activities As before
performed in Placement 1
Investigate and review a dispensing O1.4.5
error
© Auckland District Health Board 2008 26Placement 3 (Sept – Dec)
Competence
Activity ADHB Training Comments EVOLVE
Standards
Organisation / Management
Organise dispensary workload Paediatric IVN Training and Validation As before plus
Assign tasks to staff M2.4.3
Perform late lock up with a pharmacist
Address Dispensary Meeting
Manage receipt of Paediatric IVN
Screening
As previously Second screen is mandatory until Intern Laminated cards to be used to As before Assignment 4
has APC as a pharmacist. identify items screened by interns
Prescription
Once this is achieved, a graduated Interventions for
process of decreased 2nd checks can Monthly portfolio
occur over a 2 week period.
Checking
As previously Second check is mandatory until Intern As before Assignment 5
has APC as a pharmacist.
Prescription
Once this is achieved, a graduated Interventions for
process of decreased 2nd checks can Monthly portfolio
occur over a 2 week period.
© Auckland District Health Board 2008 2713 Medicines information (MI)
The aim of the placement in Medicines Information is to acquire the basic skills and knowledge that are
needed to answer enquiries about medicines either in the MI department or in clinical situations. You
will initially undertake training exercises and learn how to use a variety of resources and databases.
Learning methods may include reading, discussion, self-assessed exercises, and online tutorials. A wide
variety of medicines information enquiries will be attempted under supervision. Interns are also
encouraged to bring their own enquiries from clinical areas they are or have been working in. Each
intern will be given their own copy of the NZ Medicines Information Training Workbook (2007).
By the end of the placement, interns should be able to
receive medicines information enquiries and obtain all relevant background information
using a search strategy, obtain information from appropriate resources
evaluate and interpret the information to determine relevance and weight of evidence
communicate the answer clearly and in an appropriate manner
describe the legal and ethical issues relating to Medicines Information
Milestones
The PSNZ competencies form the basis for the training programme and the learning outcomes outlined
above are linked to these. Several activities are proposed in order to meet these competencies and
outcomes, and the selection of these is to be negotiated by the interns and supervisor at the start of the
placement. Some activities overlap in the competencies they cover, whilst other competencies and
activities may be covered during other placements.
To ensure that all interns cover the core of Medicines Information training during their placement, the
following milestones should be completed. An enquiry in each of the following categories should be
attempted. Some of these may not arise during the placement; hence as an alternative a practice
enquiry must be completed.
Supervising pharmacist
Milestone Date achieved
signature
Administration/dose
Adverse drug reactions
Drug interactions
Drugs in pregnancy
Drugs in breastfeeding
Children and Medicines
Critical evaluation
IV compatibility
Ethical/legal dilemmas
Renal/liver disease
Pharmacokinetics
Herbal or complementary medicines
Product availability
Formulary/funding issues
Pharmaceutical excipients
© Auckland District Health Board 2011 28Communication methods The intern should gain experience in giving responses to enquiries by utilising each of the following methods: telephone email fax letter in person Assessment Methods of assessment will vary depending on the learning method chosen. Some of the exercises attempted will have prepared answers for the intern to check their own answer against. Others will involve a discussion with the supervisor, or observation. Feedback can be obtained from enquirers directly (e.g. pharmacists within the department whom the intern has answered an enquiry for, and also from colleagues during peer review sessions). © Auckland District Health Board 2011 29
14.1 Learning outcomes
Supervising
pharmacist
signature
achieved
Learning Outcomes PSNZ Competency area Possible Tasks and activities
Date
Receive medicines 5.2.1. Evaluates situation to Essential
information enquiries and determine if able to provide Read the introductory sections of NZMI training workbook
obtain all relevant information to the required (A+B+C)
background information level or needs to refer Complete the background information training questions
Prepare a checklist for background information required
5.5.1. Responds to queries when receiving medicines information enquiries
and requests for medicines Read the in-house protocol on which enquiries to refer and
and healthcare information who to refer to (GPs, Community Pharmacists etc.)
Using a search strategy, 5.1.1. Describe reference Essential
obtain information from sources Read section D of NZMI training workbook describing the
appropriate resources information resources
5.1.2. Find information in Complete the test exercises in conjunction with reading
reference sources Tutorials 1-13 in NZMI training workbook
Practice using the databases available, using the in-house
5.2.2. Differentiates training packs (Micromedex, IDIS, Pharmline, Mi.net).
between information sources Attend the library training session on using Medline,
regarding their reliability Cochrane and e-journals.
Review and become familiar with the content of the MI
intranet site
Locate and become familiar with the MI search strategies
that are on the Intranet
Optional
Assist a colleague in finding relevant information for an
enquiry
Prepare a search strategy for a specific area, listing relevant
resources and suitable terms for searching the databases
© Auckland District Health Board 2011 30Supervising
pharmacist
signature
PSNZ Competency
achieved
Learning Outcomes Possible Tasks and activities
area
Date
Evaluate and interpret the 5.2.3. Compares information Essential
information to determine from different sources Use the resources available to find the information to an
relevance and weight of enquiry type in the milestones provided. Discuss your
evidence 5.2.4. Interprets information findings with your supervisor
on behalf of healthcare Write a short summary of the information found for an
professionals, patients and enquiry, pitched at a level appropriate to the enquirer
members of the public Write a letter in response to an enquiry interpreting
information and evidence found
5.3.1. Explains the Demonstrate use of appropriate resources to explain
pharmacology and terminology relating to enquiries
therapeutic use of common Present an enquiry you have worked on in peer review at
medicines the MI meeting
Optional
Read Tutorial 7 in NZMI training workbook
Perform a literature evaluation on 2 selected papers and
form a conclusion from your findings. Discuss with
supervisor
Write a comparison on the pros and cons of the different
resource types
Discuss the advantages and disadvantages of the different
resource types (e.g. books, databases, journals) with MI
manager/senior MI
© Auckland District Health Board 2011 31Supervising
pharmacist
signature
PSNZ Competency
achieved
Learning Outcomes Possible Tasks and activities
area
Date
Communicate the answer 5.3.2. Advises about the use Essential
clearly and in an appropriate of medicines Respond to enquiries from the ward e.g. nurses, patients
manner Respond to enquiries from other pharmacists and doctors
5.3.3. Provides medicine and Answer a medicines information enquiry for each category
healthcare information to listed
individuals and groups Provide responses to enquirers via phone, email, letter, and
in person.
5.5.2. Communicates verbal
and written information fit Optional
for the receiver Discuss with supervisor the needs of different receivers in
terms of communication
5.5.3. Communicates Discuss with supervisor the different methods of
effectively with other health communication and their appropriateness
professionals and patients Develop a patient information leaflet for a chosen drug
Describe the legal and 5.2.1. Evaluates situation to Essential
ethical issues relating to determine if able to provide Read Tutorial 9 in NZMI training workbook
Medicines Information information to the required Read UKMi Legal and Ethical Briefings 1-6.
level or needs to refer Read Ethical issues survey (Wills S et al. A survey of ethical
issues surrounding supply of information to members of the
public by hospital pharmacy medicines information centres.
Pharm World Sci 2002; 24(2):55-60))
Optional
Discuss how to handle ethical and legal dilemmas with
supervisor
© Auckland District Health Board 2011 3214 Project Undertaking a research project provides an opportunity for the interns to develop skills associated with undertaking an audit or research relating to pharmacy practice under the supervision of a pharmacist (ideally with an interest in that area). Ideally interns will be able to work on their project during their “paperwork” time (11am – 1.30pm daily). However, it is recognised that this time period may not always fit in with the demands of the project (e.g. during data collection periods). In these circumstances, interns need to discuss their requirements with their supervisors, to negotiate appropriate project time. In December all the interns will present their work to staff within the Pharmacy Department at the weekly CE meeting. Interns are encouraged to present their work outside the department e.g. NZHPA conference, wherever possible. Process 1. The topic will be advised in January 2. Prepare detailed project plan and submit to the Practice Research Group (date TBA) 3. Commence project work once outline is approved 4. Draft report (Date TBA) 5. Final report (Date TBA 6. Project presentations to pharmacy department December 2018 Research report guidance Reports should be prepared according to the Journal of Pharmacy Practice (JPPR) information for authors (see referencing guidance as well). A structured abstract or executive summary should be included in the report. We suggest you read other articles published in the JPPR to get an idea of the style and flow of published work. The maximum word limit is 3000 for the full report with no more than 8-10 figures. A shorter paper suitable for publication can then be written from this report. You will need to identify 4 key tables or figures that you would use for publication. Guidance on writing reports can be found ..\..\CE meetings\Session notes\2008\Report writing\Written reports - getting your message across.ppt © Auckland District Health Board 2011 33
15 Community placement
The purpose of the community placement is to give the intern the opportunity to experience the practice
of pharmacy in the primary health care sectors, and acquire the skills and knowledge specific to a
community pharmacist, particularly around OTC prescribing.
Interns will work towards achieving competency in behaviours more usually required within a
Community Pharmacy, such as those within Domains O1:Health and Medicine Management, and O2:
Public Healthcare.
To provide a framework for both interns and community supervisors, the following goals have been
identified in relation to a number of activities undertaken in the community setting. This is not an
exhaustive list, neither is it compulsory as some scenarios may not be applicable in all community
settings.
1. Dispensary Processes Comments
• Introduction to Toniq
• Dispensary SOP’s
• Dispensing Validation process (ACH Retail)
• Clozapine Prescriptions
• Paediatric Prescriptions
• Blister Packing
• Complete EVOLVE Prescription Intervention Forms if
appropriate
• Handling Prescriptions including
o Identifying & Resolving issues
o Dispensing correctly
o Undertaking a Final check (P’cist to then
check)
• Counselling patients on Prescription meds
2. Inventory & Administration Processes Comments
Inventory SOP’s
Healthpac Claiming
Prescription Batch Filing
3. Controlled Drugs Comments
• Legal requirements for Prescriptions
o Drs, Dentists, Midwives, other prescribers
• Storage requirements
• Record keeping requirements
• Pharmac subsidies
© Auckland District Health Board 2011 344. Pharmac Issues Comments
• Familiar with all sections of the Schedule
• Can locate information quickly and accurately in the
most up-to-date version
• Can describe differing periods of supply and exemptions
• Special Authority
• NPPA
• DCS
• S012
5. Manufacturing & Compounding Comments
(Competency O3.3))
• Prepare extemporaneous products
• Complete Evidence Records for EVOLVE
6. Providing Primary Health Care Comments
(Domain O1 & O2)
• Elicit Patient History
o WWHAM questions
• Determine Best Treatment option
• Supply Pharmacist Only Meds
o Examples of meds in this category
o Criteria for supply
o Record keeping requirements
• Supply Pharmacy Only Meds or GSL
o Examples of meds in this category
o Criteria for supply
• Counsel patient on best use of the medicine
• Advise on Diagnostic Aids
• Advise on Non Drug Treatments & Lifestyle measures
• Complete Primary Healthcare Evidence Forms
7. Emergency Supply Comments
1. Criteria for supply
2. Record keeping requirements
© Auckland District Health Board 2011 35You can also read
