1. Inpatient Pharmacy Services Log Book

Transcription

1 1 PRP log Books 1. Inpatient Pharmacy Services Log Book A. KKM log book requirements: (Duration of attachment: 8 weeks) Items Descriptions Measurement Remarks Management of inpatient pharmacy/satellite pharmacy Knowledge of stock movement and control, peak hour management (staff mobilization), staff training, handling drug information requests and pharmacy quality assurance program. (based on 8weeks) - Currently carried out by pharmacists and senior pharmacy assistant. Inpatient dispensing Proficient in prescription ordering and supply system, familiarity with drug range, generic names, pharmacological grouping, MOH/hospital formularies. Ability to contact prescriber to discuss errors or ambiguous prescriptions. Review medication profiles, refilling prescription & counterchecking. Processing prescriptions/reviewi ng medication profile (Min. 60/day). Total to achieve = Counterchecking prescription/indent orders (Min. 60/day). Total to achieve = Preparation/observat ion/counter-checking of job sheet of extemporaneous (min 10 each). Total to achieve = 10. -

2 2 Dangerous/psychotrop ic drug management Knowledge of psychotropic and dangerous drugs distribution and disposal in accordance to: Dangerous Drug Act 1952, Poisons Act 1952, Poison (Psychotropic Substances) Regulations Min 10 prescriptions/week. Total to achieve = 80 - Patient medication counseling Ability to advice on indications, storage conditions, precautions, side effected, food/drug interactions, dosage regimen, compliance and missed doses; use of devices. Discharge dispensing and counseling. Bedside dispensing and discharge counseling (Min 10 patients/week)*at least 5 bedside dispensing and counseling must be assessed by a senior pharmacist. Total to achieve = 80. UMSC ward dispensing. Leong prepares medication, PRP dispense to patient. Ward inspection Stock handling, identify storage requirements, records. Min 10 ward/unit inspections. Total to achieve = 10. Assigned to pharmacist to conduct ward check. Qty: 2-3 wards. B. Requirements prepared by inpatient pharmacists in accordance to log book and UMMC services requirement. (Duration: Min 10 weeks - 1week packing, 2weeks DDA, 2weeks methadone, 3weeks screening, 1week dispensing, 2 weeks keying/checking) Section 1: Processing of prescriptions/ Reviewing Medication Profile 1 st Column (number of profiles reviewed) - log view the total prescriptions issued per day 2 nd Column - explain the type of intervention (both screening and non-

3 3 Section 2 : Counterchecking of Prescription / Indent Orders screening) on a separate sheet of paper/exercise book and validate daily (floor manager preferably who will randomly select a few) Minimum 4 weeks (target of 60 patients/day not necessary) Minimum 2 weeks Validate (by FM) 10 per trolley and average 3 trolleys per day Section 3 : Patient medication counseling UMSC patient (old batch PRP) Discharge patients - inform FM that you re going to dispense the discharge medications - 10 patients per week Minimum 6 weeks Section 4 : Ward Inspection 2 thorough ward checks - accompanying the pharmacist 3 DD checks (use current form available) Section 5 : Dangerous Drugs Minimum 8 weeks (10 prescriptions per week) - fill up for 8 weeks with the number of DD prescriptions dispensed/recorded over the current 2 week attachment Section 6 : Extemporaneous Minimum 10 - pick out 10 prescriptions for syrups (not the readily prepared ones) throughout the IP attachment and prepare them from beginning to end i.e. processing the prescription to preparing the syrup (FM to check)

4 4 2. Ward Pharmacy Practice A. KKM log book requirements: (Duration of attachment: 6 weeks) Items Section 1: Medication History Assessment - Should be taken within 24 hours of admission. Section 2 : Clerking and Reviewing - To assess the ability of the PRP to read, comprehend patients case notes and identify pharmaceutical care issues. Section 3 : Medication counseling - At least 5 bedside counseling must be assessed by a senior pharmacist Section 4 : Ward Round / Pharmacist Round Section 5 : Case Report Section 6 : Case presentation Section 7 : ADR Report - ADR can be reported from other activities Measurement (based on 6 weeks) Min 15 cases/week (use the CP1 form, KKM) Total to achieve = 90 Min 15 cases/week (use pharmacotherapy review form-cp2) Total to achieve = 90 Min 10 patients/week. Total to achieve = 60 To be done daily. Min 2 cases/week Min 5 cases Min 3 cases B. Requirements prepared by inpatient pharmacists in accordance to log book and UMMC services requirement. (Duration: 2weeks) Section 1 : Medication History Assessment 15 cases / week - to use the KKM s CP1 form Minimum 2 weeks Section 2 : Clerking and Reviewing Using the PPUM clerking form - must include simple PCIs (drug related problems, inappropriate drug regimen e.g. dose, frequency, therapeutic duplication) IF there are no PCIs, to include : things learnt from the case 15 cases / week Minimum 2 weeks Section 3 : Medication counseling 1 bedside counseling / week to be

5 5 assessed by the relevant pharmacist that you have followed to the ward Include at least 4 UMSC bedside counseling per week Minimum 2 weeks i.e. minimum 10 counseling over the 2 weeks Section 4 : Ward Round / Pharmacist Round Follow log book (to be brought along during rounds) Section 5 : Case Report Expand 3 cases out of the 15 cases / week that were done under Section 2 - detailed PCIs which would cover the appropriate management of the patients disease states. Need to include desired outcome, proposed actions and monitoring parameters. References would primarily include clinical studies/trials and guidelines Total 6 cases Can use the same PPUM clerking form but additional sheets need to be added to cover the above Section 6 : Case presentation Total 6 cases from Section 5 5 cases will be presented one to one to the relevant pharmacist and 1 case will be used as the power point case presentation - UMMC case presentation) Section 7 : ADR Report Follow log book (pharmacist to validate at the point of reporting)

6 6 3. Clinical Pharmacokinetic Service A. KKM log book requirements: (Duration of attachment: 4 weeks) Items Section 1 : Operational Task - Analysis of serum drug concentration Section 2 : Pharmacokinetic Knowledge - All calculations must be counterchecked. - At least 5 recommendations must be assessed by a senior pharmacist. Section 3A : Clinical Assessment - Able to read and comprehend patients case notes. - Able to assess patient suitability for therapeutic drug monitoring - Number of CP cases monitored, Pharmaceutical Care Issues identified (not necessary pertaining to CP only) and number of intervention done. Section 3B : Ward Round Section 3C : Bedside Case Presentation Section 3D : Able to handle/advise on the toxicology cases within 2 hours of request Measurement (based on 4 weeks) Aminoglycoisides and vancomycin 8/week. Antiepileptics and theophylline 8/week. Digoxin 5/week. Tacrolimus 5/week. Cyclosporin 5/week. Methotrexate 5/week. Others 3/week. Aminoglycoisides and vancomycin 8/week. Antiepileptics and theophylline 8/week. Digoxin 5/week. Tacrolimus 5/week. Cyclosporin 5/week. Methotrexate 5/week. Others 3/week. - Target (Min): 10 case notes/week. Total=40 - Target: 10 cases (Min) Once daily. 1 presentation/week. Total=4 2 cases B. Requirements prepared by inpatient pharmacists in accordance to log book and UMMC services requirement. (Duration: 4 weeks) Section 1 : Operational Task Not applicable (leave it blank)

7 7 Section 2 : Pharmacokinetic Knowledge Follow log book Section 3A : Clinical Assessment To use the same PPUM clerking form but PCIs would need to be TDM related Clerk minimum 3 cases / week (to focus on factors/patient conditions that affect pharmacokinetic parameters Total 12 cases Section 3B : Ward Round Based on cases from the Ward Pharmacy attachment that have medications that require TDM Section 3C : Presentation 4 out of the 12 cases clerked under Section 3A to be presented one to one Section 3D : Toxicology Cases Not applicable UNLESS a PRP actually receives a query during office hours (rarely) or while they were on call which would then need to be validated immediately The pharmacist on call is responsible for validating this part

8 8 4. Drug and Poison Information Service Items Provision of drug & poison information service 1. Ability to respond and gather information on the enquiry and requestor in an efficient manner. 2. Ability to locate, analyze and deliver the information required in a skillful, efficient and evidence-based manner to meet the needs of the requestor. 3. Ability to document enquiries and information given in a clear systematic manner. 4. Knowledge in formulary development, evaluation and maintenance, and ability to provide support in Pharmacy & Hospital Drug Committee agendas. 5. Ability to assist in the preparation of bulletin or newsletter publications. 6. Ability to assist in evaluating ADR procedures. 7. Knowledge in primary, secondary and tertiary sources of information such as journals, bibliographic databases and books; for acquisition, retrieval and maintenance purposes. 8. Ability to compile appropriate date and produce reports on the service. 9. KKM log book requirements: (Duration 4 weeks) 1) Enquiries=110 2) ADR=4 3) Ability to appraise clinical paper=2 4) Project=1 5) Bulletin/newsletter publication=1 Requirements prepared by drug information pharmacists in accordance to log book and UMMC services requirement: (Duration 1 week) 1) Enquiries = Min 80 2) ADR = 4 3) Appraise clinical paper = 2 4) Project = 1 5) Pharmacy update= 1

9 9 Educational activities 1) Ability to search for appropriate materials, prepare and deliver lectures to colleagues and other healthcare providers. 2) Ability to communicate and discuss effectively case studies and perform peer review. 1) CPD presentation=3 1) CPD presentation=3

10 10 5. Out Patient Pharmacy Section Duration / Requirement Section 1 : Screening 12 weeks Section 2: Filling Of Precribtions 5 complete filling process (Include labeling and Recording) Section 3: Dispensing Minimum 4hours/day equivalent to 50 prescriptions. Section 4: Medication Counselling Individual minimum 3/week for 12 weeks Section 5: Medication Counselling Group Minimum 1/month Section 6: Dangerous Drug and Psychotropic 6 Section 7: Preparation / Observation / Counter-checking Minimum 10 each of Job Sheet of Extemporaneous. MOH Log book requirement Actual activity in UMMC MOH required measurement Screening Omitted 12 weeks Filling Of Precriptions (Include labeling and Recording) 5 complete filling process (Assessed by pharmacist) 5 complete filling process (Assessed by pharmacist) Dispensing ± 150 prescriptions/day Minimum 4hours/day equivalent to 50 prescriptions. Medication Counseling Medication Counseling Only have 30 counseling sessions in Pharmcare and 5 counseling sessions in Asthma Clinic Not all PRP has the opportunity to do the group counseling. Individual minimum 3/week for 12 weeks Group Minimum 1/month

11 11 Dangerous Drug and Psychotropic Preparation / Observation / Counter-checking of Job Sheet of Extemporaneous. There is person in charge for DD, PRP only do dispensing unless we request for a day to do DD Not all PRP involve in extemporaneous preparations. Only a few have the opportunity to observe Minimum 10 prescriptions/week Minimum 10 each

12 12 6. Inventory Control and Management Section Section 1: Store Management Section 2: Procurement and Distribution Section 3: Storage Section 4: Inventory Control Section 5: Disposal Section 6: Product Complains Section 7: Product Recall Section 8: Dangerous / Psychotropic Drugs Management Duration / Requirement Knowledge and understanding of the principles of store management organization structure, inventory, stock movement and control, cleanliness, and security Knowledge of ordering process and monitoring of vendor performances. Knowledge of storage in accordance to Good Storage Practice Knowledge and understanding of drug usage patterns, identification of slow and nonmoving stocks, maximum and minimum stock levels, cost accounting, and expiry date monitoring. Knowledge of disposal procedures and documentation. Write off / disposal. Knowledge of handling of product complaints and reporting procedures. Knowledge of handling of product recall and reporting procedures. Knowledge of psychotropic and dangerous drugs distribution and disposal in accordance to the respective legislation. MOH Log book requirement Actual activity in UMMC MOH required measurement Store Management, Procurement and Distribution, Storage, Inventory Control, Disposal, Product Complaint, Product Recall and Dangerous/Psychotropic Drugs Management 12 weeks attachment 4 weeks attachment

13 13 7. Manufacturing and Repacking Section Section 1: Preparation and Counter-checking of Job Sheet for Galenicals / Repacking. 1.1: Galenical Preparation 1.2: Repacking Preparation Section 2: Management of Manufacturing and Repacking Section 3: Competent Assessment Duration / Requirement Minimum 10 Minimum 10 Knowledge of principles of good manufacturing practices and quality assurance in manufacturing and repacking area MOH Log book requirement Actual activity in UMMC MOH required measurement Section 1: Preparation & Counter-checking of job sheet for galenicals/repacking Half day or 1 day attachment at prepacking lab. Prepare one product under supervision. 2 weeks attachment Min 20 preparations

14 14 8. Oncology Pharmacy Service MOH Log book requirement Actual activity in UMMC (8 weeks) MOH required measurement (4 weeks) Section 1: Assess patient suitability for chemotherapy and adjunct regime Perform 20 dose calculation and 3 intervention per day Min 20 cases Section 2: Preparation of worksheet calculation/ worksheet Prepare 20 worksheets and labels and countercheck 5 products and worksheet per day Min 20 cases Section 3: Reconstitution Packing around 30 cytotoxic medication per day and observe 10 reconstitution technique 20 preparations. At least 5 process must be assessed by preceptor. Section 4: patient monitoring/ counseling Issue, pack and dispense the medication. Monitor and counsel on certain medications Monitor and counsel 20 patients on different medication.

15 15 9. Parenteral Nutrition Intravenous Additive Service MOH Log book requirement Actual activity in UMMC (10 weeks) MOH required measurement (4 weeks) Section 1: Ability to access patient suitability for Parenteral Nutrition Request Screening of Parenteral Nutrition request Communication with prescriber (Under supervision of Pharmacist Screening of Parenteral Nutrition request Communication with prescriber 10 paediatric & 10 adult cases Section 2: Calculation/ worksheet Worksheet and label was done with the help of specific software. No counterchecking been done by PRP. Regime manual calculation attend a workshop/ class. Worksheet, label Counterchecking Manual Calculation (min 5 cases) 30 including manual calculation Section 3: Compounding Reconstitution was not been done by PRP Adult (min 10 preparations) Paediatric (min 20 prep.) 100 IV Additives, where service available Section 4: Patient monitoring Monitoring (20 cases) Monitoring (30 cases)