Community Pharmacy III Training Manual (0201463)

Introductory Pharmacy Practice Experience 2 (PHRM 062)

Al Ain University of Science and TechnologyCollege of Pharmacy

Introductory Pharmacy Practice Experience IIICourse Code: 0201463Training ManualStudent Name:.Student I.D.:.Introductory Pharmacy Practice Experience 3 (0201463)

Crd. hrs: 3 hrs

Contact hrs: 120 hrs

Prerequisite: (0201362)Introductory Pharmacy Practice Experience 3 (0201463)The course introductory pharmacy practice experience 3 is designed to be taken during the summer, following the completion of the introductory pharmacy practice 2 (PHRM 062). This is the third introductory pharmacy practice experience and is carried out to improve student's practice skills in interaction with more pharmacists, assistant pharmacist and patients. Consolidation of confidence, personal responsibilities and dispensing of prescriptions under the supervision of the pharmacy preceptor (licensed pharmacist).

The trainees should widen their knowledge about the controlled drugs with regard to their dispensing, storage, and order.

Emphasize will be given to how to check the type of prescription and patient consultation by the registered pharmacist. Also during this course the student will be able to predict the prescribing errors and the type of error, so, the student will be able to differentiate between the right prescription and the one with error.

The training is expected to follow the eighth semester level. The training sites are expected to be within the Abu Dhabi Emirate in order to facilitate monitoring by the college supervisor.

Selection of Community Pharmacy

Student applying for training must first find a suitable community pharmacy or hospital pharmacy which accepts him or her for the purpose of training and supervision. Outpatient pharmacy is accepted as community pharmacy. The college will also retain prepare a list of recommended pharmacies and preceptors which will help the students securing the appropriate site. The criteria for selection of community pharmacy are:1. Complying with the requirements of HAAD and MOH

2. Managed by a qualified pharmacist3. Found in a suitable place for the student and for the college supervisor (can be visited by the college supervisor)Learning objectives of the1. Learn about the proprietary names and to which group of controlled drugs is categorize.

2. Read products labeling and leaflets of the controlled drugs available including their storage conditions and return them back properly (with the consent of the pharmacy preceptor).3. Learn about the indications and contraindications of the controlled drug sold.4. Learn about the strength of the controlled drugs (different strengths and dosage forms).

5. Learn about equivalent substitutes for different controlled drugs.

6. Learn about the pharmacological classes and pharmacological action to which the controlled drugs belong to.

7. Learn about the signs and symptoms to which the products are prescribed.8. Learn about administration of the controlled drugs (frequency and method).

9. Learn about drug-drug and drug-food interactions.

10. Learn about patient counseling and reconciliation for the conditions to which the controlled drugs prescribed and strengthen communication skills. 11. Learn about how to read different prescriptions and predict if there is a prescribing error.12. Write in the log book the errors in the prescriptions and categorize the types of errors.13. Strengthen communication skills with the pharmacists and assistant pharmacists.

14. Prepare a standard report of the controlled drugs and the prescribing errors (explained later).

Supervision of Introductory PPE 3Introductory PPE 3 is carried out under the supervision of the College PPE 3 Supervisor and a preceptor who possess the following characteristics.Preceptor's Characteristics

The Preceptor is a qualified pharmacist should:

1. Take personal responsibility for medication dispensing and counseling.

2. Have minimum of two years of professional experience in community pharmacy.3. Have the responsibility of training not more than two students at any time. 4. Be competent in the area of practice.

5. Be involved in professional organizations.

6. Demonstrate the ability of having latest scientific knowledge in Pharmaceutical field.

7. Demonstrate a desire and an aptitude for teaching.

8. Demonstrate the ability to assess and document student performance.

9. Practice continuous professional development and collaborate with other healthcare professionals as a member of a team.

10. Demonstrate a commitment to his/ her organization, professional society and community.Responsibilities of Introductory PPE 3 Supervisors

a) College Supervisor1. To prepare a list of community pharmacies and approved preceptors who are willing to cooperate to help the students secure training sites.

2. To prepare a list of students eligible for the professional practice along with their details.

3. To send the students documents for their training approval to the HAAD (Abu Dhabi Emirate) and then to the ministry of labor after getting the approval from HAAD.4. To co-ordinate with the Community Pharmacy preceptor for:

Monitoring the professional practice program.

Solving any problem hindering proper professional practice. Receiving students evaluation in sealed envelopes.5. Meeting with the students to discuss training activities and requirements when necessary.

6. Revision and evaluation of the prepared reports by the trainees.

7. Examining the students following their completion of their training.

8. Registering students total scores.

b) Role of the Preceptor

1. To train the students as per the objectives of introductory PPE 3.

2. To evaluate students for their performance during introductory PPE 2 in developing and demonstrating the explicit skills mentioned for each introductory PPE 2 objective.

3. To ensure the recording of all data in the logbook.

4. To report to the College supervisor after completion of PPE 3.Financial Compensation for Preceptors in the Community Pharmacy

In order to encourage the acceptance of the students into different community pharmacy within the province of Abu Dhabi, the university has decided to compensate preceptors who fulfill the requirements and characteristics of approved preceptors by paying them Dhs. 450 for each student completing the training. This money is for the services given by the preceptors in the community pharmacies; however, it is not accepted for one preceptor to supervise more than two students at one time in order for the process to be effective and for the student to have sufficient contact time with the preceptor. The money will be paid after the student has completed his/her training and the evaluation sheet with other necessary documents have been received by the college supervisor.

Regulations Governing Students Training Period1. The intern must exhibit a professional appearance in manner and dress. The intern must adhere at all times to the standards of dress behavior and code of conduct specified by the preceptor.

2. She & He must wear the name badge at all time during PPE 2 (if required).

3. He or she must regard all information and activities relating to the pharmacy, the medical community and customers to be confidential and, under no circumstances will such knowledge be revealed to anyone.4. He or she must keep in mind that the primary aim of internship is learning. Learning is not a passive process, but requires a continuous, active commitment.

5. He or she should recognize that the best learning environment is one that fosters mutual respect and courtesy between the intern and preceptor.

6. The intern should never question the advice or directions of the preceptor in public, personnel, but rather accept the as a means of learning.

7. He or she should never be hesitant to admit that something is not known to her and should seek help whenever needed.

8. He or she should be aware of all laws and rules, which govern her practice and should seek clarification of any points that are not clear.

9. If the intern is regularly asked to violate laws or has knowledge that the pharmacy where the training occurs violates such laws, then he or she should immediately report and ask for change of training site or the preceptor. Steps for Enrolling into and Completing the Introductory PPE31. The student will fill an application form (college form) taken from the college supervisor for the IPPE3 with his/her information in order to obtain initial approval after assessing students eligibility for training. This application must be filled two to three months in advance before the expected training starts.

2. After obtaining initial permission from the college supervisor, the student is required to contact suitable pharmacies (see selection of community pharmacy) and suggest at least one community pharmacy of his/her choice with the names and qualifications of the pharmacists working in the pharmacy. The pharmacist who will be in charge of the training (see preceptors characteristics) in the selected pharmacy must be named. Details regarding the establishment number, copy of a valid commercial license and copy of the approved pharmacy signature must be secured from the pharmacy (for submission to the ministry of labor).

In order to help the students to gain acceptance into the community pharmacy and to help improve the training of the students by the preceptor in the community pharmacy, the college is holding a list of approved preceptor who will be willing to take responsibility for training. Those preceptors will be compensated for their services.

3. The college supervisor will prepare a list of students along with their choice of pharmacies and will seek the approval for their training from HAAD (for Abu Dhabi Emirate).

4. After receiving approval from HAAD, the list along with the information and documents obtained from the pharmacy (see point 2) will be used for an application form (ministry of labor form) to get the ministry of labor approval for each student. The following are details regarding the ministry of labor application and the documents required:

5. After obtaining the approval from the ministry of labor, each student will be given the ministry of labor approved application with a copy of the list of students approved by HAAD.

6. The student who got approved should register the training course in the university registration system.

7. The college supervisor will set a date for all registered students who got approval for training to explain to them the objectives of the training, their responsibilities and will be given the necessary forms and documents.

8. Each student receives a letter signed by the Dean for the preceptor who has the starting date and completion date of IPPE 3. This letter may be issued initially after college supervisor gives initial consent to the training to help the student find a suitable community pharmacy training site.9. After completion of the introductory PPE 3 the college supervisor receives preceptor's reports and evaluation sheets. The student must submit a training report.

10. The college supervisor will set a date to examine all the students together after the completion of the training. Only students who have their documents complete (training certificate for the 120 hrs, preceptors reports and evaluation and student report will be allowed to set for the exam. Written exam will be given once and no repetition will be allowed. Evaluation of Introductory PPE3At the end of the practice experience, the community pharmacy preceptor will send the assessment results to the college supervisor confidentially. The college supervisor will assess the results of the students in general as obtained from the different training sites for homogeneity. The college supervisor will, after ensuring that the student undergone proper training, evaluate students reports and set a date for a general written examination. The distribution of marks out of 100 will be as the following:

No.SupervisorAssessmentMaximum ScoreAchieved Score

1Community Pharmacy PreceptorAttendance10

2Adherence to professional attitudes10

3Skills acquired during training10

5

College SupervisorReport Assessment40

6General Written Examination30

Total100

Training Report

Training report should be prepared professionally using Microsoft Word and submitted on time as a hard copy along with a CD containing the same contents of the report. The report should include the monographs of controlled drugs sold (see later). Each monograph should contain:

1. The product name and generic name as the title.

2. Manufacturing company and the distributor (agency).

3. Table containing the range of products marketed with the same trade name for the same company (containing the same active ingredient(s)), their strengths, product sizes and prices, dosage forms, routes of administration, medication type, their corresponding pharmaceutical equivalents (up to 3), prices, manufacturing companies, and distributers (agencies).

4. Therapeutic class and subclass and pharmacological action.

5. Indications, signs and symptoms to which the drug is indicated, cautions, contra-indications and side-effects.

6. Dose and dosing for different age groups of different conditions and severity, including the mode and method of administration.

7. Drug-drug and drug-food interactions and the severity of these interactions.

8. Product storage conditions.9. Patient counseling points.

The report must have a title page containing the title of the report, student name, student I.D., college training advisor name, the month and year in which the report was prepared. The report should include copies of the training certificate, attendance record completed by the preceptor and students general report on the training. Original copies (or approved copies) of the previous certificates are submitted to the college training supervisor. Table of contents should be included in the report and any reference used in the report should be listed adequately on the last page of the report.

The following is a table which contains the five groups of the schedules of controlled substances.

( but should submit the report on the second table containing selected commonly sold 25 products.) SCHEDULES OF CONTROLLED SUBSTANCES Certain drugs have a potential for abuse that lead to physical or psychological dependence. As a result, the U.S. Federal government has placed these drugs into schedules & referees to them as controlled substances 1. SCHEDULE I (CI; C-I) Drug may not kept in pharmacy nor dispensed pursuant to a prescription (except for properly registered facilities for investigative or research purposes). Ex: heroin.

a. The drug has high potential for abuse.

b. The drug has no currently accepted medical use.

c. There is a lack of accepted safety.

2. SCHEDULE II (CII; C-II) Ex: morphine, amphetamines, barbiturates.

a. The drug has a high potential for abuse.

b. The drug has a currently accepted medical use.

c. Abuse of the drug may lead to severe psychological or physical dependence.

3. SCHEDULE III (CIII; C-III) a. The drug has a potential for abuse less than I, II.

b. The drug has currently accepted medical use.

c. Abuse may lead to moderate or low physical or psychological dependence.

4. SCHEDULE IV (CIV; C-IV) a. The drug has low potential for abuse relative to III.


c. Abuse of the drug may lead to a limited physical & psychological dependence relative to III.

5. SCHEDULE V (CV; C-V) a. The drug has low potential of abuse relative to IV.


c. Abuse of the drug may lead to limited physical or psychological dependence relative to IV.

The potency of abuse of controlled drugs should be I>II>III>IV>V. schedule I should be considered the highest potential for abuse and schedule V the lowest potential for abuse.

Controlled I drugs:It is not for dispensing upon prescription, it is for research and investigation.Controlled II drugs:

Active ingredientTrade Name

Methylphenidate

Dextroamphetamione

Amphetamine + Dextroamphetamine

Morphine sulfate

Oxycodone

Oxycodone + APAP

Meperidine

Hydromorphone

Methadone

Fentanyl

Oxycodone + Aspirin

Controlled III drugs:Active ingredientTrade name

Hydrocodone + Aspirine

Acetaminophen + Codeine

Butalbital + APAP + Caffeine + Codiene

hydrocodone

Controlled IV drugs:

Active ingredientTrade name

Pentazocine

Pentazocine + Naloxone

Pentazocine + APAP

Pentazocine + Aspirine

Propoxyphene

Propoxyphene + Aspirine

Propoxyphene + APAP

Meprobamate

Chlordiazepoxide

Diazepam

Oxazepam

Clorazepate

Flurazepam

Clonazepam

Lorazepam

Estazolam

Temazepam

Triazolam

Alprazolam

Zolpidem

Pemoline

Controlled V drugs:Active ingredientTrade name

Buprenorphine

Diphenoxylate

Table 2. Selected pharmaceutical products available in the UAE in the year 2010 No.Proprietary NameExample of Product Packaging

1Xanax

2Valium 10 mg

3Klonopin

4Clonazepam

5Alprazolin XR

6Chlordiazepoxide HCl

Clidinium Bromide

7

8Atarax

9Zoloft

10Prozac

11Imipramine HCl

12Tofranil 25

13Strattera 60 mg

14Depo-testosterone

15Deca-Durabolin

16

17

18

19

20

21

22

23

24

25

The following resources may be used to help you in your report:

1. B.N.F. (Number: 59; March, 2010).

2. Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11th edition, by: Laurence Brunton, John Lazo, Keith Parker. The McGraw-Hill Companies, Inc., 2005.

3. Handbook of Clinical Drug Data, 11th edition, by: Kelly Smith, Daniel M. Riche, Nicole Henyan. The McGraw-Hill Companies, Inc., 2010.

4. Pharmacotherapy: A Pathophysiologic Approach, 7th edition, by: Joseph T. DiPiro, Robert L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael Posey. The McGraw-Hill Companies, Inc., 2008

The following format can be utilized to make up the training report (the student may add or delete as necessary):

Product Title (Generic Name(s))

Manufacturing Company:

Distributing Agency:

Product Range Details and Equivalent Products (you can add and delete rows as necessary):

Trade nameActive ingredientDosage FormRoute of AdministrationStrength Pack SizePriceMedication Group (Controlled Drug)Equivalent Products Pack SizePriceManufacturing CompanyDistributing Agency

Therapeutic Class:Therapeutic Sub-Class:Pharmacological Action:Indications:Signs and Symptoms for the Main Indication:

Contra-Indications:

Cautions:Side-Effects:

Dosage Regimens and Administration Method:

Drug-Drug and Drug-Food Interactions:

Product Storage Conditions:

Patient Counseling:Forms for IPPE3:

The following forms will be used for the introductory PPE3 training purpose:

1- Student Request Form for IPPE3:This application will be used by the students and submitted to the college supervisor in order to gain initial permission to start searching for a suitable community pharmacy. Alternatively, the college supervisor may allocate a training site and a preceptor for the student based on availability.

The student should confirm that all training pre-requisites have been completed or will be completed before the training starts. This application must be submitted at least two to three months before the expected commencement of the training period. 2- Training Request Application from the Ministry of Labor:

After gaining acceptance from the HAAD, the student is required to fill an application form requesting permission to training from the ministry of labor. All necessary documents must be furnished along with the filled application as was shown and explained under Steps for Enrolling into and completing the Introductory PPE3. The student must be approved for training before starting his/her training.3- Attendance Record Form Completed by the Preceptor.

This form will be used to verify that the students have completed their training period. The attendance record should be signed by the preceptor who witnessed the students attendance. This form is filled on daily basis during training.

4- Trainee Evaluation Record Completed by the Preceptor.

This report will be used to mark the students in accordance with the evaluation of students section by the introductory PPE 3 preceptor. The form also leaves space for additional comments. This section will be used to monitor the satisfaction of the preceptor site with the students training and to study their recommendations in order to improve the training process.Although the students may have a copy of the evaluation, the conveyance of the evaluation results for each student must be done securely and directly to the college training advisor. This may be handed directly, in a securely sealed envelops by the student, by postal services or by e-mail (for verified e-mails only).

5- Students General Report Form.

This report will be used to monitor students opinion about the training and the training site to help improving the training process.

The Forms are given in the following pages:

Al Ain University of Science and Technology

College of Pharmacy

Introductory Pharmacy Practice Experience 3 (0201463)Student Request Form for IPPE 3Student Name:

Student I.D.:

Gender: ( Male ( Female

Major:

GPA:

Expected Credit Hours Earned after

Completing Current Semester (before Training):

Expected Graduation Semester/Year:

Which of the following Pre-requisites ( Human Anatomy and Histology

Has/have NOT been Completed Successfully? ( Physiology

( Pharmacology 1

Which of the Pre-requisites is Currently being Studied (in this Semester, before the Training)?

Home Tel: -------------------------------------------------------------------------------------------------------

Mobile: ----------------------------------------------------------------------------------------------------------

E-mail Address:

Where in UAE You would Prefer to have Your Training?

Once given the permission, you will be responsible for arranging a suitable community pharmacy in accordance with the characteristics set by the college training manual for the community pharmacy. The pharmacy preceptor must agree to actively involved in the training. A letter may be issued by the dean for you to use it for arranging suitable training site. The college, based on the availability, may arrange the training site for you.

Preferred Training Period for the Completion of the 120 hrs ( 15 Working Days): -----------------------------

--------------------------------------------------------------------------------------------------------------------------------------------

Signature and Date of Filling the Application: -------------------------------------------------------------

This Section is to be Used by the College Training Advisor:

College Advisor Name:

Approval: ( Approved ( Not Approved; Reason:

Comments:

Date and Signature:

This form must be filled and submitted by the student to the college training advisor at least two to three months prior to the desired training period.


College of Pharmacy

Introductory Pharmacy Practice Experience 3 (0201463)Attendance Record Completed by the PreceptorPreceptor Details

Preceptor Name: Pharmacy Name:......Preceptor Qualification: . Phone/Mobile Number:Preceptor Position in the Pharmacy: E-mail address:...

Students Details:

Students Name: ..Students I.D.: .

DateDayAMPMTotal HrsComments and Signature

InOutInOut

S

Su

M

T

W

Th

S

Su

M

T

W

Th

S

Su

M

T

W

Th

Total Hrs

This form should be completed and signed by the preceptor at the training site. The student will collect the form at the end of the training period and should include a copy of it in the training report, while the original is handed to the college training supervisor.Al Ain University of Science and Technology

College of Pharmacy

Introductory Pharmacy Practice Experience 3 (0201463)Trainee Evaluation Record Completed by the PreceptorPreceptor Details

Preceptor Name: Pharmacy Name:......Preceptor Qualification: . Phone/Mobile Number:Preceptor Position in the Pharmacy: E-mail address:...

Date: .

Students Details:

Students Name: ..Students I.D.: ..CriteriaDescriptionTotal Marks AllottedMarks Achieved Signature of the Preceptor

AttendanceThe student is expected to complete the training of 120 hrs. The student should adhere to the predetermined training program timetable10

Adherence to professional attitudes-Confidentiality-Professional awareness- Accuracy

-Attention to details

-Welcoming responsibilities

-Working in a team and interaction at work- Tidiness 10

Skills acquired during training-Ability to organize medications into the proper shelves

- Ability to read prescriptions- Ability to use retailer software-Ability to resolve problems

-Communication skills (with staff and patients)-Writing skills10

Total30

Additional Comments (about the student or to improve training process):

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This sheet should be sent by the preceptor to the college training advisor directly as soon as the student training is over. The sheet can be handed directly, by postal services or by e-mail attachment of scanned copy. It may also be handed by the students using securely sealed envelop.


College of Pharmacy

Introductory Pharmacy Practice Experience 3 (0201463)Students General Report Form

Students Name: ----------------------------------------------Students I.D.: ------------------------------------------------Period of Training: -------------------------------------------Training Site Name and Address: -------------------------1) What are the outcomes achieved from your training?

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2) What is the extent of relationship between theory learned in your Pharmacy College and practice in the training site?

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3) To what extent you believe you have gained skills and experience from your training?

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4) To what extent were the site of training and the preceptor helpful in achieving the training goals?

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5) How does this training help you in your future after graduation?

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6) What are your suggestions to improve the training process?

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7) Would you like to make any comment?

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This form must be completed by the trainee student. A copy of this form must be included in the training report, while the original is handed to the college training supervisor.

Table 1: different conditions treated with controlled drugs (Bran and Generic name).

Disease stateDrug nameBrand B or Generic GDosage formStrengthcomments

Table 1:(continue) different conditions treated with controlled drugs (Bran and Generic name).


Table 1:(continue) different conditions treated with controlled drugs (Bran and Generic name).


Table 1: (continue) different conditions treated with controlled drugs (Bran and Generic name).


Table 2: (continue) list the prescriptions with errors of any type

Disease stateDrug nameBrand B or Generic GDosage formStrengthType of error and comment



Table 2: (continue)list the prescriptions with errors of any type






Documents

Community Pharmacy III Training Manual (0201463)