C. Ambulatory Care APPE Rotation

1. DESCRIPTION

The Ambulatory Care Rotation is a four credit hour course taken as part of the pharmacy practice series. During this course, you will be assigned to a clinical site in central or eastern Oklahoma with a SWOSU COP Pharmacy Practice faculty preceptor.

This core rotation is designed to enable the student to provide patient-centered care in an outpatient setting. The student will work closely with the faculty preceptor at the practice site, participating in patient care activities for a diverse patient population.

The student at a minimum will be exposed to the following core disease states:

1. Cardiovascular disease-hypertension, hyperlipidemia, heart failure
2. Respiratory-chronic obstructive pulmonary disease, asthma
3. Endocrinology-Diabetes mellitus
4. Chronic anticoagulation
5. Public Health-immunizations, smoking cessation

2. DAILY ACTIVITIES

Each student will devote a minimum of eight hours per day to daily activities or other assignments made by the faculty preceptor. Activities may include the following:

1. Preview patient records in preparation for appointments
2. Patient/disease state discussions with preceptor
3. Provide medication reconciliation
4. Provide patient education and counseling
5. Follow the Pharmacists’ Patient Care Process Pharmacist Patient Care Process
6. Communicate medication therapy recommendations to members of the health are team
7. Provide drug information to health care professionals
8. Demonstrate effective teamwork/collaboration skills

3. OBJECTIVES

The preceptor(s) and student(s) will work together to meet rotation objectives by setting goals, guiding activities, performing assessments, and conducting self-reflections.

1. Foundational Knowledge and Skills
   1. Demonstrate appropriate depth and breadth of pharmacotherapeutics and disease-related knowledge for common conditions in ambulatory care patients
   2. Effectively prioritize patient care and other rotation responsibilities
   3. Formulate a response to drug information requests utilizing appropriate resources and drug literature
   4. Perform pharmacokinetic and pharmaceutical calculations
2. Direct Patient Care
   1. Collect relevant patient information to provide patient-centered care
   2. Assess collected information and develop individualized patient care plans including the following:
      1. Determine the presence of drug-drug, drug-disease, drug-food, and/or drug-laboratory test interactions and recommend adjusting the prescribed medications accordingly
      2. Identify possible adverse effects or allergies associated with prescribed medications and recommend alternative therapy
   3. Implement the care plan in collaboration with the health care team and patient/caregiver
   4. Evaluate care plans; determine needed adjustments and document as appropriate
   5. Incorporate health, wellness, and preventative measures and public health initiatives into the overall patient treatment plans
   6. Provide effective and appropriate patient education
   7. Consider and appropriately utilize psychosocial, behavioral, socioeconomic, and cultural factors that can influence pharmacotherapy
   8. Demonstrate effective verbal and/or written communication
3. Interprofessional Collaboration
   1. Identify the roles and responsibilities of healthcare team members and educate team members on pharmacy topics relevant to their roles and practice
   2. Provide appropriate information utilizing current evidence-based guidelines to other members of the healthcare team
   3. Effectively communicate with other members of the healthcare team
4. Practice/Systems Management
   1. Apply evidence-based medicine and information mastery principles in patient care activities
   2. Demonstrate an understanding of pharmacoeconomic issues that can impact drug therapy outcomes
   3. Consider patient and/or site specific factors when designing cost effective drug therapy
   4. Utilize the facility’s resources and technology to ensure continuity of patient care
5. Professionalism and Accountability
   1. Demonstrate ability to engage in self-assessment and self-directed learning.
   2. Demonstrate an ability to work well with others including preceptor, staff, healthcare professionals, and other students
   3. Demonstrate professionalism as it relates to appearance, timeliness, initiative, responsibility, judgment, and insight

4. STATEMENT OF STUDENT CONDUCT

Every student participating in the Ambulatory care experience is expected to conduct him/herself in a professional manner. Students are required to follow the EE Appearance Policy during rotations. A white laboratory coat with your name tag must be worn when you are participating in activates related to the rotation unless otherwise advised. Students must adhere to signed confidentiality agreements(s). Protected patient information must be considered confidential and not discussed in public areas or in the presence of other patients or visitors. Protected patient information shall not be removed from the site. All patient related documents must be disposed of appropriately at the site.

Student conduct resulting in actual or potential harm to the service or the staff’s relationships with patients or other health professionals may result in experience modification, removal, or failure.

5. REQUIRED ASSESSMENTS

Midpoint and final evaluations will be performed for each student. Students will be required through multiple opportunities to demonstrate progress and successfully complete the following tasks. These may be evaluated as part of the overall preceptor evaluation and/or projects on the evaluation form. Dates from completion will be determined by the preceptor.

1. Formal education presentation (e.g. case presentation, in-service presentations)
2. Patient communication activity (e.g. medication reconciliation, medication counseling)
3. Interprofessional interactions and practice
4. Patient care activities (e.g. medication monitoring, note writing)
5. Retrieval & analysis of scientific literature (e.g. prepare and lead a journal club, drug information response, evidence-based medication activity)

6. GRADING AND EXAMINATION

The final grade will be assigned based on evaluations in the following areas:

Preceptor Evaluations = 50 points

Oral/Written Examinations(s) = 30 points

Projects = 20 points

Total = 100 points

The following scale will normally be used in evaluation all areas of performance in the Ambulatory care professional Experience rotation.

A = 93 or above
B = 86 – 92
C = 75 – 85
D = 70 – 74
F = 69 or below