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Pharmacy, Volume 4, Issue 4 (December 2016)

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Open AccessArticle
Exploration of Learning during an International Health Elective Using Photovoice Methodology
Pharmacy 2016, 4(4), 39; https://doi.org/10.3390/pharmacy4040039 - 29 Nov 2016
Cited by 2 | Viewed by 1261
Abstract
Based on surveys and structured interviews, International Health Experiences (IHEs) improve cultural sensitivity, communication, and self-confidence among health professions students. However, open-ended methods to explore student learning during an IHE are not widely utilized. We sought to explore pharmacy student-identified learning during an [...] Read more.
Based on surveys and structured interviews, International Health Experiences (IHEs) improve cultural sensitivity, communication, and self-confidence among health professions students. However, open-ended methods to explore student learning during an IHE are not widely utilized. We sought to explore pharmacy student-identified learning during an IHE in an open-ended fashion using Photovoice methodology. Pharmacy students on an IHE in Guatemala were given disposable cameras and asked to photograph images that reflected their learning. Through the application of Photovoice methodology students captured, reflected upon, and presented photos to describe the learning they experienced. Themes were drawn from the reflective and focus group data collected. During three IHEs, six students captured seventy-seven photos. Four main learning themes emerged: culture/cultural competence, professional growth, shifting of attitudes, and meaningful/emotional experiences. Pharmacy students documented learning in expected (cultural competence, professional growth) and unexpected (emotional experiences) domains during an IHE. Photovoice may be an effective methodology for the exploration of learning, allowing students to capture their own learning including and beyond what is expected by their instructors. Full article
(This article belongs to the Special Issue Contemporary Issues in Pharmacy Education)
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Open AccessArticle
Medication Safety: Experiential Learning for Pharmacy Students and Staff in a Hospital Setting
Pharmacy 2016, 4(4), 38; https://doi.org/10.3390/pharmacy4040038 - 17 Nov 2016
Viewed by 1247
Abstract
Medication Safety has been an established pharmacy specialty in Australian hospitals since the early 2000s and is now one of the ten Australian hospital accreditation standards. Although advances have occurred, medication-related patient harm has not been eradicated. Victorian undergraduate pharmacy programs include some [...] Read more.
Medication Safety has been an established pharmacy specialty in Australian hospitals since the early 2000s and is now one of the ten Australian hospital accreditation standards. Although advances have occurred, medication-related patient harm has not been eradicated. Victorian undergraduate pharmacy programs include some aspects of medication safety, however clinical pharmacy experience, along with interpersonal and project management skills, are required to prepare pharmacists to be confident medication safety practitioners. This article outlines the range of medication safety-related training offered at an Australian tertiary teaching hospital, including; on-site tutorial for undergraduate students, experiential placement for pharmacy interns, orientation for pharmacy staff and resources for credentialing pharmacists for extended roles. Improvements continue to be made, such as electronic medication management systems, which increase the safe use of medications and facilitate patient care. Implementation and evaluation of these systems require medication safety expertise. Patients’ engaging in their own care is an acknowledged safety improvement strategy and is enhanced by pharmacist facilitation. Building educator skills and integrating experiential teaching with university curricula should ensure pharmacists have both the knowledge and experience early in their careers, in order to have a leading role in future medication management. Full article
(This article belongs to the Special Issue Contemporary Issues in Pharmacy Education)
Open AccessArticle
Early Vancomycin Concentrations and the Applications of a Pharmacokinetic Extrapolation Method to Recognize Sub-Therapeutic Outcomes
Pharmacy 2016, 4(4), 37; https://doi.org/10.3390/pharmacy4040037 - 10 Nov 2016
Cited by 1 | Viewed by 1114
Abstract
Vancomycin trough concentrations should be measured within 30 min of the next dose, but studies have shown that troughs are often measured too early, producing erroneous results that could lead to dosing errors. The purpose of this study was to identify the frequency [...] Read more.
Vancomycin trough concentrations should be measured within 30 min of the next dose, but studies have shown that troughs are often measured too early, producing erroneous results that could lead to dosing errors. The purpose of this study was to identify the frequency of early trough measurements and to evaluate whether pharmacokinetically extrapolating mistimed concentrations may locate sub-therapeutic concentrations. Vancomycin troughs were retrospectively reviewed. For troughs ≥10 mg/L and measured >0.5 h early, the true trough was estimated using pharmacokinetic extrapolation methods to identify sub-therapeutic outcomes. Differences ≥2 mg/L between the measured and estimated true trough level was considered to have potential clinical significance. Of 143 troughs evaluated, 62 (43%) were measured too early and 48 of those troughs were ≥10 mg/L. 25% of those 48 troughs were sub-therapeutic. The potential for a difference ≥2 mg/L between the measured and estimated true trough was found to be greatest when the measured trough was ≥10 mg/L, the patient’s creatinine clearance (CrCl) was ≥60 mL/min, and the timing error was ≥2 h. To increase the therapeutic utility of early vancomycin trough concentrations, estimated true troughs can be determined by extrapolating measured values based on the time difference and CrCl. Full article
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Open AccessArticle
Using Continuing Professional Development with Portfolio in a Pharmaceutics Course
Pharmacy 2016, 4(4), 36; https://doi.org/10.3390/pharmacy4040036 - 07 Nov 2016
Viewed by 1858
Abstract
The introduction of Continuing Professional Development (CPD) to encourage individual life-long learning as a way of maintaining professional competency in pharmacy has faced resistance. To investigate ways to address this barrier we included CPD with portfolio in a university Pharmaceutics course. Underpinning knowledge [...] Read more.
The introduction of Continuing Professional Development (CPD) to encourage individual life-long learning as a way of maintaining professional competency in pharmacy has faced resistance. To investigate ways to address this barrier we included CPD with portfolio in a university Pharmaceutics course. Underpinning knowledge for the course was delivered using a flipped classroom approach and students used the CPD model to address clinical scenarios presented in a simulated pharmacy setting. Students produced portfolio items for the different case scenarios and submitted these for assessment. This provided the opportunity for students to carry out repeated application of the CPD cycle and, in so doing, develop skills in critical thinking for self-reflection and self-evaluation. This course was designed to encourage the development of higher level learning skills for future self-directed learning. Thirty six students submitted a completed portfolio. Twenty nine students achieved a result of >70%, five students scored between 57%–69%, one student obtained a mark of 50% and one student failed. The end of course survey revealed that while students found portfolio development challenging (40%), they also reported that it was effective for self-learning (54%). Differentiating between the concepts “reflection” and “evaluation” in CPD was problematic for some students and the use of clearer, simpler language should be used to explain these processes in future CPD work. Full article
(This article belongs to the Special Issue Contemporary Issues in Pharmacy Education)
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Open AccessArticle
Irrational Use of Medicines—A Summary of Key Concepts
Pharmacy 2016, 4(4), 35; https://doi.org/10.3390/pharmacy4040035 - 28 Oct 2016
Cited by 21 | Viewed by 2624
Abstract
Medicines play an integral part of healthcare delivery. However, they are expensive commodities and account for a significant proportion of overall health expenditure in most countries. Irrational use of medicines is a major challenge facing many health systems across the world. Such practices [...] Read more.
Medicines play an integral part of healthcare delivery. However, they are expensive commodities and account for a significant proportion of overall health expenditure in most countries. Irrational use of medicines is a major challenge facing many health systems across the world. Such practices are likely to lead to poor health delivery that may put patients at risk and result in wastage of scarce resources that could have been used to tackle other pressing health needs. The concept of “rational use of medicine” can at times be confusing and not easily appreciated by patients, healthcare providers, policy makers, or the public, all of whom need to collaborate effectively to address this challenge. In this article, we summarize basic concepts such as rational medicine use, good prescribing and dispensing, and explore some of the factors that contribute to irrational use of medicines as well as potential impacts of such practices. This article has been written with the intention of offering a clear, concise, and easy to understand explanation of basic medicine use concepts for health professionals, patients, policy makers, and the public. Full article
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Open AccessArticle
Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation
Pharmacy 2016, 4(4), 34; https://doi.org/10.3390/pharmacy4040034 - 25 Oct 2016
Cited by 2 | Viewed by 1394
Abstract
There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking [...] Read more.
There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality. Full article
(This article belongs to the Special Issue Contemporary Issues in Pharmacy Education)
Open AccessCommentary
Serving with Pharmacy Students: Reflections from a Medical Mission Team Leader and Preceptor
Pharmacy 2016, 4(4), 33; https://doi.org/10.3390/pharmacy4040033 - 24 Oct 2016
Cited by 1 | Viewed by 1078
Abstract
The medical mission field is an innovative setting for training and evaluating health care professional students. The motivating factor of serving indigent populations as a means of a humanitarian, or oftentimes a spiritual act, makes medical missions an attractive option for student participation. [...] Read more.
The medical mission field is an innovative setting for training and evaluating health care professional students. The motivating factor of serving indigent populations as a means of a humanitarian, or oftentimes a spiritual act, makes medical missions an attractive option for student participation. At the Gregory School of Pharmacy, medical mission teams are an integral part of the pharmacy program, including the opportunity for students to earn elective credit during their fourth year. This commentary provides five key elements to consider when serving with, training and evaluating pharmacy students from the perspective of a team leader and preceptor. Full article
Open AccessArticle
Retrospective Evaluation of Pharmacist Interventions on Use of Antimicrobials Using a Clinical Surveillance Software in a Small Community Hospital
Pharmacy 2016, 4(4), 32; https://doi.org/10.3390/pharmacy4040032 - 21 Oct 2016
Cited by 3 | Viewed by 1451
Abstract
The Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America “Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship” recommend the use of computer-based surveillance programs for efficient and thorough identification of potential interventions as part of an [...] Read more.
The Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America “Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship” recommend the use of computer-based surveillance programs for efficient and thorough identification of potential interventions as part of an antimicrobial stewardship program (ASP). This retrospective study examined the benefit of utilizing a clinical surveillance software program to help guide antimicrobial therapy in an inpatient setting, in a small community hospital, without a formal ASP. The electronic health record (EHR) was used to retrieve documentations for the following types of antibiotic interventions: culture surveillance, duplicate therapy, duration of therapy and renal dose adjustments. The numbers of interventions made during the three-month periods before and after implementation of the clinical surveillance software were compared. Antibiotic related interventions aggregated to 144 and 270 in the pre- and post-implementation time frame, respectively (p < 0.0001). The total number of antibiotic interventions overall and interventions in three of the four sub-categories increased significantly from the pre-implementation to post-implementation period. Clinical surveillance software is a valuable tool to assist pharmacists in evaluating antimicrobial therapy. Full article
(This article belongs to the Special Issue Hospital Pharmacy)
Open AccessArticle
Making the Transition from Student to Resident: A Method to Individualize a PGY1 Program
Pharmacy 2016, 4(4), 31; https://doi.org/10.3390/pharmacy4040031 - 20 Oct 2016
Viewed by 1031
Abstract
A Postgraduate Year One (PGY1) resident’s concerns, limitations, and strengths may be self-identified early in the residency year but are reliant on self-awareness and insight. Program directors commonly find difficulty in identifying a resident’s specific knowledge deficits at the beginning of the program. [...] Read more.
A Postgraduate Year One (PGY1) resident’s concerns, limitations, and strengths may be self-identified early in the residency year but are reliant on self-awareness and insight. Program directors commonly find difficulty in identifying a resident’s specific knowledge deficits at the beginning of the program. A standardized resident examination can identify limitations early in training and these results can be incorporated into a tailored resident development plan. A total of sixty-two PGY1 residents completed the examination pre- and post-training over a five-year timespan. Scores increased in most core disciplines in each of the five years, indicating an overall improvement in resident knowledge throughout their PGY1 year. The approach of utilizing the scores for the resident’s individualized plan allows for customization to ensure that the resident addresses knowledge gaps where necessary. Full article
(This article belongs to the Special Issue Contemporary Issues in Pharmacy Education)
Open AccessArticle
Assessment of Perceived Barriers to Herpes Zoster Vaccination among Geriatric Primary Care Providers
Pharmacy 2016, 4(4), 30; https://doi.org/10.3390/pharmacy4040030 - 18 Oct 2016
Cited by 2 | Viewed by 1084
Abstract
The herpes zoster vaccine is recommended for use in adults 60 years of age and older to reduce the incidence and morbidity associated with infection. Its limited uptake has been attributed to logistical barriers, but uncertain efficacy and safety in subsets of this [...] Read more.
The herpes zoster vaccine is recommended for use in adults 60 years of age and older to reduce the incidence and morbidity associated with infection. Its limited uptake has been attributed to logistical barriers, but uncertain efficacy and safety in subsets of this patient population could also be contributing. The purpose of this study was to evaluate the current vaccination practices, barriers to vaccination, knowledge of vaccination reimbursement and strategies to evaluate for insurance coverage among an urban, safety net, teaching hospital, geriatric primary care provider group through a survey administered via paper and online platforms. Survey participants (n = 10) reported lack of availability of the vaccine in their practice settings (6/10), with half of providers (5/10) referring patients to outside pharmacies or to other practice settings (2/10) for vaccine administration. Reimbursement issues and storage requirements were perceived as major barriers by 40% (4/10) of providers, whereas 80% (8/10) of providers reported that concerns about safety and effectiveness of the vaccine were not major barriers to vaccination. Logistical barriers, rather than concerns about safety and effectiveness of the vaccine, were reported as major barriers to vaccination by a significant portion of providers. Lack of availability and reimbursement problems for practice sites allow for gaps in care. Partnership with community and long-term care pharmacies could serve as a possible solution. Full article
Open AccessArticle
Perception of the Professional Knowledge of and Education on the Medical Technology Products among the Pharmacists in the Baltic and Nordic Countries—A Cross-Sectional Exploratory Study
Pharmacy 2016, 4(4), 29; https://doi.org/10.3390/pharmacy4040029 - 13 Oct 2016
Viewed by 1957
Abstract
With increased development of medical technology (MT), new challenges emerge related to education and training of pharmacists and other healthcare specialists. Currently, only a few universities in the EU promote MT education and research. Objectives: The aim of this study was to evaluate [...] Read more.
With increased development of medical technology (MT), new challenges emerge related to education and training of pharmacists and other healthcare specialists. Currently, only a few universities in the EU promote MT education and research. Objectives: The aim of this study was to evaluate the current status, views on, and need for the education on MT for the pharmacy students and practicing pharmacists in the Baltic and Nordic countries. Methods: The representatives of higher education institutions and community/hospital pharmacists from six Baltic and Nordic countries participated in a qualitative cross-sectional exploratory internet-based study from May to October 2014. Results: Approximately two-third of the respondents considered professional knowledge about MT products important for pharmacists, but half of them had never participated in any MT courses. More practicing pharmacists than representatives of academia underlined the need for increased MT education for pharmacy students in the future. Conclusions: The pharmacists in the Baltic and Nordic countries consider the professional knowledge about MT as pertinent in their education and work. The limited number and status of MT courses available today, however, is a major concern among both pharmacy students and practicing pharmacists in these countries. In the future, increasing education combining theory and practice about MT products would be one possible solution to overcome this challenge. Full article
(This article belongs to the Special Issue Contemporary Issues in Pharmacy Education)
Open AccessArticle
Interprofessional Education (IPE) and Pharmacy in the UK. A Study on IPE Activities across Different Schools of Pharmacy
Pharmacy 2016, 4(4), 28; https://doi.org/10.3390/pharmacy4040028 - 26 Sep 2016
Cited by 2 | Viewed by 2179
Abstract
Interprofessional education (IPE) has been recognised internationally as a way to improve healthcare professional interactions and team working in order to enhance patient care. Since pharmacists are increasingly part of multi-professional healthcare teams and are expanding their clinical roles, many pharmacy regulators have [...] Read more.
Interprofessional education (IPE) has been recognised internationally as a way to improve healthcare professional interactions and team working in order to enhance patient care. Since pharmacists are increasingly part of multi-professional healthcare teams and are expanding their clinical roles, many pharmacy regulators have stipulated IPE must be included in educational curricula. This study aimed to examine how different Schools of Pharmacy (SOPs) in the UK implement IPE within their pharmacy course. Information about IPE was mainly obtained through interviews with staff from various SOPs. Nine telephone interviews were conducted which were analysed using a thematic analysis approach in order to derive common categories. These were identified as students, activities, barriers and facilitators and benefits of IPE. It was found that teaching methods used for IPE varied across SOPs. No standard strategy to deliver IPE was identified. Students were thought to value the IPE experience, especially the interaction with other professionals. The main barriers to implementing IPE arose from limited financial and organisational support. In general, many SOPs in the UK are undertaking IPE but challenges remain in establishing it as a routine part of the course, something which seems to echo difficulties in implementation of IPE both nationally and internationally. Full article
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