Welcome Note
Welcome to the clinical clerkship module, be aware that you don’t become a great pharmacist overnight. The journey through school and practical attachments requires a high level of commitment and hard work. this module of the clinical clerkship is intended to strengthen your practical ability to accomplish real-life work as a pharmacist in three main domains, that is to say, Hospital, the supply chain of health commodities, and regulatory authority.
With your hard work and commitment, this clerkship will help in improving the care we provide and moving from GOOD to GREATER competencies! In this program, we provide a number of suggested activities to improve your performance. They are organized by the core competencies which are the fundamental domains of being a great pharmacist
COURSE DESCRIPTION
On the completion of the bachelor's degree with honors, the candidate will accomplish 10 weeks clerkship in hospital, regulatory agency, and supply chain management. The aim is to develop professional skills through a series of patient-orientated practices.
EXPECTED OUTCOMES
hospital
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Task 1 – The dispensing process
- Look for branded and non-branded medicines in the dispensary and comment on the usage of each.
- Ask a member of staff to explain the pharmacy computer system to you and create labels for medicines.
- Dispense at least 10 of the following:
a. Ward stock item
b.In-patient non-stock item
c. Out-patient prescription
- Describe the steps involved in receiving, dispensing and supplying medications in each case.
- What checking systems are in operation?
- Outline the procedure for the destruction of unwanted medicines including controlled drugs at pharmacy and ward level.
Task 2 – Types of prescriptions
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Look at an example of each of the following:
- A prescription chart form one of the wards
- An out-patient prescription
- A doctor’s own prescription
Task 3 – Controlled drugs
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Describe the documentation and record keeping required for the provision of a controlled drug to a ward
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Task 4- Miscellaneous drugs
- Give one example of each of the following used in hospital:
- A trial drug
- A named-patient drug
- Unlicensed drug
- Specials
- What records are kept and who is responsible for recording the information?
- Ask the pharmacy manager about the procedures for dealing with these drugs within the hospital
Task 5- Service hours
- At this hospital, what provision are there for out of hours services to be provided and how are these services provided?
- Does this differ from other hospitals? (For example use of residency pharmacists, emergency medicines cupboards)
Task 6 – Health promotion
- Identify the types of health promotion which could take place in the hospital environment. Does this differ from community?
Task 7 – The training manual
- Familiarise him/herself with the medicines information Training manual (all drug information departments possess one of these).
a. Drug Interactions/Compatibilities
b.Therapeutics
c.Self Medication
d.Vitamins/Herbals
e.Drug Administration
f.Dosage Adjustment
Task 8 – The role of the medicines information pharmacist
- Outline the role of the medicines information pharmacist
- What information is recorded when a telephone enquiry is received?
- Give an example of an enquiry received from the following:
a. A hospital ward
b. A medical officer
c. Clinical officer
d.Nurse
e. A community pharmacist
f. A member of the public
Take care to maintain confidentiality.
- For each of the above, outline which information sources were used to answer the enquiry.
- Who else might contact the medicine information department?
Task 9– Specialist services
- Which medicine information departments provide poisons information? Where would you obtain this information?
- Match regional medicine information departments to specialist information provision (e.g. drugs in breast milk, drugs in liver failure, paediatrics, etc)
Section5: Supply medicine (see unit 3)
Section 6: Manufacturing/QA
Task 1 – Types of services
- What types of product should be made in an aseptic unit and why aren’t they prepared on the ward?
Task 2 – Quality assurance
- What is meant by “good manufacturing practice”?
- Choose one product prepared within the pharmacy (e.g. aseptic preparation) and list the quality assurance measures built into the production process.
- What documentation is needed?
- How does the batch numbering work? Give an example.
- What would happen if a medicine had to be recalled?
- What kind of environmental monitoring occurs within the department?
- What information sources are used to check the compatibility and stability of ingredients
supply chain
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Task 1: Making Sure Products are always available for your patients
- Explain the concept of commodity security as the framework for the course and its relationship to logistics
- Describe the purpose of a health logistics system
- Identify some of the major activities within logistics and the range of people who are involved in logistics activities
- List the components of a logistics system and describe the interrelationships of these components as they relate to the logistics cycle
- Define pipeline, lead time, issues data, and dispensed-to-user data
- Describe push and pull distribution systems
Task 2: Using Records to Collect Logistics Data You Need
- What are the purposes of Logistics Management Information System (LMIS)?
- What are the three essential data items, with their definition, that need to be collected to run any supply system?
- What are the three types of records used in LMIS?
- What is the difference between Records and Reports in a LMIS?
- What are the two types of Stock Keeping Records? What is their difference?
Task 3: Storing Health Commodities
- Listing the guidelines for the proper storage of health commodities
- Resolving selected product-related problems commonly found in warehouses
Task 4: Assessing the stock status
- Describe the purpose of assessing health commodity stock status
- Describe the process of assessing health commodity stock status
- Calculate the Months of Stock available at any storage level
- Explain how to assess the stock situation at any level, including the national level
- Explain how aggregated data can give a false impression of actual stock situations
- Explain how stock status can indicate the overall quality of commodity management
Task 5: Avoiding Stock Outs and Overstocks
- Define the meaning of the terms Maximum (months of stock and quantity), Minimum (months of stock and quantity), Review Period, Lead Time, Safety Stock, and Emergency Order Point
- State the storekeeper's decision rule for three versions of Max-Min
- Determine order/supply quantities using Maximum‑Minimum inventory control procedures
- Order, issue, and receive health commodities using the <<Rwanda Report and Requisition form>>
Task 6: Determining how much you need to serve every customer
- Explain what quantification is and why it is important
- Explain what forecasting is and why it is important
- Explain what procurement planning is and why it is important
- Explain the relationship between quantification, forecasting, and procurement planning
- Describe the general steps to quantification, forecasting, and procurement planning
- Make adjustments for a variety of situations
- Describe preparation of a commodity forecast using four data types
- Identify conversion factors required to convert number of visits, people, and incidents of a disease into quantities of commodities
Task 7: Supply Planning and Shipment Scheduling
- Describe the purpose of supply planning
- Describe the steps in supply planning
- Identify the data necessary for calculating annual commodity supply requirements, the sources of these data, their possible limitations, and some possible remedies for those limitations
- Explain the principles of shipment scheduling, including the sharing of data
- Demonstrate the use of Pipeline software as a resource for supply planning and shipment tracking
Task 8: Procurement (What to do when you are ready to procure required quantities)
- Define procurement
- Describe the procurement methods
- Explain good Pharmaceutical Procurement Practices
- Describe the factors influencing prices and total costs
- Describe the organization and management of the procurement system
Task 9: Assessing logistics systems for continuous improvement
- Describe the purpose of conducting a logistics system assessment.
- List steps in planning and conducting a logistics system assessment
- Identify and select indicators to measure logistics system performance
- Describe the Logistics Indicators Assessment Tool and the Logistics System Assessment Tool used in assessing a logistics system
- Identify elements of effective recommendations.
- Identify characteristics of an implementation strategy
- Describe their role in the assessment and improvement of logistics systems
Task 10: Monitoring and Supervision
- Define terms in Monitoring and Supervision
- Discuss the purpose of monitoring logistics activities
- Discuss the purpose of supervising logistics personnel
- Discuss the differences between monitoring and supervision
- Explain the difference between traditional and supportive supervision
- Describe the principles of supportive supervision
- Give and receive feedback