A Simulated Hospital Pharmacy Module Using an Electronic Medical Record in a Pharmaceutical Care Skills Laboratory Course

By Kirwin, Jennifer L.; DiVall, Margarita V. et al. | American Journal of Pharmaceutical Education, April 2013 | Go to article overview

A Simulated Hospital Pharmacy Module Using an Electronic Medical Record in a Pharmaceutical Care Skills Laboratory Course


Kirwin, Jennifer L., DiVall, Margarita V., Guerra, Christina, Brown, Todd, American Journal of Pharmaceutical Education


INTRODUCTION

A 2010 AACP report described the Core Performance Domains and Abilities that should be achieved by students prior to beginning advanced pharmacy practice experiences (APPEs). (1) This report highlights 11 core performance domains, including patient safety, accurate dispensing of medications, basic patient assessment, identification and assessment of drug-related problems, and general communication abilities, and described several possible activities that might be used by colleges and schools of pharmacy to document student achievement of these competencies. Identification of activities that can be used to document this achievement is increasingly important as programs of pharmacy complete programmatic assessment mapping activities. Many of the competencies described can be taught within a pharmacy practice laboratory course. (1)

The need for strong preparation in hospital pharmacy practice has also been described by professional pharmacy organizations. A 2010 publication issued by a joint taskforce from the American Society of Health-System Pharmacists and ACPE concluded that graduates possessed strong clinical knowledge but were not universally prepared to enter practice or residency training in the hospital setting. (2) The report identified a comprehensive list of competencies needed for hospital/health system pharmacy practice, including: describing relevant standards that hospitals use to ensure safe and appropriate medication use; performing medication reconciliation during transitions of care; documenting appropriate therapeutic recommendations related to medication therapy; and triaging multiple patient priorities in times of high activity and workload.

The hallmark of the 6-year doctor of pharmacy (PharmD) program at Northeastern University School of Pharmacy is student participation in full-time introductory pharmacy practice experiences (IPPE) through the university's cooperative education program. All students are required to complete three 4-month long full-time cooperative education/IPPE experiences, one of which is required to be in an institutional pharmacy. Usually, students complete the required institutional experience in a hospital pharmacy department. Competencies developed for the institutional experience direct students to learn to fulfill medication orders; develop communication and problem-solving skills, professional behaviors, and professional ethics; and observe and appreciate hospital pharmacy operations.

As part of PharmD training, students must also be introduced to electronic health records or electronic medical records as such technology is increasingly used to improve the accessibility of patient information and the overall safety of healthcare delivery. (3) To address several of these issues, and to expand students' preparation for required APPEs in community pharmacy, hospital/ institutional pharmacy, and ambulatory care, skills laboratory faculty members within the department of pharmacy practice wanted to provide a comprehensive laboratory experience where students could integrate the skills required for these practice settings. The Pharmaceutical Care Skills Laboratory course was redesigned to include activities organized into 3 modules: community, hospital, and ambulatory care.

At the same time the course was redesigned, the school of pharmacy needed to update the pharmacy system used in the pharmacy practice laboratory. In 2010, Medical Information Technology, Inc., donated the MEDITECH software package (Medical Information Technology, Inc., Westwood, Massachusetts) to the university for use in all health professions programs. As a result, the Bouve College of Health Sciences began a plan to use the software in each of the programs (including in pharmacy, nursing, physical therapy, and physician assistant) and as a platform for interprofessional collaboration. In the school of pharmacy, the MEDITECH software was integrated into the Pharmaceutical Care Skills Laboratory course to use as prescription dispensing software and to create electronic medical records to present patient case information in the hospital pharmacy module. …

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