Carr-Lopez Sian M, Strohecker Lorrie, Mai Yvonne, Miyahara Randell K, Shek Allen
VA Northern California Health Care System, Mather, California
University of the Pacific Thomas J. Long School of Pharmacy, Stockton, California.
Am J Pharm Educ. 2020 Dec;84(12):ajpe7664. doi: 10.5688/ajpe7664. Epub 2020 Jul 31.
To describe and assess the effectiveness of an ambulatory care introductory pharmacy practice experience (IPPE) module in medication safety monitoring that was conducted remotely for first- and second-year pharmacy students in collaboration with a Department of Veterans Affairs (VA) health care system. A module in medication safety was developed and piloted as part of a required, one-unit IPPE in ambulatory care. The module encompassed three sessions of the 15-week course. Working remotely at the school under the direct supervision of VA clinical pharmacists, students accessed the electronic health records (EHRs) of veterans for whom methotrexate, sulfasalazine, or mineralocorticoid receptor antagonists had been prescribed as such patients require ongoing laboratory monitoring to screen for adverse drug effects. After reviewing the record, students ordered laboratory tests under the prescriber's name, documented notes in the patient's EHR, and sent laboratory reminder letters to patients. Students completed a brief survey at the beginning and end of the course. Differences in survey responses were compared using the Wilcoxon signed rank test. Fifty-eight students reviewed 148 patient records, including non-VA electronic records, and ordered laboratory tests for 79 patients. On the follow-up survey at course completion, students reported significant changes in their ability to monitor laboratory tests, use an actual (non-simulated) EHR to perform patient care, and explain the role of a clinical dashboard to conduct population health activities. Remotely conducting an ambulatory care IPPE course in which pharmacy students used an actual EHR to participate in medication safety monitoring for ambulatory patients expanded the pharmacy school's ability to provide crucial practice experience. Other pharmacy schools struggling with logistical challenges and limited resources should explore this approach to fulfilling the experiential education requirements for pharmacy students.
描述并评估一个门诊护理药学实践入门体验（IPPE）模块在药物安全监测方面的有效性，该模块是与退伍军人事务部（VA）医疗保健系统合作，为药学专业一、二年级学生远程开展的。开发并试点了一个药物安全模块，作为门诊护理必修的一个单元IPPE的一部分。该模块涵盖了15周课程中的三个课时。学生们在学校远程工作，在VA临床药剂师的直接监督下，访问已开具甲氨蝶呤、柳氮磺胺吡啶或盐皮质激素受体拮抗剂的退伍军人的电子健康记录（EHR），因为此类患者需要持续的实验室监测以筛查药物不良反应。查看记录后，学生们以开处方者的名义订购实验室检查，在患者的EHR中记录笔记，并向患者发送实验室提醒信。学生们在课程开始和结束时完成了一份简短的调查问卷。使用Wilcoxon符号秩检验比较调查回复的差异。58名学生查看了148份患者记录，包括非VA电子记录，并为79名患者订购了实验室检查。在课程结束时的后续调查中，学生们报告称，他们在监测实验室检查、使用实际（非模拟）EHR进行患者护理以及解释临床仪表板在开展人群健康活动中的作用方面的能力有了显著变化。远程开展门诊护理IPPE课程，让药学专业学生使用实际的EHR参与门诊患者的药物安全监测，扩大了药学院提供关键实践经验的能力。其他在后勤挑战和资源有限方面苦苦挣扎的药学院应该探索这种方法，以满足药学专业学生的实践教育要求。
