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                   Table of Contents

Description………………………………………………………………………….3


Purpose……………………………………………………………………………...3


Ability Outcomes and Objectives…………………………………………….…5


Poster Advisors……………………………………………………………………..7


Project Timeline and Activities……………………………………………….…7


Methods of Evaluation.……………………………………………………….…..8


Special Needs Policy…………..………………………………………………….8


Appendices…….……………………………………………………………….…10


    Appendix A. Format for Topic Approval (example)

    Appendix B. Written Proposal (example)

    Appendix C. Evaluation Instrument—Will be distributed at a later date

    Appendix D. Uniform Requirements for Manuscripts

    Appendix E. Examples of Poster Layouts

    Appendix F. Additional Resources
                                                                                                    3




I.     Description

Pharmacotherapy Poster Forum. This project begins during the senior year of pharmacy
school while students are involved in the Advanced Practice Experience (APE). As students
progress through the APE, they will identify relevant topics or therapeutic controversies
pertinent to the profession of pharmacy. After developing the poster project idea, with the
support of a faculty advisor, each student will present the information to colleagues at the end of
the year during a school-wide Poster Forum. This gives students the opportunity to develop a
“colleague consciousness” by learning to identify and effectively communicate therapeutic
issues encountered in clinical practice to students, peers, and other health care professionals.
It will prepare students for their future professional responsibility of sharing new approaches,
patient care techniques and drug information within the profession of pharmacy.



II.    Purpose

The aim of this project is to encourage students to be self-directed, critically reflective and
competent in skills essential to providing optimal patient care and maintaining an effective
pharmacy practice. More importantly, it will prepare students for the challenge of
communicating within the profession of pharmacy. The profession is in the midst of change.
Economic forces, technological advances, and quality of patient care issues are re-framing
pharmacy practice. As pharmacists transition to this new philosophy of practice, they will
encounter unique challenges and identify strategies for resolving therapeutic problems. This will
make information sharing a necessary component of pharmaceutical care. Recognizing this
need, many state and national pharmacy organizations have incorporated posters into meetings
and conferences. Their intention is to promote communication of innovative ideas among
practicing pharmacists in a fun, non-threatening, and efficient manner. This project will provide
Pharm.D. graduates with the knowledge and skills needed to participate in state and national
poster symposiums and therefore, contribute to the advancement of pharmacy practice.
                                                                                                    4




Why Posters? The poster presentation format is considered an effective and efficient
communication tool. Posters facilitate the sharing of information in a creative and interactive,
yet professional manner. Many use poster presentations as a way to escape the confines of the
lecture and the constraints of having to listen to the obvious, repetitious, uninteresting, and
irrelevant.

Posters promote independent thought, allow speakers to create unique, self-paced works, and
necessitate critical thinking and application of learned material. It also requires speakers to
have a firm understanding of their topic areas so they may answer unrehearsed questions from
viewers.

Posters: a method to facilitate professionalism. For students, socialization into a profession
such as pharmacy evolves to the greatest extent when individuals matriculate through the
professional curriculum. Socialization develops primarily through social interactions with faculty
members, practitioners, peers, and other health care professionals. Pharmacists develop a
“colleague consciousness” through attending professional meetings and reading pharmacy
journals. Obviously pharmacy students must be skilled at professional presentations since this
format is commonly used for sharing ideas at regional and national pharmacy meetings.

Posters as Teaching Tools. The instructional effectiveness and popularity of poster sessions
have been described in regards to science fairs and various undergraduate seminars.
Educators indicate individuals who participate in poster sessions work harder, enjoy their course
more, and understand the basic principles of the topic better than students who do not
participate in such an event. Poster presentations promote activities that encourage students to
explore alternative means of defining content in a condensed, easily assimilated fashion.
Posters foster critical thinking and motivation by values of professionalism, responsibility, and
achievement. They provide students opportunities to teach and learn from each other while
fostering development of professional communication skills.
                                                                                                                    5




III.       Ability Outcomes and Objectives

                                                                   Instructional               Methods for
       Outcomes                     Objectives                       Methods                   Assessmenta
Communication Abilities            Students will                 Advisor/Student            Student self
                                    demonstrate verbal,            discussions                 Assessment
The student shall read,             nonverbal, listening                                       (OPPE Form)
write, speak, listen, and use       and written skills as         Oral presentation
media to communicate.               they participate in the                                   Observation-based
                                    development and               Written communication       Advisor Assessment
                                    presentation of a                                          (OPPE Form)
                                    poster



       Social Interaction,         Students will work            Responsibilities and       Self Assessment
    Citizenship, Leadership         effectively in a team          interaction during          (OPPE Form)
                                    and actively participate       advisor/student team
The student shall                   in discussions and             meetings                   Observation-based
demonstrate appropriate             activities                                                 Advisor Assessment
interpersonal and                                                 Interaction with            (OPPE Form)
intergroup behaviors.              Demonstrates                   viewers of the poster
                                    accountability and             presentation
                                    reacts to criticism in a
                                    professional manner




                                   During the                    Responsibilities and       Self Assessment
                                    development and                interactions during         (OPPE Form)
                                    presentation of the            advisor/student team
                                    poster, students will          meetings                   Observation-based
         Professional               display habits,                                            Advisor Assessment
       Ethics & Identity            attitudes, and values         Interaction with            (OPPE Form)
                                    of a professional              viewers of the poster
The student shall behave                                           presentation
ethically. The student shall       Students will
accept the responsibilities         demonstrate an
embodied in the principles          evolving professional
of pharmaceutical care.             identity and the
                                    formation of a
                                    professional value
                                    system or “colleague
                                    consciousness”


a
    See Appendix C
                                                                                                                    6




Continued…
                                                                  Instructional                Methods for
       Outcomes                    Objectives                       Methods                    Assessmenta
    Self-Learning Abilities       Students will                 Advisor/Student             Self Assessment
                                   independently identify         Reflective Discussions       (OPPE Form)
The student shall assess           areas of weakness
continuously his/her                                             Completion of the           Observation-based
learning needs and develop        Students readiness for         poster project               Advisor Assessment
the ability to respond             lifelong learning will                                      (OPPE Form)
appropriately.                     increase through self-
                                   directed completion of
                                   the project




      Thinking Abilities          Students will identify a      Comprehensive               Self Assessment
                                   topic, acquire and             literature search            (OPPE Form)
The student shall acquire,         interpret data, and
comprehend, apply,                 justify, in writing and       Written paper
analyze, synthesize, and           orally, their                                              Observation-based
evaluate information. The          recommendation                Presentation of poster       Advisor Assessment
student shall integrate                                           and interaction with         (OPPE Form)
these abilities to identify,      Students will present          viewers
resolve, and prevent               an informative poster
problems and make                  that demonstrates
appropriate decisions.             comprehension,
                                   analysis, synthesis
                                   and evaluation of the
                                   topic



a
    See Appendix C
                                                                                                     7



IV.    Poster Advisors

Platform advisors are faculty members, both affiliate and full-time, as well as preceptors at sites
throughout the state who are scheduled to precept students assigned as their advisors during
APE or at least have interaction with the students through their rotations.
In addition to providing guidance to students throughout the
year, Poster Advisors will assist with the construction and development of posters. A complete
list of office addresses, telephone numbers, and e-mail addresses for Poster Advisors is
provided in the Pharmacy Practice Experience Manual.



V.     Project Timeline and Activities


Topic Approval. Each student must submit a 1-page paper to the advisor summarizing the
proposed pharmacotherapy topic. The paper should include a brief description of the project
idea including a rationale of importance and proposed objectives. Also, a tentative timetable for
project completion should be included. A specific deadline for this portion of the project will be
determined between the advisor and student (see course syllabus). The advisor will approve
the topic and timetable and offer specific suggestions to the student. (See Appendix A)

Written Proposal Draft. After the pharmacotherapy topic is approved, each student must
complete a written draft of the project and submit this to the advisor for assessment and
feedback. This should include literature search strategies, topic introduction, general outline,
preliminary data analysis, and conclusions. The advisor will assist the student with the
evaluation of biomedical literature to ensure the development of a clear, concise
pharmacotherapy issue, an extensive search strategy, and appropriate evaluation of pertinent
literature. A reasonable deadline date will be determined between the student and the advisor
(see course syllabus).

Final Written Proposal. Students will submit a technical paper similar to those required at
national pharmacy meetings for poster presentations. An example is shown in Appendix B. The
paper should include components such as an abstract, introduction, objectives,
methods/procedures, results, conclusions, and a statement of importance to current or future
pharmacy practice. The format of the paper should follow the Uniform Requirements for
Manuscripts Submitted to Biomedical Journal (See Appendix D). Students are not required to
                                                                                                                                            8


submit the papers for publication. A specific deadline for this portion of the project will be
determined between the advisor and student. The Overall Poster Project Evaluation (OPPE)
Form, found in Appendix C, explicitly outlines the requirements for the written proposal.

Poster Preview. Students will submit a sketch draft of the anticipated poster layout to the
poster advisor prior to preparing the final version of the poster. Examples of poster layouts may
be seen in Appendix E. A specific deadline will be determined between the advisor and the
student. Feedback will be given regarding format and appearance of the layout. The advisor
will guide the student in the construction of the final poster. It will be the responsibility of the
student to purchase materials necessary for the construction of the poster (See Appendix F).


AU Poster Forum. Each student will present his/her poster during the Poster Forum held at the
School of Pharmacy.



VI.        Methods of Evaluation (See Appendix C)


                    Context                                           Assessment Instrument
                           1
Student Performance                                    Overall Poster Project Evaluation (OPPE) Form
                                                  The Poster Appraisal Tool will be used by a multi-disciplinary panel to award prizes to
                                                  the top three presenters



Perceptions of Project                                 Student Perception Survey
1
    Overall grade = 50% podium presentation score + 50% platform presentation score

         Any student receiving a grade below a "C" on the poster presentation must repeat that
          portion of the course within 4 weeks. The grade assigned during the repeat presentation
          will be used to calculate the final grade. Students receiving a final grade lower than a "C"
          must repeat the entire course.


VII.       Special Needs Policy

It is the policy of Auburn University to provide accessibility to its programs and activities and
reasonable accommodation for persons defined as having disabilities under Section 504 of the
Rehabilitation Act of 1973, as amended, and the Americans with Disabilities Act of 1990.
Students should contact the Program for Students with Disabilities, 1244 Haley Center, (334)
844-2096 (Voice/TT). Students must receive approval before individual instructors will grant
special accommodations. Students with defined special needs should see the instructor at the
beginning of the project so that accommodations can be scheduled.
                                                                           9



                                  Activity Checklist

                                                Deadline     Date      Advisor
                                                           Completed
                  Activities                     Date                  Sign-Off

Topic Approval

Written Proposal Draft

Final Written Proposal

Poster Preview

Student Self Assessment (Use OPPE Form)

Advisor Evaluation of Project (Use OPPE Form)

Student Perception Survey


Comments:
                            10




    Appendix A
Format for Topic Approval
          (Example)
                                                                                                             11




Description

Conduct a literature evaluation to describe the antiplatelet effects of clopidogrel compared to current

therapeutic options.



Rationale

Clopidogrel was recently approved by the U.S. food and Drug Administration for the reduction of ischemic

events in patients with recent myocardial infarction, stroke, or peripheral arterial disease with no added

risk for neutropenia. Antiplatelet agents are used primarily to treat and prevent arterial thrombosis.

Aspirin, a relatively weak antiplatelet agent, has been shown through years of extensive experience and

numerous trials to be of substantial benefit in the treatment and prevention of acute coronary syndromes.

This review will focus on the mechanism of action, pharmacology, and major clinical applications of

another class of antiplatelet agents-thienopyridines-that achieve moderate levels of platelet inhibition.

More importantly, this evaluation will describe its role among currently available therapeutic options.


Objective

Describe the antiplatelet effects of clopidogrel and its place in therapy.


Timetable

November 1, 1999         Complete literature search and review important articles
January 1, 2000          Turn in written draft to mentor
March 15, 2000           Turn in final written paper
April 1, 2000            Review poster layout with mentor
April 15, 1999           Finish poster and begin preparing for Poster Forum
                   12




Appendix B
Written Proposal
     (Example)
                                                                                                                 13




Rationale
                                                                                                   1,2
        The profession of pharmacy has adopted pharmaceutical care as a model of practice.

Concepts important to this practice model include collection and interpretation of patient information to
                                                    3
identify and prevent medication-related problems. An essential component to pharmaceutical care is

effective communication of ideas and recommendations to other health care professionals in order to
                           4
promote optimal therapy.

        Interdisciplinary communication comes in many forms like written progress notes. This is a
                                                                                           4
common method used to share medical information pertaining to hospitalized patients. Progress notes

are an integral part of the health care system by which current, pertinent information is shared between

health care professionals. As a result, it is imperative to clearly present information in a manner that

minimizes the possibility of ambiguity or misinterpretation. Also, it is essential to include information that

supports the validity of recommendations. The rationale of this project was three-fold: first, to identify

patterns of pharmacy documentation, evaluate the appropriateness of documentation, and determine the

need for staff development within the Department of Pharmacy.



Objectives

The primary project objective was to identify pharmacy documentation patterns and evaluate "consult

note" content found in medical records. A secondary objective was to determine the need for future staff

development or standardized departmental policies for the documentation process.



Methods

        A retrospective study to evaluate the appropriateness of pharmacokinetic consults (PCs) written

between November 1996 and November 1997 was conducted at a regional medical center. A list of initial

PCs was compiled from the pharmacy intervention database. A total of 545 initial PCs were documented

as clinical interventions during this period. Of these, forty-seven adult patients were randomly chosen for

review. The pharmacokinetic consult notes pertaining to aminoglycoside or vancomycin were evaluated.
                                                                                                            14


Although, PCs written for other medications were not evaluated. However, the vast majority of total

consults primarily involved aminoglycosides and vancomycin dosing. Only the medical records of adult

patients were included in the randomization process.

        Each medical record was reviewed to identify whether specific items, identified prior to the study,

were present in the PCs. These items were based on current departmental policy and procedures that

outlined steps for pharmacy intervention documentation. Each pharmacokinetic consult was broken into

segments including introductory comments, patient-specific information, pharmacokinetic variables,

assessment of drug therapy, therapeutic recommendations, and closing segment was parameters. Each

reviewed to identify the presence of essential items.

        The introduction was evaluated for the presence of general information including date and time of

the pharmacy consult, identification of the pharmacy service, and the name of specific consult drug (i.e.

gentamicin,).

        Patient vancomycin specific information was identified such as age, gender, history of present

illness, dose modifying factors, indication and presence of other significant medications. Furthermore,

specific pharmacokinetic variables were surveyed including elimination constant, volume of distribution,

serum creatinine, albumin, estimated creatinine clearance, half life, weight, height, white blood cell count,

temperature and culture status. Appropriate assessment of drug therapy and therapeutic

recommendations were reviewed for presence of target concentrations (i.e. peak, trough), assessment of

regimen appropriateness, recommendations, and monitoring parameters. Items like pharmacist signature

and phone number were also identified.

        Pharmacy administrators ranked categorical data mentioned above to specify items perceived as

essential for appropriate PCs. Based on the survey of pharmacy administrators and current policy and

procedures, criteria for "appropriate" documentation of PCs was determined. Descriptive statistics were

used to evaluate the appropriateness of pharmacist documentation in medical records.
                                                                                                          15


Results

        A total of forty-seven medical records were randomly chosen for review. Four (10%) charts were

excluded from review due to missing or incomplete data. Five PCs (13%) were not reviewed because

they were not documented in the patients' medical records.

        Of the thirty-eight charts reviewed by independent pharmacists, the information commonly

included (i.e. present in more than 50% of consult notes) in each note is seen in Table 1. These included

items such as date of consult, age, weight, estimated creatinine clearance and target concentrations.

Items identified as frequently omitted (i.e. observed in less than 50% of consult notes) are shown in Table

2. These included specific pharmacokinetic variables such as elimination constant, volume of distribution

and half-life of medications. More importantly, data to support pharmacy recommendations where often

not included into PCs.

        Based on departmental policy and procedures and a survey of the pharmacy administration,

criteria for appropriate pharmacokinetic consult notes were developed. However, none of the PCs

reviewed included all of the items necessary to be considered appropriate according to current hospital

standards.



Conclusions

        Progress notes in medical records are essential for communicating current, pertinent information

between health care professionals. Based on our study, we identified several areas for improvement.

According to the criteria set forth by pharmacy colleagues within our institution and the policy and

procedures developed by a multi-disciplinary group, none of the thirty-eight notes included the

components considered essential for an appropriate note. In fact, only 18% of the notes reviewed

included assessments to support the pharmacy recommendation.

        The Joint Commission on Accreditation of Healthcare Organizations has emphasized the
                                               5
importance of multidisciplinary documentation. Clearly, the value of pharmacist interventions has been

addressed, as well as the importance for documentation as part of the patient's chart. Based on the

information gathered from our project, a staff development program or a policy for standardized pharmacy

documentation is necessary to ensure the quality of pharmacy documentation in medical records.
                                                                                                       16




Importance to Pharmacy Practice

The importance of this project to pharmacy practice centers on the need to create mechanisms to ensure

recommendations are appropriately documented in medical records. This may be accomplished through

identification of pharmacy documentation patterns and provision of standardized documentation

procedures, staff development, and constructive feedback. This will insure high standards set forth,

historically, within our profession are maintained.



References

1. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm
    1990; 47: 533-43.
2. American Pharmaceutical Association, American Society of Hospital Pharmacists, National
    Association of Retail Druggists. Joint statement on the entry-level doctor of pharmacy degree. Am J
    Hosp Pharm 1992; 49: 244-51.
3. Winslade NE, Strand LM, Pugsley JA, Perrier DG. Practice functions necessary for the delivery of
    pharmaceutical care. Pharmacotherapy 1996; 16: 889-98.
4. Lacy CF, Saya FG, Shane RR. Quality of pharmacists' documentation in patients' medical records.
    Am J Health-Syst Pharm 1996; 53: 2171-5.
5. 1995 comprehensive accreditation manual for hospitals. Oakbrook Terrace, IL: Joint Commission on
    Accreditation of Healthcare Organizations; 1995.
Table 1. Items Commonly Included in Pharmacokinetics Documentation


                  Items Included          Number (%)

        Pharmacist Signature*             38, (100)

        Date*                             37, (97)

        Dosing Interval*                  33, (87)

        Recommended Dose*                 32, (84)

        Drug Identification*              29, (76)

        Monitoring Parameters*            27, (71)

        Age*                              26, (68)


        Gender*                           26, (68)

        Target Peak Concentration*        26, (68)

        Target Trough Concentration*      24, (63)

        Weight*                           22, (58)

        Estimated Creatinine Clearance*   19, (50)

          * Items Identified as Essential Components
                                                                      18




Table 2. Items Frequently Omitted in Pharmacokinetics Documentation


                    Items Omitted             Number (%)

        Pharmacist Telephone Number*          36, (95)

        Albumin                               34, (89)

        Rationale for Recommendation          31, (82)

        Temperature                           31, (82)

        White Blood Cell Count*               30, (79)

        Height of Patient                     28, (74)

        Half-life                             27, (71)

        Other Significant Medications         25, (66)

        Time of Consult*                      25, (66)

        Serum Creatinine*                     22, (58)

        Volume of Distribution (VD)*          21, (55)

        Elimination Constant (Ke)*            20, (53)

        Indication for Drug*                  20, (53)

        Dose Modifying Factors*               20, (53)

        History of Present Illness            20, (53)

              * Items Identified as Essential Components
                                                       19




          Appendix C
     Evaluation Instrument
Revised version will be distributed at a later date.
                            20




    Appendix D
Uniform Requirements for
      Manuscripts
       (refer to Website)
                             21




     Appendix E
Examples of Poster Layouts
        (refer to Website)
                          22




  Appendix F
Additional Resources
     (Refer to Website)

				
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