The Advanced Practice Inpatient Medicine Experience

General Objectives

At the conclusion of the inpatient medicine experience the student should be able to:

  1. Describe the following for all medication administered to assigned patients:
    1. Indications for use and appropriateness of therapy
    2. Dosage and schedule
    3. Routes of administration and precautions
    4. Mechanism(s) of action
    5. Alternative treatment available
    6. Onset and duration of action
    7. Drug-drug interactions, drug-lab interactions
    8. Pharmacokinetics and biopharmaceutics
    9. Influence of disease state on drug absorption
    10. Therapeutic and toxic levels [if available]
    11. Adverse effects
    12. Appropriate patient information
    13. Formulation and compatibilities [I.V. admixtures]
  2. Describe the pathophysiology, drug treatment, and therapeutic parameters to monitor disease states encountered during the rotation and those assigned by the instructor.
  3. List the normal ranges for the common laboratory tests; interpret values of individual patients and apply this data to the patient's drug therapy.
  4. List the therapeutic blood concentrations, toxic blood concentrations, and related adverse reactions for drugs commonly monitored with blood concentrations. Specify the appropriate times to draw samples and be able to apply the resultant information to the patient.
  5. Develop, implement, and monitor a pharmacotherapeutic patient care plan for each patient assigned identifying: a) the pertinent therapeutic drug-related problems; b) the priority ranking of those problems within the patient; c) the plan for the drug-related treatment of those problems and the intervention strategies; and, d) the indices necessary to monitor the progress of the problem resolution.
  6. Appropriately assess and recommend fluid and nutrient therapy for the patient.
  7. Effectively communicate recommendations for changes and/or alternative drug therapy to other health care professionals.
  8. Provide drug information with appropriate documentation.
  9. Demonstrate an understanding of the anatomic, physiologic, and psychological interactions of multiple disease states on the drug therapy of patients.
  10. Demonstrate an understanding of the effects on drug therapy of acute disease states in patients with coexisting chronic diseases.
  11. Appropriate documentation in the permanent medical record of patient care interventions.
  12. Monitor progression of diseases and/or effects of therapy via clinical symptoms and pertinent information obtained from the patient, medical team, or medical records.
  13. Appreciate the role of the pharmacist as a part of a multidisciplinary team approach to patient care.
  14. Identify patients who may benefit from medication teaching and be able to identify methods to overcome barriers which may exist.

Required Inpatient Medicine Clerkship Forms

Those to return to the office

  1. End-of-Rotation Assessment - preceptor completes online
  2. Mid Rotation Self Assessment
  3. Personal Reflection - one copy goes to the preceptor, one copy goes to Purdue
  4. Clerkship Site/Instructor Evaluation Form (online)
  5. Affidavit of Experience- original goes to Purdue, copy goes in the student's portfolio
  6. Request for Absence Form (if applicable)

Those to place in student portfolio

Required
  1. Mid Rotation Self-Assessment
  2. End-of-Rotation Assessment
  3. Oral Presentation Evaluation Form(s)
  4. Skill-based Competency Sign Off sheets (place these in the front of the manual)
As Applicable
  1. All cases, handouts, and bibliographies from presentations
  2. End of Block Evaluation Form
  3. Articles and reports prepared by the student during rotations
  4. Other documents prepared during clerkship rotations evidencing relevant experiences and abilities

Potential Activities for the Inpatient Medicine Experience

  1. Be assigned to a health care professional(s) and be responsible for communicating drug information and therapeutic recommendations as they relate to patient care.
  2. Participate in regular rounds with appropriate health care professionals.
  3. Participate in regular clinical pharmacy rounds and/or discussions with the clinical instructor.
  4. Maintain an organized, current Pharmacotherapeutic Patient Care Plan on each assigned patient. Information should include a pharmacist problem list, drug profile, desired therapeutic outcomes and monitoring parameters.
  5. Attempt to detect drug-related problems in assigned patients (e.g. interactions, dosing, adverse reactions) and develop rational solutions to these problems.
  6. Research and answer drug information questions from the assigned health care practitioner and clinical instructor.
  7. Interview and regularly communicate with patients and participate in discharge planning and education.
  8. Provide and attend a variety of oral presentations, including cases, lectures, conferences, journal clubs and inservices as assigned by the instructor.
  9. Provide pharmacokinetic and nutritional consultations for assigned patients, as appropriate.
  10. Attend and participate in various committee meetings of the health care setting as available.
  11. Develop an understanding of the overall functions of the Pharmacy Service at the respective institutions.
  12. Participate in research projects when feasible.

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