Objective. To implement and evaluate the use of a situated-learning experience to prepare second-year pharmacy students to conduct medication history interviews in preparation for introductory pharmacy practice experiences (IPPE) at ambulatory clinic sites. Design. Second-year doctor of pharmacy (PharmD) students (n5200) used the Medication Mysteries Infinite Case Tool, a game-like educational tool in which groups of 3 students assumed the roles of pharmacist, patient, and observer and rolled a die and drew cards to determine the drugs, patient personality, medication problems, and other variables that guided a medication history taking session. Assessment. After the laboratory session, faculty members assessed students' medication historytaking skills. One hundred sixteen (58%) and 78 (39%) of 200 students achieved excellence or competence, respectively, on the final assessment. Two weeks after the assessment, 53 of 200 (26.5%) students completed a survey instrument. The respondents indicated that their self-confidence in conducting medical history taking significantly improved following completion of the learning experience. Conclusion. Using the Medication Mysteries Infinite Case Tool increased students' confidence and skills in conducting medication history taking prior to their clinical IPPE experience.Keywords: medication reconciliation, medication history, self-efficacy, introductory pharmacy practice experiences INTRODUCTIONThe 2012 Joint Commission cites the need to "maintain and communicate accurate patient information" as a National Patient Safety Goal in a variety of healthcare settings. The process of medication reconciliation is intended to identify and resolve discrepancies and involves comparing the medications a patient is taking (or should be taking) with those newly prescribed.1 The ability to perform a patient interview is identified by the Agency for Health Care Research and Quality as a key training component for the process of medication reconciliation. 2In various healthcare settings, pharmacist involvement in medication reconciliation has been shown to reduce preventable adverse drug events. [3][4][5] Accreditation Council for Pharmacy Education (ACPE) standards for pharmacy education include conducting patient interviews to gather patient information as an important learning objective for introductory as well as advanced pharmacy practice experiences (IPPEs and APPEs). Education on the process of medication reconciliation during transitions of care is also suggested as content to include within the basic clinical sciences curriculum. 6 A white paper from the American College of Clinical Pharmacy recommends that medication reconciliation and the performance of other activities related to care transitions be included in IPPEs as well as APPEs. Also, the importance of effective communication by pharmacists is emphasized by the ACPE as well as the American Association of Colleges of Pharmacy's Center for Advancement of Pharmaceutical Education Educational Outcomes. 6,8 In order to provide s...
Community pharmacists can positively affect patient medication adherence during the 6-month period following counseling by a pharmacist along with an improvement in patient BP. However, there is much room for improvement in PC programs and in the number of patients who properly adhere to their medications.
BackgroundSchool-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits.MethodsFor the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida.ResultsVaccination of ∼50% of 5–17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0–4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13.ConclusionWider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities.
School-based influenza immunization programs are increasingly recognized as a key component of community-based efforts to control annual influenza epidemics. Computer modeling suggests that immunizing 70% of schoolchildren could protect an entire community from the flu. Most of the school-based influenza immunization programs described in the literature have had support from industry or federal grants. This article describes a program that used only community resources to administer live, attenuated influenza vaccine supplied by the state health department. Beginning in 2006, the Alachua County Health Department and school system, working in collaboration with the University of Florida, began exploration of a non-mandatory community-wide school-based influenza immunization program, with the goal of achieving high levels of immunization of the ~22,000 public and private pre-K through grade 8 students in the county. In 2009-10 the program was repeated. This report describes the procedures developed to achieve the goal, the barriers that were encountered, and solutions to problems that occurred during the implementation of the program. Preliminary data suggest that the crude immunization rate in the schools was approximately 55% and that at least 10% more students were immunized by their health providers. At an operational level, it is possible to achieve high immunization rates if the stakeholders share a common vision and there is extensive community involvement.
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