Increasing adult immunization rates in a rural state through targeted pharmacist education.

BACKGROUND: Most immunization rates fall below the Healthy People 2020 goals for adults. Pharmacists have the potential to have a positive effect on immunization rates through vaccine administration. OBJECTIVE: The purpose of this study was to assess if an educational program developed for pharmacists could increase pharmacist-delivered statewide immunization rates. PRACTICE DESCRIPTION: This study was conducted in the state of North Dakota. North Dakota law allows authorized pharmacists to provide any immunization to individuals aged 11 years or older. PRACTICE INNOVATION: In collaboration with the state health department, a needs assessment of North Dakota pharmacists was conducted to determine what resources and education could increase the delivery of immunizations within the pharmacy. The results were used to develop focused continuing pharmacy education material, create an online toolkit, and provide immunization administration certification. EVALUATION: The number and proportion of pharmacist-delivered immunizations and overall adult immunizations rates were compared pre- and postintervention. The North Dakota Immunization Information System was used for data comparison. In addition, the number of pharmacists registered to provide immunizations with the State Board of Pharmacy was tabulated. RESULTS: The number of pharmacist-provided immunizations increased by more than 3900 doses. In addition, the percentage of adult immunizations provided by pharmacists and overall adult immunization rates increased throughout the state. After adjusting for seasonality, there was an increase in the number of pharmacist-delivered pneumococcal polysaccharide vaccine immunizations (P < 0.001). The number of pharmacists registered to provide immunizations increased throughout the study period by 39%. CONCLUSION: This study suggests that focused education and resources delivered to pharmacists can increase pharmacy-based immunization rates and adult immunization rates overall. Improving adult immunization rates through greater pharmacist engagement may help to decrease overall infectious disease threats.

Use of Simulations to Improve Pharmacy Students' Knowledge, Skills, and Attitudes About Medication Errors and Patient Safety.

Objective. To design and evaluate the use of simulations in preparing students to identify and reduce medication errors and promote patient safety. Methods. Third-year pharmacy students used methods of root cause analysis (RCA) to determine the cause of a medication error in three simulated pharmacy settings. Before and after the activity, students completed an anonymous survey. They also completed a modified Healthcare Professionals Patient Safety Assessment instrument to measure changes in their knowledge, skills, and attitudes. Results. Ninety out of 165 students submitted complete data sets for analysis. Students demonstrated significant changes in knowledge, skills, and attitudes regarding medication errors. They felt they could find the cause of an error, identify factors leading to an error, and work with a team to prevent error recurrence. They also demonstrated an increase in knowledge about medication-related errors and the root cause analysis process. Conclusion. Students used RCA methods to discover medication errors in three simulated pharmacy settings. Students improved their knowledge, skills, and attitudes regarding medication errors through this process.

Report of the 2017-2018 Student Affairs Standing Committee.

The 2017-2018 American Association of Colleges of Pharmacy (AACP) Student Affairs Standing Committee addressed charges related to student wellness and resilience and identified ways where AACP can assist member organizations to build positive wellbeing in students. The Committee report provides nine recommendations to AACP, three suggestions for colleges and schools of pharmacy, and one proposed policy statement related to student wellness and resilience. The report focuses on themes of consequences of burnout and declining resilience, culture shift around wellness, creating community around times of grief, partnerships with member organizations to create campus cultures that promote overall wellbeing and strategies to help students to manage stress in healthy ways. Committee members challenge AACP, and other professional organizations, to include the student voice when future programs and strategies are developed. Finally, this report provides future recommendations for the Student Affairs Standing Committee.

Use of an Auditory Hallucination Simulation to Increase Student Pharmacist Empathy for Patients with Mental Illness.

Objective. To increase student pharmacist empathy through the use of an auditory hallucination simulation. Design. Third-year professional pharmacy students independently completed seven stations requiring skills such as communication, following directions, reading comprehension, and cognition while listening to an audio recording simulating what one experiencing auditory hallucinations may hear. Following the simulation, students participated in a faculty-led debriefing and completed a written reflection. Assessment. The Kiersma-Chen Empathy Scale was completed by each student before and after the simulation to measure changes in empathy. The written reflections were read and qualitatively analyzed. Empathy scores increased significantly after the simulation. Qualitative analysis showed students most frequently reported feeling distracted and frustrated. All student participants recommended the simulation be offered to other student pharmacists, and 99% felt the simulation would impact their future careers. Conclusions. With approximately 10 million adult Americans suffering from serious mental illness, it is important for pharmacy educators to prepare students to provide adequate patient care to this population. This auditory hallucination simulation increased student pharmacist empathy for patients with mental illness.

Performance and Perceptions: Evaluation of Pharmacy Students' Consultation via Telepharmacy.

Background: Pharmacy education standards highlight the importance of effective communication skills and the use of technology to provide patient care. As technology evolves, pharmacists have opportunities to communicate in different and broader ways. Objective: The objectives of this study were 3-fold: to evaluate student ability to counsel via telepharmacy, to determine if there is a difference in students' abilities to counsel face-to-face or via telepharmacy, and to determine students' perceptions regarding patient consultation via telepharmacy. Methods: Professional pharmacy students completed a pharmaceutical care laboratory activity focused on communication via telepharmacy. Comparisons were made between students' ability to provide patient consultation via telepharmacy and face-to-face utilizing a faculty-developed rubric. Students also completed a questionnaire on their perception of utilizing telepharmacy technology to provide patient consultation. Results: Eighty-two second-year professional pharmacy students participated in the study. Results showed students are able to successfully provide patient consultation via telepharmacy without prior practice; however, there was a statistically significant difference between students' ability to counsel face-to-face and via telepharmacy (P < .001). Overall, students were more successful at providing face-to-face consultation than via telepharmacy, and students who were first assessed on their ability to counsel face-to-face perceived a greater difference between telepharmacy and face-to-face consultation (P < .05). Conclusion: Student-perceived differences between the 2 means of consultation and demonstrated a difference in their ability to counsel via telepharmacy and face-to-face. It appears that, when evaluating the need to teach professional pharmacy students how to provide patient consultation via telepharmacy, additional exposure to telepharmacy technology could be beneficial by enhancing student comfort and proficiency.

Design and evaluation of a self-care educational activity as a student learning experience.

OBJECTIVE: To design an educational activity and evaluate its effectiveness on increasing third-year pharmacy students' knowledge and confidence to recommend self-care products to patients. DESIGN: Faculty members created a self-care activity, the Amazing Self-Care Race, for educational use in a pharmaceutical care laboratory course. Student teams worked competitively to complete 15 stations focused on self-care. A complex, real-world case was presented at each station. Student recommendations were presented to a facilitator. Prior to and following the activity, students were invited to complete an online anonymous survey instrument. ASSESSMENT: Eighty-six students completed presurvey and postsurvey instruments to assess their knowledge and perceived confidence to recommend a self-care product to a patient prior to and following participation in the Amazing Self-Care Race. Students demonstrated a significant increase in their ability and confidence to recommend self-care products following the activity (p<0.001). CONCLUSION: The Amazing Self-Care Race is an effective educational activity that increases student knowledge and confidence in self-care therapeutics. The activity helped students to develop self-care skills, enabled them to learn through doing, encouraged them to synthesize information while making self-care recommendations, and helped them to develop confidence by thinking on their feet.

Comparison of low- and higher-fidelity simulation to train and assess pharmacy students' injection technique.

OBJECTIVE: To evaluate 2 forms of simulation used to train and assess third-year pharmacy students' subcutaneous and intramuscular injection techniques. DESIGN: A cross-over comparison was used to evaluate an injection pad vs a patient simulator injection arm to train students in injection administration. ASSESSMENT: Students completed a survey instrument rating their proficiency, confidence, and anxiety before and after each form of simulated practice. All students demonstrated competence to administer an injection to a peer after using both forms of simulation. Students' self-ratings of proficiency and confidence improved and anxiety decreased after practicing injections with both forms of simulation. The only significant difference in performance seen between students who used the 2 types of simulations was in students who first practiced with the injection pad followed by the injection arm. CONCLUSION: Student ability to administer an injection and their self-perceived levels of confidence, proficiency, and anxiety were not dependent on the type of simulation training used.

A medical mission to Guatemala as an advanced pharmacy practice experience.

OBJECTIVE: To describe the development and outcomes of an advanced pharmacy practice experience (APPE) for a medical mission trip to Guatemala. DESIGN: Pre-mission preparation and post-mission reflection activities were combined with in-country activities to create a 5-week APPE. During the 10-day medical mission trip, pharmacy students dispensed medications, counseled patients, conducted quality improvement assessments, and presented their findings and experiences as part of an interdisciplinary health care team. ASSESSMENT: The students who completed the mission trip met the objectives of the APPE and reported substantial learning in the areas of interdisciplinary teamwork and cultural competency. All students' scores on the Inventory for Assessing the Process of Cultural Competence-Student Version (IAPCC-SV) increased. The majority (81%) of student-generated quality improvement recommendations were implemented by the mission team. CONCLUSIONS: The medical mission APPE provided a rich learning environment for pharmacy students and resulted in modifications to the medical mission operation. This type of APPE could be implemented in other colleges of pharmacy via formation of partnerships with established medical mission teams as this one was.

Provision of medication therapy management to university faculty and staff members by third-year pharmacy students.

OBJECTIVE: To develop and implement a medication therapy management (MTM) curriculum and assess students' skills and attitudes after the provision of MTM services to faculty and staff members. DESIGN: Third-year students enrolled in a pharmaceutical care laboratory course received lectures and participated in MTM activities in preparation for an MTM encounter. Students conduced MTM sessions with university faculty and staff members, providing comprehensive medication review, blood pressure checks, and optional blood glucose and cholesterol (total cholesterol and HDL) screenings. ASSESSMENT: A faculty-developed rubric was used to evaluate students' ability to explain MTM to the participant and address medication-related problems. Students' responses on pre- and post-encounter survey instruments showed their confidence to provide MTM services, communicate with participants and other health care providers, and provide point-of-care screening services had increased. CONCLUSION: Incorporating MTM into an existing laboratory course increased students' confidence and perceived ability to provide MTM services.