Penn Foster Community Pharmacy Practice Externship Evaluation

Student Name: ______

Externship Dates: ______

Site Location: ______

Preceptor: ______

The student will be evaluated at each clinical site using the attached outline. For each ASHP based objective listed, the site supervisor will initial and assign each competency the following values:

 zero (0) : did not meet the requirements for this competency

 one (1) : partially met the requirements for this competency

 two (2) : fully met the requirements for this competency

The student is instructed to self-evaluate all areas during the rotation as well. In the event that hands- on cannot be accomplished at the site, (e.g. automated counter, compounding) please discuss the concept and give any instruction verbally that can be given.

Documentation is required if a student receives a zero in any area. Space is provided for documentation/comments on the last page of this assessment packet.

Competency Areas Assessed:

Documentation

Inventory and Billing

Community Pharmacy Practice

Communication

Error Prevention and Quality Control When the student has finished the required externship hours, please post this completed form to the RxPreceptor site.

Please Note:

Student should keep a copy of completed assessment form for their records. Preceptor Competency After completing this section, the student will: Grade Initials Storage Follow storage requirements for all classification of drugs. Requirements Store caustic, poisonous, and flammable substances. List references used to guide decisions on drug storage and

control. Medication Demonstrate the procedures and requirements for medications control through a hospice order or other emergency, Explain the disposition of various drug classifications from Documentation receipt to use (e.g., controlled drug, etc.). Prepare required dispensing documentation for controlled

drugs, investigational drugs, and nonprescription drugs. Identify those items a technician cannot document. Demonstrate the ability to participate in the pharmacy’s quality control and medication error prevention plan. Discuss the policy for schedule IV drugs and the requirements needed to purchase. Inventory and Employ inventory and purchasing procedures to include purchasing ordering from wholesaler, want book entry, or returns. procedures Record inventory and purchases. Inspect shelves including various automated functions such as

returns, credits, expired drugs, or replenishment. Use a computer for inventory and purchases by entering or

checking an order from the wholesaler. Perform third party on line adjudication and identify required Billing insurance information. Complete at least 5 register transactions including RX and OTC purchases. Prescription Prepare prescriptions to include interpretation, data entry, interpretation retrieval of medication from stock, insurance information. Prepare medication for dispensing including counting, pouring,

or repackaging. Discontinued Retrieve discontinued medications from shelves and return medications accordingly. Compounding Use compounding equipment properly. Clean equipment used in compounding. Store equipment used in compounding. Select ingredients. Calculate amount of ingredients. Measure amount of ingredients. Complete worksheet including record of weights and volumes,

and manufacturer's lot numbers. Mix product. Prepare product. Packaging and Demonstrate selection and preparation of packages/containers labeling and closures. Use proper packaging technique for compounding products,

blister packing, and nursing home medications. Demonstrate correct selection and preparation of labels.

Preceptor Competency After completing this section, the student will: Grade Initials Discuss the guidelines and procedures used in immunizations

done at a pharmacy and the technician’s role. Infection Demonstrate proper hand washing technique. Describe microbial growth and transmission. Disinfection Demonstrate proper cleaning techniques on work surface areas. techniques Demonstrate work practices that inhibit possibilities of infection

transmission. Clean equipment used in drug product preparation. Uses various compounding equipment and perform proper

record keeping requirements. Discuss importance of good work habits such as absenteeism, Policies and tardiness, incompetence, dishonesty, and conflict resolution. Procedures State institutional and departmental policies applicable to each

of the pharmacy job responsibilities. Discuss examples of "a decision requiring a pharmacist's judgment" (ex. DUR, interactions, new prescriptions over the phone). State legal aspects of technologist functions, such as accountability, pharmacy regulations, and use and storage of controlled substances. Demonstrate verbal face-to-face communication as well as correct telephone communication techniques to be used when receiving and initiating calls. Demonstrate the ability to resolve conflicts through negotiation. Appreciates the need to adapt to cultural differences. Recordkeeping State at least three reasons for patient information and HIPAA confidentiality. Demonstrate recordkeeping techniques for various medication

types (e.g., controlled substances and investigational drugs). Uses knowledge in receiving and screening prescriptions/medication orders for completeness, accuracy, and authenticity. Assists in monitoring practice site and/or service area for compliance with federal, state, and local laws. Describe durable medical equipment and the selection process DME equipment for customers. Aid in the selection of equipment and the procedures needed to supply them. Total Score

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