Tohono O'odham Nation Health Care (TONHC)
Pharmacy Experiential Rotation
CHIEF OF PHARMACY
LCDR Angela Leiferman; Angela.Leiferman@ihs.gov; Chief Pharmacist, TONHC
EXPERIENTIAL PROGRAM DIRECTOR
Dr. Cornelio Genilo; Cornelio.Genilo@tonation-nsn.gov
PRECEPTORS
SELLS PRECEPTORS:
Dr. Cornelio Genilo; Cornelio.Genilo@tonation-nsn.gov
Dr. Abby Garrety; Abby.Garrety@tonation-nsn.gov
SAN XAVIER PRECEPTORS:
Dr. Matthew Begay-Bruno , Matthew.Begay-Bruno@tonation-nsn.gov
SITE INFORMATION
Tohono O'odham Nation Health Care (TONHC) Sells Hospital is a tribally-run 14-bed Joint Commission-accredited facility providing ambulatory, inpatient services, and emergency room (ER) services for over 24,000 Tohono O’odham people. TONHC Sells Hospital is located off of SR Hwy 86, 60 miles west of Tucson in the Sells District. The average daily inpatient census is five. The facility receives approximately 60,000 outpatient visits and 9,000 emergency visits annually. The hospital provides general medical and primary care in an inpatient and outpatient basis and 24 hour ER services. The hospital is affiliated with three TONHC satellite facilities which are all within 60 miles of the hospital; the San Xavier Health Center, a large outpatient facility on the outskirts of Tucson, the Santa Rosa Clinic, a small outpatient facility located in the very rural setting of the north-central sector of the Tohono O'odham Reservation, and the San Simon Health Center located 30 miles east of Ajo, Arizona.
EXPECTATIONS
Demonstration of knowledge and skills
Professionalism
Communication with staff
Adaptability
Personal initiative
Punctuality
Compliance with local policies
ATTENDANCE
Interns are also expected to report for duty on the first regular business day of their scheduled rotation and remain on duty through the end of the last regular business day of their scheduled rotation (see Rotation Guidelines online for more information about pharmacy hours of operation).
A reasonable amount of travel time to and from Tucson will be made for New Employee Orientation and as needed.
Interns shall normally be on duty four days per week, ten hours per day. However, interns may be scheduled to work five days per week as required by the needs of the program.
The work schedule shall be determined by the preceptor and may be subject to change at any time as required by the needs of the program.
Interns are expected to arrive at work on time and to remain at work until the end of their scheduled shift.
Any specific requests for days off or time off during your rotation for any reason must be submitted to the preceptor for approval at least 30 days prior to the beginning of the rotation. Such requests must be accompanied by sufficient justification to allow for appropriate consideration prior to the request being approved or denied.
Unscheduled absences from work, other than due to illness, must be approved by the preceptor in advance.
COURSE OBJECTIVES
Provide pharmaceutical care to patients seen at Sells Indian Hospital & San Xavier Clinic in accordance with the Indian Health Service Standards of Pharmacy Practice.
1. Assure appropriateness of drug therapy.
2. Verify that patients understand their medications and appropriate outcomes of their drug therapy.
3. Assure availability, preparation, and control of medications.
4. Provide drug information, drug therapy consultation, and staff education relating to drug therapy.
5. Provide health promotion and disease prevention activities relating to drug use and preventive drug therapy.
6. Manage therapy for selected patients for whom medications are the principal method of treatment.
Provide quality pharmaceutical care in clinical, ambulatory, and urgent care settings.
Meet the Indian Health Service Standards of Care by screening patient medical histories via the Electronic Health Record, as well as by monitoring lab values, vital signs, and drug safety and effectiveness.
Demonstrate ability to perform patient interviews and medication counseling.
Demonstrate ability to effectively communicate with patients and providers and provide drug information and recommendations when appropriate.
Provide anticoagulation management services to patients enrolled in the pharmacy-based anticoagulation clinic.
Demonstrate an understanding of inpatient pharmacy services, including, but not limited to, unit dose dispensing, IV admixture, pharmacokinetic and pharmacotherapy monitoring, and reviews of patient health records.
Utilize guidelines and reputable sources in the provision of pharmaceutical care.
Keep abreast of new developments in drug therapy by attending classes, seminars, reading journals, and reviewing the latest drug guidelines.
Knowledgably discuss common disease states among the Tohono O’odham people, including etiologies, monitoring, and pharmacotherapeutic treatment and outcomes.
Gain a greater understanding of a unique people and their culture.
Learn about pharmaceutical care opportunities in the tribal health system, Indian Health Service, and the United States Public Health Service.
REQUIRED ASSIGNMENTS
Interns will be responsible for completing the following; additional projects may be assigned per pharmacy school's requirements:
*All are TBA or based on students' interest
Drug Information Question: Minimum of 1 question response/rotation as asked by preceptors; to be submitted via email using approved format.
Journal Club: To be presented while on rotation (1 journal club/rotation); to be submitted via email using approved format.
Patient Care Case (if requested): One case presentation, which must included a patient care plan. Case presentation will highlight a patient seen in Improving Patient Care (IPC) clinic or from Inpatient. Included must be a minimum of 2 pertinent drug interventions for each patient care case.
Public Health Presentation (if requested): A ten-minute PowerPoint presentation regarding a pertinent public health topic for our patient population, including an overview of the topic, treatment and/or prevention, and any implications for pharmacists and our patient population (i.e.
Rocky Mountain Spotted Fever, antimicrobial resistance). Interns scheduled for an Institutional Rotation may substitute the public health presentation with a topic such as investigational drugs or emergency cardiac care procedures.
Final Presentation: See information provided in folder on first day of rotation. Formal PowerPoint presentation guidelines provided separately; topic to be determined by preceptor.
Additional Assignments: Any additional assignments will be provided to the student in written form along with specific expectations and a due date.
Unless otherwise specified, all assignments must be in typed format, citations, grammar, spelling, and scientific writing style specified by preceptor.
DAILY ACTIVITIES
Interns will have the opportunity to participate in several of the following activities:
Patient counseling
Medication reconciliation
Review of non-formulary medication requests
Review of medication regimens
Inpatient rounds
Preparation of intermittent intravenous medications
Pharmacy specialty clinics
OTHER ACTIVITIES
Interns may have the opportunity to participate in several of the following activities:
Brown bag events
Shadowing providers in Podiatry and other clinics
Field trips and community education presentations with the Public Health Nursing Department
Attendance at various committee meetings (ex. Pharmacy & Therapeutics)
Sample Schedule:
One half-day each shadowing the Lead Pharmacist, Remote Pharmacist and Verify Pharmacist
One half-day shadowing the Inpatient Pharmacist
Two full-days shadowing the Anticoagulation Management Services Pharmacist
One half-day shadowing the pharmacist in Pharmacy Disease State Management clinic
One half-day shadowing the pharmacist in Improving Patient Care clinic
Other opportunities as available.
GRADING
The intern will be graded based on clinical performance, staff education presentations, enthusiasm, professionalism, and attitude.
Formal grading criteria officially established by the respective school of pharmacy shall always take precedence.
Each student will have a midpoint and a final evaluation with a preceptor.
ADMINISTRATIVE TIME
This is made available to students intermittently and in coordination with other interns when not performing patient care duties. Administrative time is to be used for the completion of assigned projects. Effective time management is the intern’s responsibility and failure to complete assignments on time will be reflected in the final course grade. Interns are also expected to utilize their own time as needed to complete assignments.
USEFUL PHONE NUMBERS
Main Pharmacy: (520) 383-7350
Hospital Security: (520) 383-7619
Maintenance Department: (520) 383-7318, (520) 383-7230
Sells Hospital Operator: (520) 383-7200