record of training and experience of ......private hospital pharmacy pharmacy board malaysia 2017 5...
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PRIVATE HOSPITAL PHARMACY
RECORD OF TRAINING AND EXPERIENCE OF
PROVISIONALLY REGISTERED PHARMACIST
(PRP)
PHARMACY BOARD MALAYSIA MINISTRY OF HEALTH MALAYSIA
2017
Private Hospital Pharmacy
2 Pharmacy Board Malaysia 2017
PERSONAL PARTICULARS
[to be completed by the Provisionally Registered Pharmacist (PRP)]
1. Name (in capital letters) :
2. New I/C Number :
3. Provisional Registration Number :
4. Telephone Numbers :
5. Home Address :
6. E-mail Address :
7. Qualification (Degree/ University/ Year) :
8. Scholarship/Sponsor (Federal/MARA/Others):
9. Principal Training Place:
10. Duration of Training: From (date): ………….. to …………
11. Name & Contact Number of person in case of emergency:
I confirm that the above information provided above is true. Signature: Date:
Private Hospital Pharmacy
3 Pharmacy Board Malaysia 2017
1. INTRODUCTION
1. The registration of Pharmacists Act (Amendment) 2003 stipulates that a person who is provisionally registered shall be required to obtain experience immediately upon being provisionally registered, engage in employment as a Provisionally Registered Pharmacist (PRP) to the satisfaction of the Pharmacy Board for a period of not less than one year.
2. The engagement as a PRP must be in any premises listed in the Second Schedule in order to be entitled for full registration.
3. The Pharmacy Board may extend the one-year period of employment of a PRP if the Board is not satisfied with the performance of that person as a PRP.
4. The provisional registration of a person shall be revoked if that person fails to engage in employment as PRP to the satisfaction of the Pharmacy Board for a period of not less than one year in any premises listed in the Second Schedule.
5. All PRPs are required to achieve at least 60% marks for all the sections in the log book and average of at least 60% marks for the personal assessment to be qualified to register as a Fully Registered Pharmacist.
6. All PRPs are also required to pass the Qualifying Examination to Practice Pharmacy conducted by the Pharmacy Board prior to full registration.
Private Hospital Pharmacy
4 Pharmacy Board Malaysia 2017
2. TRAINING MODULES AND RECORD OF TRAINING AND EXPERIENCE OF A PROVISIONALLY
REGISTERED PHARMACIST (PRP)
1. This record book is designed primarily to guide the provisionally registered pharmacists and their preceptors of various pharmacy disciplines in the training hospital/institution in coordinating activities and programmes during the one-year provisional training.
2. The number of cases in this logbook serves as a guideline and is subjected to the capacity of
each hospital/institution.
3. This record book will be the basis for the appraisal by all preceptors, which shall be submitted to the Pharmacy Board for the purpose of registration as a Fully Registered Pharmacist at the end of the training.
4. The preceptor is required to complete the record by filling the following:
i. Endorse the completion of each task with signature, name and date in the column
provided.
ii. Level of performance is based on the following scale:
Scale Rating
Description
9 – 10 Excellent Performance represents an extraordinary level of achievement and commitment in terms of quality and time, technical skills and knowledge, ingenuity, creativity and initiative.
7 – 8 Good Performance exceeded expectation. All goals, objectives and targets were achieved above the established standards.
5 – 6 Satisfactory Performance met expectations in terms of quality of work, efficiency and timeliness.
3 – 4 Unsatisfactory Performance failed to meet expectations and/or one or more of the targets were not met.
1 – 2 Poor Performance was consistently below expectations and/or reasonable progress toward achieving goals was not made. Significant improvement is needed in one or more areas.
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5 Pharmacy Board Malaysia 2017
5. The passing marks for EACH section is 60 %.
6. The final appraisal and Appendix A or Appendix A1 should be completed by the Master
Preceptor at the end of the 12th month of the training period. The original log book with
completed appraisal and Appendix A or Appendix A1 need to be sent to PBM addressed
as below by the preceptor within ONE month from the end date of the PRP training:
Setiausaha Lembaga Farmasi Malaysia Bahagian Perkhidmatan Farmasi Kementerian Kesihatan Malaysia Lot 36, Jalan Universiti
46350 PETALING JAYA
Private Hospital Pharmacy
6 Pharmacy Board Malaysia 2017
Private Hospital Pharmacy
7 Pharmacy Board Malaysia 2017
3. DUTIES AND RESPONSIBILITIES OF A PRECPTOR
1. Type of preceptors
i. Hospital Pharmacy
Preceptor : Registered pharmacist
Master Preceptor : Chief Pharmacist
Criteria of a preceptor: Must have at least 4 years’ experience in hospital/health clinic
and has undergone the Training of Preceptors (TOP) organized by Pharmacy Board of
Malaysia.
2. Responsibilities of a Preceptor
i. Serves as a learning resource for all PRPs. Ensures a PRP receives necessary
training to develop skills and attitude as a competent pharmacist.
ii. Serves as a role model instilling professional values and attitude.
iii. Evaluates PRPs performances during their training.
Note: Training of PRP should abide the Code of Conduct for Pharmacists and Bodies
Corporate and related Malaysian pharmacy legislations.
Private Hospital Pharmacy
8 Pharmacy Board Malaysia 2017
4. DUTIES AND RESPONSIBILITIES OF A PROVISIONALLY REGISTERED PHARMACIST (PRP)
1. Fulfill the requirement of all the training modules in the log book within the stipulated
time frame.
2. Undertake the training modules / programme with positive attitudes and commitments.
3. Acquire knowledge and skills by performing required tasks, observing, reading and
asking questions.
4. Actively participate in professional development programme to keep abreast of current
knowledge.
5. Adhere to the hospital / institution policies and procedures.
6. Training Module:
MODULE Private hospital
(weeks)
Gazetted Hospital
(weeks)
1. Ward Pharmacy 4
2. Outpatient Services 16
3. Inpatient Pharmacy 16
4. Clinical Pharmacokinetics
(optional)
2
5. Parenteral Nutrition (optional) 2
6. Oncology Pharmacy (optional) 2
7. Drug Information 4
8. Manufacturing 2
9. Pharmacy Logistics 4
TOTAL 52
Private Hospital Pharmacy
9 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
(Duration of Attachment: 16 weeks)
Upon completion of training, PRP must be able to:
1. read and comprehend patient’s case notes.
2. discuss with prescriber.
3. recommend pharmacotherapy regimen and monitor patient progress.
4. obtain patient drug history (and allergy) for all new admissions in the designated
ward within 24 hours (preferably) of admission.
5. clerk cases and perform medication reconciliation.
6. participate in ward rounds.
7. perform patient medication counseling.
8. write, discuss and present case reports.
9. identify and report ADR and medication error (if any).
10. document all relevant activities.
Private Hospital Pharmacy
10 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 1: MEDICATION HISTORY TAKING (Min: 5 cases/week)
Medication History Taking should be taken within 24 hours (preferably) of admission WEEK 1
Date Patient’s R/N Allergy Detected Compliance Evaluation Preceptor’s Initial
Private Hospital Pharmacy
11 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 1: MEDICATION HISTORY TAKING (Min: 5 cases/week)
Medication History Taking should be taken within 24 hours (preferably) of admission WEEK 2
Date Patient’s R/N Allergy Detected Compliance Evaluation Preceptor’s Initial
Private Hospital Pharmacy
12 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 1: MEDICATION HISTORY TAKING (Min: 5 cases/week)
Medication History Taking should be taken within 24 hours (preferably) of admission WEEK 3
Date Patient’s R/N Allergy Detected Compliance Evaluation Preceptor’s Initial
Private Hospital Pharmacy
13 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 1: MEDICATION HISTORY TAKING (Min: 5 cases/week)
Medication History Taking should be taken within 24 hours (preferably) of admission WEEK 4
Date Patient’s R/N Allergy Detected Compliance Evaluation Preceptor’s Initial
Private Hospital Pharmacy
14 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 2: CLERKING AND REVIEWING (Min: 5 cases/week)
To assess the ability of the PRP to read, comprehend patient’s case notes and identify Pharmaceutical Care Issues WEEK 1
Date Patient’s R/N Type of PCI(s) identified Intervention
Intervention
Accepted / Not
Accepted
Preceptor’s Initial
Private Hospital Pharmacy
15 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 2: CLERKING AND REVIEWING (Min: 5 cases/week)
To assess the ability of the PRP to read, comprehend patient’s case notes and identify Pharmaceutical Care Issues WEEK 2
Date Patient’s
R/N Type of PCI(s) identified Intervention
Intervention
Accepted / Not
Accepted
Preceptor’s Initial
Private Hospital Pharmacy
16 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 2: CLERKING AND REVIEWING (Min: 5 cases/week)
To assess the ability of the PRP to read, comprehend patient’s case notes and identify Pharmaceutical Care Issues WEEK 3
Date Patient’s R/N Type of PCI(s) identified Intervention
Intervention
Accepted / Not
Accepted
Preceptor’s Initial
Private Hospital Pharmacy
17 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 2: CLERKING AND REVIEWING (Min: 5 cases/week)
To assess the ability of the PRP to read, comprehend patient’s case notes and identify Pharmaceutical Care Issues WEEK 4
Date Patient’s R/N Type of PCI(s) identified Intervention
Intervention
Accepted / Not
Accepted
Preceptor’s Initial
Private Hospital Pharmacy
18 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 3: PATIENT MEDICATION COUNSELING Bedside counseling (Min: 5 cases/week)
WEEK 1
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
19 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 3: PATIENT MEDICATION COUNSELING Bedside counseling (Min: 5 cases/week)
WEEK 2
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
20 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 3: PATIENT MEDICATION COUNSELING Bedside counseling (Min: 5 cases/week)
WEEK 3
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
21 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 3: PATIENT MEDICATION COUNSELING Bedside counseling (Min: 5 cases/week)
WEEK 4
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
22 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 4: WARD ROUND / PHARMACIST ROUND (Min: 3 times/week)
WEEK 1
Date
Name of Consultant/
Doctor/ Pharmacist
Conducting the Ward Round
Number of Cases
Reviewed
Description of Queries Responded
(if any) Preceptor’s Initial
Private Hospital Pharmacy
23 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 4: WARD ROUND / PHARMACIST ROUND (Min: 3 times/week)
WEEK 2
Date
Name of Consultant/
Doctor/ Pharmacist
Conducting the Ward Round
Number of Cases
Reviewed
Description of Queries Responded
(if any) Preceptor’s Initial
Private Hospital Pharmacy
24 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 4: WARD ROUND / PHARMACIST ROUND (Min: 3 times/week)
WEEK 3
Date
Name of Consultant/
Doctor/ Pharmacist
Conducting the Ward Round
Number of Cases
Reviewed
Description of Queries Responded
(if any) Preceptor’s Initial
Private Hospital Pharmacy
25 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 4: WARD ROUND / PHARMACIST ROUND (Min: 3 times/week)
WEEK 4
Date
Name of Consultant/
Doctor/ Pharmacist
Conducting the Ward Round
Number of Cases
Reviewed
Description of Queries Responded
(if any) Preceptor’s Initial
Private Hospital Pharmacy
26 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 5: CASE REPORT (Min: 2 cases)
To assess the ability in clerking case, comprehend patient’s case note, complete case report study with evidence based approach and recommend related pharmaceutical care issues of the patients.
WEEK 1 – WEEK 4
Date Patient’s R/N Topic Summary of Case Report Preceptor’s Initial
Private Hospital Pharmacy
27 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 6: CASE PRESENTATION (Min: 2 cases)
Case presentation should be conducted in the clinical session.
To assess the ability to comprehend case notes, devise therapeutic plan, communication and presentation of case to other healthcare personnel in order to enhance rational drug use
WEEK 1 – WEEK 4
Date Types of Case Presented Summary of Case Presented Preceptor’s Initial
Private Hospital Pharmacy
28 Pharmacy Board Malaysia 2017
MODULE 1: WARD PHARMACY PRACTICE
SECTION 7: ADR AND MEDICATION ERROR REPORT (if any)
To assess the ability to identify ADR and medication error
To perform ADR and medication error report ADR
Date Patient’s R/N Suspected Drug Causing ADR Remarks Preceptor’s Initial
MEDICATION ERROR
Date Patient’s R/N Types of Medication Error Description Preceptor’s Initial
Private Hospital Pharmacy
29 Pharmacy Board Malaysia 2017
ASSESSMENT – WARD PHARMACY PRACTICE
SECTION 8: MANAGEMENT OF WARD PHARMACY PRACTICE
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Able to read and comprehend patient’s
case notes
2. Able to discuss with prescriber.
3. Able to recommend pharmacotherapy
regimen and monitoring of patient
progress.
4. Document all relevant activities
5. Obtain patient drug history (and allergy)
for all new admissions in the designated
ward within 24 hours (preferably) of
admission.
Private Hospital Pharmacy
30 Pharmacy Board Malaysia 2017
ASSESSMENT – WARD PHARMACY PRACTICE
SECTION 9: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Medication History Taking
2. Clerking & Reviewing
3. Patient Medication Counseling
4. Ward Round / Pharmacist Round
5. Case Report
6. Case Presentation
7. ADR & Medication Error Report
Private Hospital Pharmacy
31 Pharmacy Board Malaysia 2017
ASSESSMENT – WARD PHARMACY PRACTICE
SECTION 10: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 120 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
32 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
(Duration of Attachment: 16 weeks)
To familiarize with the generic names, proprietary names, pharmacological groupings and Hospital Formularies. The activities in this department include:
Screening
Labeling and filling
Counterchecking and dispensing
Medication counselling
Handling of Dangerous Drugs & psychotropic
Extemporaneous preparation SCREENING Screening and verifying of prescriptions for the following
Validity of the prescription
Dosage regimen
Polypharmacy
Drug interactions
Contraindications
Incompatibilities The screening of a prescription must be performed at any point of processing a prescription Able to contact prescriber to discuss errors or ambiguous prescriptions LABELING AND FILLING Ensure correct medication are filled according to label and prescription COUNTERCHECKING OF MEDICATION / PRESCRIPTIONS Final checking of medications prepared against prescription record any near-miss errors detected DISPENSING OF MEDICATION / PRESCRIPTIONS
Abide to the principles of 5 Rights on Quality Use of Medicines - Right patient - Right medication - Right dose - Right time - Right route of administration
Practice good communication skills and counter service
Private Hospital Pharmacy
33 Pharmacy Board Malaysia 2017
Adhere to the Guide to Good Dispensing Practice (GDsP)
Document all relevant data and statistics PATIENT MEDICATION COUNSELING
Able to advise/counsel on: - Patient drug regimen/therapy - Indications - Storage conditions - Precautions - Side effects - Food / drug interactions - Compliance and missed doses - Use of devices (e.g inhalers, insulin pen, interferon pen)
Document all patient medication counseling accordingly Note: PRP must undergo the counseling validation/ evaluation before performing actual activity. HANDLING OF DANGEROUS DRUGS / PSYCHOTROPIC SUBTANCES
Handle dangerous drugs and psychotropic substances in accordance to the respective legislations: - Dangerous Drugs Act 1952 - Poison Act 1952 - Poison (Psychotropic Substances) Regulations 1989
Private Hospital Pharmacy
34 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 1
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
35 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 2
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
36 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 3
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
37 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 4
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
38 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 5
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
39 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 6
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
40 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 7
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
41 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 8
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
42 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 9
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
43 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 10
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
44 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 11
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
45 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 12
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
46 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 13
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
47 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 14
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
48 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 15
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
49 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (At least 20 prescriptions screened must be counterchecked by the preceptor)
WEEK 16
Date
Type of Interventions Point of Screening
(Receiving/ Filling/
Dispensing)
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
50 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 prescriptions filling process must be assessed by the preceptor)
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
51 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 3: DISPENSING (Minimum 4 hours/day)
Date Number of Prescriptions Dispensed (minimum 4 hours/day) Preceptor’s Initial
Private Hospital Pharmacy
52 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 3: DISPENSING (Minimum 4 hours/day)
Date Number of Prescriptions Dispensed (minimum 4 hours/day) Preceptor’s Initial
Private Hospital Pharmacy
53 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 1
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
54 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 2
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
55 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 3
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
56 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 4
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
57 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 5
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
58 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 6
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
59 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 7
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
60 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 8
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
61 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 9
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
62 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 10
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
63 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 11
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
64 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 12
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
65 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 13
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
66 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 14
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
67 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 15
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
68 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING (Minimum 3 patients/week)
WEEK 16
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications 2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
69 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 5: HANDLING OF DANGEROUS DRUGS AND PSYCHOTROPIC SUBSTANCES
Week Date
Dangerous Drugs and Psychotropic Substances
Number of Prescriptions Dispensed & Recorded (minimum 5 prescriptions/week) Preceptor’s
Initial
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Private Hospital Pharmacy
70 Pharmacy Board Malaysia 2017
MODULE 2: OUT-PATIENT PHARMACY SERVICES
SECTION 6: PREPARING EXTEMPORANEOUS MEDICATIONS (Minimum 10 preparations)
Ability to understand formulation and calculate the appropriate quantities required
Date Batch Number Name of Preparation Remarks Preceptor’s Initial
Private Hospital Pharmacy
71 Pharmacy Board Malaysia 2017
ASSESSMENT – OUT-PATIENT PHARMACY SERVICES
SECTION 7: MANAGEMENT OF OUT-PATIENT PHARMACY
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Familiarity with generic names,
proprietary names, pharmacological
groupings, Ministry of Health / Hospital
Formularies
2. Guide to Good Dispensing Practice.
Private Hospital Pharmacy
72 Pharmacy Board Malaysia 2017
ASSESSMENT – OUT-PATIENT PHARMACY SERVICES
SECTION 8: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Screening
2. Labelling and Filling Medications
3. Counterchecking and Dispensing
4. Patient Medication Counseling
5. Handling of Dangerous Drugs &
Psychotropic Substances
6. Preparing Extemporaneous Medications
Private Hospital Pharmacy
73 Pharmacy Board Malaysia 2017
ASSESSMENT – OUT-PATIENT PHARMACY SERVICES
SECTION 9: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 80 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
74 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
(Duration of Attachment: 16 weeks)
The activities in this department include:
Screening
Labelling and Filling
Counterchecking and Supply
Patient Medication Counseling
Handling of Dangerous Drugs & Psychotropic Substances
Ward Medications Inspections
Management of In-Patient Pharmacy SCREENING
Screening and verifying of prescriptions for the following - validity of the prescription - dosage regimen - polypharmacy - drug interactions - contraindications - incompatibilities etc
Review medication profile
The screening of a prescription must be performed at any point of processing a prescription
Ability to contact prescriber to discuss errors or ambiguous prescriptions. LABELLING AND FILLING
Ensure correct medication are filled according to label and prescription COUNTERCHECKING OF MEDICATION / PRESCRIPTIONS
Final checking of medications prepared against prescription
Record any near-miss errors detected
SUPPLY OF MEDICATIONS TO THE WARDS
Understand the ward supply system (UOU, UD, ward stock, emergency trolley)
Private Hospital Pharmacy
75 Pharmacy Board Malaysia 2017
Abide to the principle of 5 Rights on Quality Use of Medicine - Right patient - Right medication - Right dose - Right route of administration - Right time
Document all relevant data and statistics. PATIENT MEDICATION COUNSELING
Able to advise/ counsel on: - patient drug regimen/ therapy - indications - storage conditions - precautions - side effects - food / drug interactions - compliance and missed doses - use of devices (e.g. inhalers, insulin pens, interferon pens)
Discharge and bedside dispensing and counseling.
Document all patient medication counseling accordingly. Note: PRP must undergo the counseling validation /evaluation before performing actual activity HANDLING OF DANGEROUS DRUGS / PSYCHOTROPIC SUBSTANCES
Handle dangerous drugs and psychotropic substances in accordance to the respective legislations: - Dangerous Drugs Act 1952 - Poisons Act 1952 - Poisons (Psychotropic Substances) Regulations 1989
WARD MEDICATIONS INSPECTION
Stock handling
storage requirements
Records
Private Hospital Pharmacy
76 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 1
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
77 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 2
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
78 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 3
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
79 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 4
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
80 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 5
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
81 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 6
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
82 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 7
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
83 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 8
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
84 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 9
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
85 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 10
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
86 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 11
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
87 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 12
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
88 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 13
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
89 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 14
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
90 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 15
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
91 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 1: SCREENING (Minimum 30 prescriptions/day)
WEEK 16
Date
Total
number of
profiles
reviewed
Type of Interventions
Description of
Intervention(s)*
Preceptor’s
Initial Incomplete
Prescriptions
Inappropriate
Regimens
Inappropriate
Prescriptions Others
*1. Incomplete Prescriptions - a. Frequency b. Duration c. Signature & Stamp d. Countersignature
2. Inappropriate Regimens - a. Medicine b. Duration c. Dose d. Frequency 3. Inappropriate Prescriptions - a. Spelling b. Wrong Identification c. Polypharmacy d. Interaction
e. Contraindication 4. Others - a. Not in the hospital drug formulary b. Authenticity c. Illegibility
Private Hospital Pharmacy
92 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 1
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
93 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 2
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
94 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 3
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
95 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 4
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
96 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 5
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
97 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 6
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
98 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 7
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
99 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 8
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
100 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 9
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
101 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 10
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
102 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 11
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
103 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 12
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
104 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 13
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
105 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 14
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
106 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 15
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
107 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 2: LABELLING AND FILLING OF PRESCRIPTIONS (At least 5 complete filling process must be assessed by the preceptor)
WEEK 16
Date Patient’s R/N Number of Items in Prescriptions Remarks Preceptor’s Initial
Private Hospital Pharmacy
108 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 1
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
109 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 2
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
110 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 3
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
111 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 4
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
112 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 5
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
113 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 6
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
114 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 7
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
115 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 8
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
116 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 9
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
117 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 10
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
118 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 11
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
119 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 12
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
120 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 13
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
121 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 14
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
122 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 15
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
123 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 3: COUNTERCHECKING AND/OR SUPPLY OF PRESCRIPTIONS / INDENT ORDERS (Minimum 30 items or prescriptions per day)
WEEK 16
Date Items / Prescriptions Supplied Number of Prescriptions
Wrongly Filled Description of Error Preceptor’s Initial
Private Hospital Pharmacy
124 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 1
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
125 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 2
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
126 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 3
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
127 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 4
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
128 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 5
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
129 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 6
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
130 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 7
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
131 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 8
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
132 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 9
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
133 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 10
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
134 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 11
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
135 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 12
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
136 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 13
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
137 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 14
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
138 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 15
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
139 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 4: PATIENT MEDICATION COUNSELING Bedside Dispensing and Discharge Counseling (Minimum 5 patients/week)
WEEK 16
Date Patient’s R/N *Type of Counseling Description of Counseling Preceptor’s Initial
* 1. Device (e.g insulin pen, inhaler, nasal spray) 3. Medications
2. Disease 4. Others (radiopharmaceutical, chemotherapy, smoking cessation)
Note: PRP must undergo the counseling validation / evaluation before performing actual activity
Private Hospital Pharmacy
140 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 5: WARD MEDICATION INSPECTIONS (Minimum 4 wards or unit inspections)
Date Ward / Unit Preceptor’s Initial Comments
Note: Ward inspections report must be completed and submitted within a week post inspections
Private Hospital Pharmacy
141 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 5: WARD MEDICATION INSPECTIONS (Minimum 4 wards or unit inspections)
Date Ward / Unit Preceptor’s Initial Comments
Note: Ward inspections report must be completed and submitted within a week post inspections
Private Hospital Pharmacy
142 Pharmacy Board Malaysia 2017
MODULE 3: IN-PATIENT PHARMACY SERVICES
SECTION 6: HANDLING OF DANGEROUS DRUGS AND PSYCHOTROPIC SUBSTANCES
Week Date
Dangerous Drugs and Psychotropic Substances
Number of Indents Supplied (minimum 5 indents/week) Preceptor’s
Initial
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Private Hospital Pharmacy
143 Pharmacy Board Malaysia 2017
ASSESSMENT – IN-PATIENT PHARMACY SERVICES
SECTION 7: MANAGEMENT OF IN-PATIENT PHARMACY
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Familiarity with generic names,
proprietary names, pharmacological
groupings, Ministry of Health / Hospital
Formularies
2. Checking of stocks (slow moving item/
near expiry item), indenting of stocks and
procedures
3. Document all relevant activities
4. Understand ward supply system
Private Hospital Pharmacy
144 Pharmacy Board Malaysia 2017
ASSESSMENT – IN-PATIENT PHARMACY SERVICES
SECTION 8: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Screening
2. Labelling and Filling Medications
3. Counterchecking of Prescriptions /
Indent Orders
4. Patient Medication Counseling
5. Ward Medication Inspections
6. Handling of Dangerous Drugs &
Psychotropic Substances
Private Hospital Pharmacy
145 Pharmacy Board Malaysia 2017
ASSESSMENT – IN-PATIENT PHARMACY SERVICES
SECTION 9: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 100 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
146 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES (OPTIONAL)
(Duration of Attachment: 2 weeks)
Upon completion of training, PRP must:
1. have knowledge of blood sampling time, evaluation of patient parameters, analysis of serum drug concentration, calculations of dosage estimation, result interpretation and make recommendations.
2. be able to read and comprehend patient case notes.
3. be able to assess patient suitability for therapeutic drug monitoring.
4. be able to discuss with preceptor.
5. be able to monitor patient progress in the ward.
Private Hospital Pharmacy
147 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 1: ANALYSIS OF SERUM DRUG CONCENTRATION (OPTIONAL)
Types of Drugs
(where applicable)
Aminoglycosides
and Vancomycin
Antiepileptics
and
Theophylline
Digoxin Tacrolimus Cyclosporin Methotrexate Others
Target
(min) 2 cases / week 2 cases / week 1 case /
week 1 case /
week 1 case / week 1 case / week 1 case / week
WEEK 1
Date Patient’s R/N Drug Status of PRP
(Observer / Assistant / Performer) Preceptor’s Initial
Private Hospital Pharmacy
148 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 1: ANALYSIS OF SERUM DRUG CONCENTRATION (OPTIONAL)
Types of Drugs
(where applicable)
Aminoglycosides
and Vancomycin
Antiepileptics
and
Theophylline
Digoxin Tacrolimus Cyclosporin Methotrexate Others
Target
(min) 2 cases / week 2 cases / week 1 case /
week 1 case /
week 1 case / week 1 case / week 1 case / week
WEEK 2
Date Patient’s R/N Drug Status of PRP
(Observer / Assistant / Performer) Preceptor’s Initial
Private Hospital Pharmacy
149 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 2: CALCULATION OF DOSAGE(S), RESULTS INTERPRETATION AND RECOMMENDATIONS
All calculations must be counterchecked
At least 5 recommendations must be assessed by a senior pharmacist
Types of Drugs
(where applicable)
Aminoglycosides
and Vancomycin
Antiepileptics
and
Theophylline
Digoxin Tacrolimus Cyclosporin Methotrexate Others
Target
(min) 2 cases / week 2 cases / week 1 case /
week 1 case /
week 1 case / week 1 case / week 1 case / week
WEEK 1
Date Patient’s R/N Drug Preceptor’s Initial Comments
Private Hospital Pharmacy
150 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 2: CALCULATION OF DOSAGE(S), RESULTS INTERPRETATION AND RECOMMENDATIONS
All calculations must be counterchecked
At least 5 recommendations must be assessed by a senior pharmacist
Types of Drugs
(where applicable)
Aminoglycosides
and Vancomycin
Antiepileptics
and
Theophylline
Digoxin Tacrolimus Cyclosporin Methotrexate Others
Target
(min) 2 cases / week 2 cases / week 1 case /
week 1 case /
week 1 case / week 1 case / week 1 case / week
WEEK 2
Date Patient’s R/N Drug Preceptor’s Initial Comments
Private Hospital Pharmacy
151 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 3: CASE CLERKING (minimum 3 cases/week) WEEK 1
Date Patient’s R/N Number of PCI(s) Identified Number of Interventions Preceptor’s Initial
Private Hospital Pharmacy
152 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 3: CASE CLERKING (minimum 3 cases/week) WEEK 2
Date Patient’s R/N Number of PCI(s) Identified Number of Interventions Preceptor’s Initial
Private Hospital Pharmacy
153 Pharmacy Board Malaysia 2017
MODULE 4: CLINICAL PHARMACOKINETIC SERVICES
SECTION 4: CASE PRESENTATION (1 case)
Date Patient’s
R/N Ward/ Unit Name of Drug(s) Diagnosis and Description of Case Preceptor’s Initial
Private Hospital Pharmacy
154 Pharmacy Board Malaysia 2017
ASSESSMENT – CLINICAL PHARMACOKINETIC SERVICES
SECTION 5: MANAGEMENT OF CLINICAL PHARMACOKINETIC SERVICES
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Drugs with narrow therapeutic index
2. Evaluation of patient parameters
3. Clinical waste disposal (theory)
4. Procedures on blood sampling
5. Procedures of informing the results to
the prescribers
Private Hospital Pharmacy
155 Pharmacy Board Malaysia 2017
ASSESSMENT – CLINICAL PHARMACOKINETIC SERVICES
SECTION 6: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Analysis of Drug Serum Concentration
(optional)
2. Calculation of Dosage(s), Results
Interpretation and Recommendations
3. Case Clerking
4. Case Presentation
Private Hospital Pharmacy
156 Pharmacy Board Malaysia 2017
ASSESSMENT – CLINICAL PHARMACOKINETIC SERVICES
SECTION 7: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 90 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
157 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS
ADDITIVE SERVICES (OPTIONAL)
(Duration of Attachment: 2 weeks)
Upon completion of training, PRP must:
1. have knowledge of aseptic technique.
2. be able to read and comprehend patient’s case notes.
3. be able to discuss with preceptor.
4. be able to calculate and prepare worksheet.
5. be able to compound preparations.
6. be able to monitor patient progress.
7. be able to present case.
Private Hospital Pharmacy
158 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS
ADDITIVE SERVICES
BRIEFING CHECKLIST
No. Date Title Briefing *
Yes No
1. Principles of laminar flow cabinet and clean room design
2. Maintenance of laminar flow cabinet and clean room
Cleaning of laminar flow cabinet and clean room
Quality Assurance Test
3. Principles of aseptic techniques
Hand Washing
Gowning
Gloving
Removing Protective Clothing
Withdrawing of solution from ampoule
Adding diluent to an ampoule containing powder
form
Adding of solution from ampoule to infusion bag
Adding diluent to the vial containing powder
form
Withdrawing solution from vial
Transferring solution from bag/ bottle to syringe
Transferring solution from vial to bag
Transferring solution from ampoule to vial
Private Hospital Pharmacy
159 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 1: ABILITY TO ASSISST IN ASSESSING PATIENT SUITABILITY FOR PARENTERAL NUTRITION REQUEST (Minimum 3 adult cases & 3 pediatric cases) WEEK 1
Date Patient’s R/N Number of Interventions *Type of Interventions Preceptor’s Initial
*1. Incomplete Prescriptions 2. Inappropriate Regimens 3. Inappropriate Prescriptions 4. Others
Private Hospital Pharmacy
160 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 1: ABILITY TO ASSISST IN ASSESSING PATIENT SUITABILITY FOR PARENTERAL NUTRITION REQUEST (Minimum 3 adult cases & 3 pediatric cases) WEEK 2
Date Patient’s R/N Number of Interventions *Type of Interventions Preceptor’s Initial
*1. Incomplete Prescriptions 2. Inappropriate Regimens 3. Inappropriate Prescriptions 4. Others
Private Hospital Pharmacy
161 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 2: CALCULATION / WORKSHEET (Minimum 5 cases) WEEK 1
Date Patient’s R/N Type of cases (e.g colorectal,
renal, post-surgery) Description of Case Preceptor’s Initial
Private Hospital Pharmacy
162 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 2: CALCULATION / WORKSHEET (Minimum 5 cases) WEEK 2
Date Patient’s R/N Type of cases (e.g colorectal,
renal, post-surgery) Description of Case Preceptor’s Initial
Private Hospital Pharmacy
163 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 3: COMPOUNDING OF PREPARATIONS (Minimum 5 cases) WEEK 1 – WEEK 2
Date Patient’s
R/N
Number of Preparations Preceptor’s
Initial Adult Pediatric IV Additive
Private Hospital Pharmacy
164 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 4: PATIENT MONITORING (Minimum 5 cases) WEEK 1
Date Patient’s R/N Monitoring (e.g BUSE/ Calorie &
Fluid Requirements etc) Description of Case Preceptor’s Initial
Private Hospital Pharmacy
165 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 4: PATIENT MONITORING (Minimum 5 cases) WEEK 2
Date Patient’s R/N Monitoring (e.g BUSE/ Calorie &
Fluid Requirements etc) Description of Case Preceptor’s Initial
Private Hospital Pharmacy
166 Pharmacy Board Malaysia 2017
MODULE 5: PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 5: CASE PRESENTATION (1 case)
Date Patient’s
R/N
Ward/
Unit Regime Diagnosis and Description of Case Preceptor’s Initial
Private Hospital Pharmacy
167 Pharmacy Board Malaysia 2017
ASSESSMENT – PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 6: MANAGEMENT OF PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Principles of laminar flow cabinet and
clean room design.
2. Principles of aseptic technique.
3. Maintenance of laminar flow cabinet and
clean room
Cleaning of laminar flow cabinet
and clean room
Quality assurance
Private Hospital Pharmacy
168 Pharmacy Board Malaysia 2017
ASSESSMENT - PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 7: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Ability to assist in assessing the patient
suitability for parenteral nutrition
request
2. Calculation and Worksheet Preparation
3. Compounding
4. Patient Progress Monitoring / Counseling
5.
Case Presentation
Private Hospital Pharmacy
169 Pharmacy Board Malaysia 2017
ASSESSMENT - PARENTERAL NUTRITION / INTRAVENOUS ADDITIVE SERVICES
SECTION 8: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 80 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
170 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES (OPTIONAL)
(Duration of Attachment: 2 weeks)
1. Knowledge of aseptic technique, cytotoxic spill procedures, safe handling of cytotoxic drugs, disposal / incineration of cytotoxic waste
2. Able to read and comprehend patient’s case notes
3. Discuss with preceptor
4. Calculation and worksheet preparations
5. Reconstitution
6. Patient progress monitoring and counseling
Private Hospital Pharmacy
171 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
BRIEFING CHECKLIST
No. Date Title Briefing*
Yes No
1. Principles of cytotoxic cabinet and clean room design
2. Maintenance of cytotoxic cabinet and clean room
Cleaning of cytotoxic cabinet and clean room
Quality Assurance
3. Principles of aseptic techniques
Hand Washing
Gowning
Gloving
Removing Protective Clothing
Withdrawal of cytotoxic drug solution from
ampoule
Adding diluent to an ampoule containing cytotoxic
drug in powder form
Adding of drug solution from ampoule to infusion
bottle
Adding diluent to the vial containing cytotoxic drug
in powder form
Withdrawing drug solution from vial
Transferring solution from bag/ bottle to syringe
Transferring solution from vial to bag/ bottle
Transferring solution from ampoule to vial
4. Safety issues related to cytotoxic drugs
Personnel Protective Equipment (PPE)
Disposal of Cytotoxic Waste
Spill Management
Health Monitoring
Transportation
Private Hospital Pharmacy
172 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
No. Date Title Briefing*
Yes No
Storage
Extravasation
Common side effects
5. Management of extravasations
Private Hospital Pharmacy
173 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
SECTION 1: ABILITY TO ASSISST IN ASSESSING PATIENT SUITABILITY FOR CHEMOTHERAPY AND ADJUCT REGIME (Minimum 5 cases) WEEK 1
Date Patient’s R/N Number of Interventions *Type of Interventions Preceptor’s Initial
*1. Incomplete Prescriptions 2. Inappropriate Regimens 3. Inappropriate Prescriptions 4. Others
Private Hospital Pharmacy
174 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
SECTION 1: ABILITY TO ASSISST IN ASSESSING PATIENT SUITABILITY FOR CHEMOTHERAPY AND ADJUCT REGIME (Minimum 5 cases) WEEK 2
Date Patient’s R/N Number of Interventions *Type of Interventions Preceptor’s Initial
*1. Incomplete Prescriptions 2. Inappropriate Regimens 3. Inappropriate Prescriptions 4. Others
Private Hospital Pharmacy
175 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
SECTION 2: CALCULATION AND WORKSHEET (Minimum 5 cases)
WEEK 1 – WEEK 2
Date Patient’s R/N Name of Cytotoxic Drug Preceptor’s Initial Comments
Private Hospital Pharmacy
176 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
SECTION 3: RECONSTITUTION (Minimum 5 preparations)
WEEK 1 – WEEK 2
Date Patient’s R/N Number of Preparations Name of Cytotoxic Drugs Preceptor’s Initial
Private Hospital Pharmacy
177 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
SECTION 4: PATIENT MONITORING / PATIENT MEDICATION COUNSELING (Minimum 5 cases) WEEK 1 – WEEK 2
Date Patient’s R/N Regimen Counseling Preceptor’s Initial
Private Hospital Pharmacy
178 Pharmacy Board Malaysia 2017
MODULE 6: ONCOLOGY PHARMACY SERVICES
SECTION 5: CASE PRESENTATION (1 case)
Date Patient’s
R/N Ward/ Unit Regime Diagnosis and Description of Case Preceptor’s Initial
Private Hospital Pharmacy
179 Pharmacy Board Malaysia 2017
ASSESSMENT - ONCOLOGY PHARMACY SERVICES
SECTION 6: MANAGEMENT OF ONCOLOGY PHARMACY SERVICES
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Principles of cytotoxic cabinet and clean
room design.
2. Principles of aseptic technique
3. Maintenance of cytotoxic cabinet and
clean room
Cleaning of cytotoxic cabinet and
clean room
Quality assurance
4. Safe Handling of cytotoxic drugs and
Personnel Protective Equipment (PPE)
Disposal of cytotoxic waste
Spill management
Health monitoring
Transportation
Storage
5. Management of extravasation
Private Hospital Pharmacy
180 Pharmacy Board Malaysia 2017
ASSESSMENT - ONCOLOGY PHARMACY SERVICES
SECTION 7: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Ability to assist in assessing the patient
suitability for chemotherapy and adjunct
regime
2. Calculation and Worksheet Preparation
3. Reconstitution
4. Patient Monitoring / Counseling
5.
Case Presentation
Private Hospital Pharmacy
181 Pharmacy Board Malaysia 2017
ASSESSMENT - ONCOLOGY PHARMACY SERVICES
SECTION 8: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 100 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
182 Pharmacy Board Malaysia 2017
MODULE 7: DRUG INFORMATION SERVICES
(Duration of Attachment: 4 weeks)
The activities in this department include:
1. Gather evidence based information and respond the requestor.
2. Document enquiries and information given.
3. Participate / assist in medicines evaluation for hospital formulary development and maintenance.
4. Participate in preparation of bulletin or newsletter. 5. Identify the different resources in drug information.
6. Participate in CPE and consumer education
7. Conduct a short study/project
Private Hospital Pharmacy
183 Pharmacy Board Malaysia 2017
MODULE 7: DRUG INFORMATION SERVICES
SECTION 1: RECEIVE, ANSWER AND DOCUMENT ENQUIRIES (Minimum 10/week) WEEK 1
Date Description of Enquiries Preceptor’s Initial
Private Hospital Pharmacy
184 Pharmacy Board Malaysia 2017
MODULE 7: DRUG INFORMATION SERVICES
SECTION 1: RECEIVE, ANSWER AND DOCUMENT ENQUIRIES (Minimum 10/week) WEEK 2
Date Description of Enquiries Preceptor’s Initial
Private Hospital Pharmacy
185 Pharmacy Board Malaysia 2017
MODULE 7: DRUG INFORMATION SERVICES
SECTION 1: RECEIVE, ANSWER AND DOCUMENT ENQUIRIES (Minimum 10/week) WEEK 3
Date Description of Enquiries Preceptor’s Initial
Private Hospital Pharmacy
186 Pharmacy Board Malaysia 2017
MODULE 7: DRUG INFORMATION SERVICES
SECTION 1: RECEIVE, ANSWER AND DOCUMENT ENQUIRIES (Minimum 10/week) WEEK 4
Date Description of Enquiries Preceptor’s Initial
Private Hospital Pharmacy
187 Pharmacy Board Malaysia 2017
MODULE 7: DRUG INFORMATION SERVICES
SECTION 2: EDUCATIONAL ACTIVITIES WEEK 1 – WEEK 4
Date
Investigate and
Compile ADR /
Medication Error
(if any)
CPE Presentation
/ Activity
(minimum 1 case)
Clinical Paper
Appraisal
(minimum 1 case)
Short Study /
Project
(minimum 1)
Bulletin /
Newsletter
(optional)
Preceptor’s
Initial
Private Hospital Pharmacy
188 Pharmacy Board Malaysia 2017
ASSESSMENT – DRUG INFORMATION SERVICES
SECTION 3: MANAGEMENT OF DRUG INFORMATION SERVICES
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Retrieve, analyze and deliver the
information required in a skillful,
efficient and evidence – based manner to
meet the needs of the requestor.
2. Document enquiries and information
given in a clear and systematic manner.
3. Formulary development, evaluation and
maintenance, and ability to provide
support in Pharmacy & Hospital Drug
Committee agendas.
4. Sources of information such as journals,
bibliographic databases and books, for
acquisition, retrieval and maintenance
purposes.
5. Ability to compile appropriate data and
produce reports on the service.
Private Hospital Pharmacy
189 Pharmacy Board Malaysia 2017
ASSESSMENT – DRUG INFORMATION SERVICES
SECTION 4: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. ADR and Medication Error (if any)
2. CPE Presentation / Activity
3. Paper Appraisal
4. Short Study / Project
5.
Bulletin / Newsletter (optional)
Private Hospital Pharmacy
190 Pharmacy Board Malaysia 2017
ASSESSMENT – DRUG INFORMATION SERVICES
SECTION 5: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 100 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
191 Pharmacy Board Malaysia 2017
MODULE 8: MANUFACTURING AND REPACKING
(Duration of Attachment: 2 weeks)
1. Perform raw materials checking, recording, storage and release.
2. Calculate formula for galenical preparations, use of appropriate diluents and correct labeling.
3. Adhere to master formula, production record, prepare worksheet, compound using appropriate equipment, perform final visual inspection.
4. Adhere to Good Preparation Practice (GPP) and Good Distribution Practice (GDP)
guideline. 5. Abide to quality processes in repacking of bulk products (galenical and tablets).
Private Hospital Pharmacy
192 Pharmacy Board Malaysia 2017
MODULE 8: MANUFACTURING AND REPACKING
SECTION 1: PREPARATION & COUNTER-CHECKING OF JOB SHEET FOR GALENICALS / REPACKING GALENICAL PREPARATIONS (minimum 5 products)
Date Name of Preparation Batch Number Remarks Preceptor’s Initial
Private Hospital Pharmacy
193 Pharmacy Board Malaysia 2017
MODULE 8: MANUFACTURING AND REPACKING
SECTION 1: PREPARATION & COUNTER-CHECKING OF JOB SHEET FOR GALENICALS / REPACKING REPACKING PREPARATIONS (minimum 5 products)
Date Name of Preparation Batch Number Remarks Preceptor’s Initial
Private Hospital Pharmacy
194 Pharmacy Board Malaysia 2017
ASSESSMENT – MANUFACTURING AND REPACKING
SECTION 2: MANAGEMENT OF MANUFACTURING AND REPACKING
No. Knowledge Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Procedure in raw material checking,
recording storage and release.
2. Knowledge of master formula,
production record contents,
manufacturing technique, equipment
maintenance, shelf samples and
products release procedures.
3. Knowledge on in-process Quality Control
(QC), GMP, GSP and statistic.
4. Knowledge of calculation for
extemporaneous preparations,
compatibility, stability and labeling.
Private Hospital Pharmacy
195 Pharmacy Board Malaysia 2017
ASSESSMENT – MANUFACTURING AND REPACKING
SECTION 3: COMPETENT ASSESSMENT
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Preparation and counter-checking of job
sheet for galenicals / repacking.
2. Management of manufacturing and
repacking.
Private Hospital Pharmacy
196 Pharmacy Board Malaysia 2017
ASSESSMENT – MANUFACTURING AND REPACKING
SECTION 4: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 60 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
197 Pharmacy Board Malaysia 2017
MODULE 9: PHARMACY STORE MANAGEMENT
(Duration of Attachment: 4 weeks)
SECTION 1: STORE MANGEMENT
1. Understand the principles of store management, organization structure, stock movement and control, cleanliness & sanitation and security.
2. Knowledge of the store KPI and statistics.
SECTION 2: PROCUREMENT AND DISTRIBUTION
Understand the procurement processes and monitoring of vendor performances:
Procurement planning
Budget management
Procurement system – eSPKB (SISTEM Perancangan Kewangan Belanjawan) and ePerolehan
Ordering process
Quotation process
Receiving and distributing of stocks
Penalty management
Data and statistical compilation and analysis for preparation of Drug Committee Meeting
SECTION 3: STORAGE
Understand the storage requirements according to Good Distribution Practice (GDP).
SECTION 4: INVENTORY CONTROL
Knowledge and understanding of drug usage patterns, identification of slow and non-moving stocks, maximum and minimum levels, expiry date monitoring, stock counting/stock checking and stock verification.
SECTION 5: DISPOSAL/WRITE-OFF
Knowledge of disposal/ write-off of stocks and its procedures and documentation.
Private Hospital Pharmacy
198 Pharmacy Board Malaysia 2017
SECTION 6: PRODUCT COMPLAINT
Knowledge on handling of product complaints and reporting procedures.
SECTION 7: PRODUCT RECALL
Knowledge of product recall and reporting procedures.
SECTION 8: DANGEROUS DRUGS AND PSYCHOTROPIC SUBSTANCES
Knowledge of dangerous drugs and psychotropic substances distribution and disposal in accordance to the respective legislations:
Dangerous Drugs Act 1952 & its Regulations
Poison Act 1952 & its Regulations
Poison (Psychotropic Substances) Regulations 1989
Private Hospital Pharmacy
199 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 1: STORE MANAGEMENT Knowledge and understanding of the principles of store management organization structure, inventory, stock movement and control, cleanliness and security.
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Understand the principles of store
management, organization structure,
inventory, stock movement and control,
cleanliness & sanitation and security.
2. Knowledge of the store KPI and statistics
Private Hospital Pharmacy
200 Pharmacy Board Malaysia 2017
ASSESSMENT - PHARMACY STORE MANAGEMENT
SECTION 2: PROCUREMENT AND DISTRIBUTION Knowledge of ordering process and monitoring of vendor performances
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Understand the ordering processes and
monitoring of vendor performances:
Financial management
Ordering processes
Receipt of goods and distribution
Private Hospital Pharmacy
201 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 3: STORAGE Knowledge of storage in accordance to Good Storage Practice
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Good Storage
2. Cold Chain Management
Private Hospital Pharmacy
202 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 4: INVENTORY CONTROL
Knowledge and understanding of drug usage patterns, identification of slow and non-moving stocks, maximum and minimum stock
levels, cost accounting, and expiry date monitoring
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. DRUG USAGE PATTERN Able to retrieve, print and analyze reports
2. SLOW/ NON- MOVING STOCK Able to retrieve, print and analyze reports
3. ITEM BELOW / ABOVE BUFFER LEVEL Able to retrieve, print and analyze reports
4. ITEM NEAR EXPIRY Ability in managing item near expiry
5. VOTE BOOK Able to do entry of transaction
6. STOCK CHECK/ PHYSICAL CHECK/ STOCK VERIFICATION Shall be done yearly
7. SEGREGATION OF NON- CONFORMANCE PRODUCTS
Private Hospital Pharmacy
203 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 5: DISPOSAL
Knowledge of disposal procedures and documentation
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. DISPOSAL PROCESS
Able to understand the workflow
2. FORMS USED FOR DISPOSAL
Able to name the form
3. LIST OF EXPIRED ITEMS
Able to extract list from HIS system
4. LEMBAGA PEMERIKSA
Able to identify committee
5. DISPOSAL AREA
Able to locate area identified
Private Hospital Pharmacy
204 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 6: PRODUCT COMPLAINTS Knowledge of handling of product complaints and reporting procedures
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. PROCESS
Able to understand and explain workflow
2. RETRIEVAL OF DATA
Able to check with the system of batches
3. RETRIEVAL OF PRODUCT
Replace/Return product from/to user/
supplier.
4. DOCUMENTATION
Document, report to respective authority
and file complaint
Private Hospital Pharmacy
205 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 7: PRODUCT RECALL Knowledge of handling of product recall and reporting procedures
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. PROCESS
Able to understand and explain workflow
2. RETRIEVAL OF DATA
Able to check with the system of
batches/location involved
3. RETRIEVAL OF PRODUCT
Able to recall product from location
identified.
4. REPLACEMENT OF PRODUCT
Return and replace product to/from
supplier/user
5. DOCUMENTATION
Document and File recall
Private Hospital Pharmacy
206 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 8: DANGEROUS DRUGS / PSYCHOTROPIC SUBSTANCES MANAGEMENT Knowledge of dangerous drugs and psychotropic substances distribution and disposal in accordance to the respective legislations.
No. Task Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. DANGEROUS DRUGS ACT 1952, POISON
(PSYCHOTROPIC SUBSTANCES)
REGULATION 1989 AND POISONS ACT
1952
Able to:
identify the list of Dangerous/
Psychotropic Drugs
do proper receiving and storage
do proper documentation
dispose in accordance to the law
Private Hospital Pharmacy
207 Pharmacy Board Malaysia 2017
ASSESSMENT – PHARMACY STORE MANAGEMENT
SECTION 9: GENERAL COMMENT ON ATTITUDE
Marks = ______________ x 100% 270 = ______________%
Preceptor’s Name & Signature:
Private Hospital Pharmacy
208 Pharmacy Board Malaysia 2017
APPRAISAL BY MASTER PRECEPTOR
Setiausaha Lembaga Farmasi Malaysia Bahagian Perkhidmatan Farmasi Lot 36, Jalan Universiti, 46350 Petaling Jaya, Selangor.
Name of Provisionally Registered Pharmacist:
...............................................................................................................
I/C Number: ………………………………………………………………………………………
PRP Registration Number: …………………………………………………………………
Place of Training: ………………………………………………………………………………
I certify that the above PRP has completed his / her training as required under subsection 6A(2) of
the Registration of Pharmacist Act 1951.
1. Proposal:
1A. Certificate of satisfactory experience in accordance to sub-regulation 7(1) Registration
of Pharmacists Regulations 2004 is recommended to given to him/her
1B. Certificate of satisfactory experience in accordance to sub-regulation 7(1) Registration
of Pharmacists Regulations 2004 is not recommended to given to him/her
2. Preceptor’s Details:
Name: ……………………………………………………………………………………………………………………………………………
Address of Training Premise:
……………………………………………………………………………………………………………………………………………………....
……………………………………………………………………………………………………………………………………………………….
Preceptor’s Signature:
Date:
Private Hospital Pharmacy
209 Pharmacy Board Malaysia 2017
APPRAISAL BY PRP TO PRECEPTOR
Setiausaha Lembaga Farmasi Malaysia Bahagian Perkhidmatan Farmasi Lot 36, Jalan Universiti, 46350 Petaling Jaya, Selangor.
Name of Provisionally Registered Pharmacist:
...............................................................................................................
I/C Number: ………………………………………………………………………………………
PRP Registration Number: …………………………………………………………………
Place of Training: ………………………………………………………………………………
I have undergone training at the above place from (date): ________________ to _____________
Subject
Grade
Comments 1
Unsatisfactory
2
Satisfactory
3
Good
4
Excellent NA
a. Facilities of Training
Place
b. Professional
Exposure by the
Preceptor
c. Professional
Guidance by the
Preceptor
d. Training Skills of the
Preceptor
Private Hospital Pharmacy
210 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 1: DEMONSTRATE A PROFESSIONAL APPROACH
No. Assessment Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
1. Action and attitudes are
demonstrated which indicate a
commitment to quality of
pharmaceutical care of the patient
2. A polite and helpful manner is
demonstrated
3. Dress code and behavior meet the
requirements of the organisation
4. Reliability is demonstrated
5. Initiative is demonstrated
6. Recognition of personal limitation is
demonstrated
7. Work is carried out in an organised
manner and with attention to detail so
that the desired result is achieved
8. Work is prioritised effectively
Private Hospital Pharmacy
211 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 1: DEMONSTRATE A PROFESSIONAL APPROACH
No. Assessment Level of Performance Comments
1 2 3 4 5 6 7 8 9 10 NA
9. Tasks are pursued to completion and
within agreed time limits
(unless overriding circumstances make
this impossible)
10. Problems or potential problems are
identified and the appropriate corrective
action taken or solution found
11. New situation are responded to with
flexibility and willingness
12. Stressful situations are handled without
undue agitation
13. Decisions are made which demonstrated
the ability to think clearly, logically and
with discretion
14. Tasks and situation are approached
with due regard to legal implications
and organisational policy
Private Hospital Pharmacy
212 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 1: DEMONSTRATE A PROFESSIONAL APPROACH
No. Assessment Level of Performance Comments
1 2 3 4 5 6 7 8 9 10 NA
15. The safety of the working area is
maintained to all times so that the health
and safety of colleagues and the public is
not compromised
16. The security of the premises is upheld at
all times
TOTAL MARKS (SECTION 1)
Private Hospital Pharmacy
213 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 2: TEAMWORK
No. Assessment Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
17. A manner is demonstrated which
indicates that due respect is given to the
ideas and opinion of colleagues
18. Advice and criticisms are offered to
colleagues in a manner unlikely to cause
offence
19. Constructive criticism is receive in a
positive manner
TOTAL MARKS (SECTION 2)
Private Hospital Pharmacy
214 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 3: UNDERTAKE PERSONAL AND PROFESSIONAL DEVELOPMENT
No. Assessment Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
20. The ability to self-evaluate and reflect
on experiences is demonstrated
21. Feedback on performance is used
effectively to improved competence
22. The ability to accept responsibility for
meeting own development needs and
achieving targets is demonstrated
TOTAL MARKS (SECTION 3)
Private Hospital Pharmacy
215 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 4: COMMUNICATION SKILLS
No. Assessment Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
23. A sufficient command of the Bahasa
Malaysia and English Language is
demonstrated
24. Conversations (in person or over the
telephone) are conducted in a manner
which demonstrates due regard to
confidentiality and the feelings of the
other person
25. Questioning is used effectively to elicit
necessary information and increase
understanding
26. Responses in conversation are helpful
and clear
27. Body language is appropriate to the
situation
28. Clear, concise and well-structured
written material is provided when
required
Private Hospital Pharmacy
216 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 4: COMMUNICATION SKILLS
No. Assessment Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
29. All responses (whether spoken or
written) are tailored to the needs of the
recipient
30. A clear, polite and helpful telephone
manner is demonstrated
31. Complaints or demands are responded
to in a polite manner
32. An appropriately assertive manner is
used when unreasonable demands or
complaints are made
TOTAL MARKS (SECTION 4)
Private Hospital Pharmacy
217 Pharmacy Board Malaysia 2017
PRP PERSONAL ASSESSMENT BY MASTER PRECEPTOR
SECTION 5: INTEGRITY
No. Assessment Level of Performance
Comments 1 2 3 4 5 6 7 8 9 10 NA
33. The quality of being honest and having
strong moral principles
34. Implementation of appropriate policies
and procedures that ensure the
effective, efficient and ethical
management of pharmaceutical system
(medicine regulatory system and
medicine supply system).
35. Transparent, accountable, follows the
rule of law and prevent corruption.
36. Telling the truth, being open and not
taking advantage of others
37. Demonstrate responsibility, show
respect and caring of others
TOTAL MARKS (SECTION 5)
MARKS (%)
(SECTION 1 – SECTION 5)
Marks = _________ X 100
370
= _________ %
Private Hospital Pharmacy
218 Pharmacy Board Malaysia 2017
SUMMARY OF PERFORMANCE FOR EACH CLINICAL SECTION
AND PERSONAL ASSESSMENT
CLINICAL SECTION MARKS (%)
1. Ward Pharmacy Practices
2. Out-Patient Pharmacy Services
3. In-Patient Pharmacy Services
4. Clinical Pharmacokinetic Services (Optional)
5. Parenteral Nutrition / Intravenous Additive Services
(Optional)
6. Oncology Pharmacy Services (Optional)
7. Drug Information Services
8. Manufacturing and Repacking
9. Pharmacy Store Management
AVERAGE MARKS
PERSONAL ASSESSMENT MARKS (%)
1. Demonstrate a Professional Approach
2. Teamwork
3. Undertake Personal and Professional Development
4. Communication Skills
5. Integrity
Private Hospital Pharmacy
219 Pharmacy Board Malaysia 2017
TO BE FILLED BY MASTER PRECPTOR FOR EXTENDED PRP
SUMMARY OF PERFORMANCE FOR EACH CLINICAL SECTION
AND PERSONAL ASSESSMENT
CLINICAL SECTION MARKS (%)
1. Ward Pharmacy Practices
2. Out-Patient Pharmacy Services
3. In-Patient Pharmacy Services
4. Clinical Pharmacokinetic Services (Optional)
5. Parenteral Nutrition / Intravenous Additive Services
(Optional)
6. Oncology Pharmacy Services (Optional)
7. Drug Information Services
8. Manufacturing and Repacking
9. Pharmacy Store Management
AVERAGE MARKS
PERSONAL ASSESSMENT MARKS (%)
1. Demonstrate a Professional Approach
2. Teamwork
3. Undertake Personal and Professional Development
4. Communication Skills
5. Integrity