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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

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Page 1: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

PRIVATE HOSPITAL PHARMACY

RECORD OF TRAINING AND EXPERIENCE OF

PROVISIONALLY REGISTERED PHARMACIST

(PRP)

PHARMACY BOARD MALAYSIA MINISTRY OF HEALTH MALAYSIA

2017

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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:

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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.

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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. 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

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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.

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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

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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.

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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ASSESSMENT – WARD PHARMACY PRACTICE

SECTION 10: GENERAL COMMENT ON ATTITUDE

Marks = ______________ x 100% 120 = ______________%

Preceptor’s Name & Signature:

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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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.

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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

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ASSESSMENT – OUT-PATIENT PHARMACY SERVICES

SECTION 9: GENERAL COMMENT ON ATTITUDE

Marks = ______________ x 100% 80 = ______________%

Preceptor’s Name & Signature:

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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)

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

Page 93: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

Page 105: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

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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

Page 107: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

Page 138: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

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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

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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

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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

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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.

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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

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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

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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:

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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.

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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

Page 148: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 149: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 150: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 151: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 152: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 153: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 154: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 155: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 156: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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:

Page 157: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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.

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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

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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

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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

Page 161: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 162: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 163: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 164: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 165: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 166: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 167: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

Page 168: RECORD OF TRAINING AND EXPERIENCE OF ......Private Hospital Pharmacy Pharmacy Board Malaysia 2017 5 5. The passing marks for EACH section is 60 %. 6. The final appraisal and Appendix

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

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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:

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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:

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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

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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

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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

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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

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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

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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

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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.

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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)

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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:

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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).

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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

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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

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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.

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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.

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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:

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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.

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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:

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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:

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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

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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

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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

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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)

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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)

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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)

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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

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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)

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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

= _________ %

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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

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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