Sunday, May 6, 2012

Long Term Care

Posted by Melanie at Sunday, May 06, 2012

My final rotation (can't believe I am blogging about my final rotation) is Long Term Care at HomeTown Pharmacy.  It is a nontraditional rotation and is something very unique that is not covered a lot in school.

My home base is at the HomeTown Pharmacy in Chelsea.  My preceptor works four 10-hour days (which can sometimes go longer).  Three of these days she is consulting (which basically means chart review) for nursing homes/assisted living facilities across the state and the other day she works from the pharmacy.  She is responsible for reviewing each patient's chart once a month.  She has homes she consults for in Ann Arbor, Southfield, St. John's, Saginaw, Bad Axe, Okemos, and Ingham County.  Each month she reviews ~700 charts.

When she reviews the charts, she looks for appropriate drug-dosing, renally adjusting medications, appropriate medication for diagnosis, drug-interactions, appropriate lab monitoring, and gradual dose reductions for antidepressants, antipsychotics, anxiolytics, and hypnotics, as appropriate.  The maximum number of charts that she is allowed to review each day is 100; however, as many of you have spent some time working up patients, this is a rather large number of charts to review in a single day.  She usually reviews about 70 a day.  On my first day, I reviewed 2 patient charts, which she says is typical for students.  Of course, it takes longer to review a chart for a new patient than it does for a patient you have reviewed before because you can spend less time on the background and past medical history and focus on picking up where you left off (basically focus on the past month).

If you think you may be interested in Long Term Care and becoming a consultant pharmacist, I would highly recommend this rotation.  Do not be intimidated that your sites are all over the state because my preceptor and I meet in Chelsea and she drives the company car.  It really is a unique experience because you are at a different place/city almost every day.

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