Long Term Care / Geriatrics Rotation

Preceptor - Rachel Ogden, RPh, CGP, FASCP

Rotation Description:

The Long Term Care/Geriatrics experience is an optional elective for the pharmacy practice resident. This experience combines principles of both Adult Internal Medicine and ambulatory care in a skilled nursing facility with a unique focus on the geriatric population. The resident will spend four consecutive weeks (with a minimum of 40 hours per week) in the setting to learn the principles of caring for geriatrics residents in order to perform formal long term care regulatory chart review and documentations as mandated by the Centers for Medicare and Medicaid Services (CMS). Excellent communication and interpersonal skills are vital in this setting. The resident must devise efficient strategies for accomplishing all required activities.

The resident's tasks for this experience include, but should not be limited to:

  • Comprehensive assessment of each drug therapy regimen on an ongoing basis and development of a drug therapy plan for      each patient while considering each individual's previous pharmacologic recommendations, current health care status (e.g.      organ function, medical history), personal health related goals and ideology (e.g. whether to opt for aggressive or strictly      palliative treatments), and costs.
  • Providing specific and accurate recommendations pertaining to drug therapy including, but not limited to dose adjustment,      drug addition, drug deletion, and drug monitoring both verbally and in writing incorporating the principles of evidence based      medicine and established regulatory guidelines whenever possible.
  • Effectively and professionally communicating with all health care related professionals, patients and families in regard to      medications, drug therapy regimen evaluations, formal recommendations, in-service topics, case presentations and other      required communications. Collaborating with other health care professionals in order to promote pharmaceutical care      including, but not limited to, attending physicians, medical interns and residents, medical and pharmacy students, nurses,      nurses' aides, dietitians, social workers, and the nursing home administrator.
  • Performing the duties of a consultant pharmacist, including, but not limited to: state and federal guidelines impacting      medication use in the elderly (especially psychoactives), medication room inspection, policy creation, and annual survey      preparation.
  • Assist in the creation of protocols and other improvement processes to maximize patient outcomes.

    • Rotation Topic Discussions / Readings

    Common disease states with which the resident will be expected to gain facility through literature review, topic discussion and direct patient care experience include:

  • Coronary Artery Disease
  • Congestive Heart Failure
  • Constipation
  • Dementia/Alzheimer's
  • Incontinence
  • Osteoporosis
  • Pain Management
  • Parkinson's Disease

    • The resident is expected to understand the pharmacotherapy related to these disease states as well as other disease states encountered in this setting. The preceptor or designee will be available to the resident throughout the learning experience for consultation and topic discussions. Resident learning is predicated not only to the above responsibilities but also on acceptance of personal responsibility and dedication to direct patient care and team service.

    ASHP Required Goals and Objectives to be taught and evaluated:

    Goal R2.1:

  • OBJ R2.1.1

    • Goal R2.2:
  • OBJ R2.2.1

    • Goal R2.3:
  • OBJ R2.3.1

    • Goal R2.4
  • OBJ R2.4.1
  • OBJ R2.4.2
  • OBJ R2.4.3

    • Goal R2.5:
  • OBJ R2.5.1
  • OBJ R2.5.2

    • Goal R2.6:
  • OBJ R2.6.1
  • OBJ R2.6.2

    • Goal R2.7:
  • OBJ R2.7.1

    • Goal R2.8
  • OBJ R2.8.1

    • Goal R2.9:
  • OBJ R2.9.1
  • OBJ R2.9.2

    • Goal R2.10
  • OBJ R2.10.1
  • OBJ R2.10.2

    • Goal R2.12
  • OBJ R2.12.1
  • OBJ R2.12.2
  • OBJ R2.12.3

    • Goal R5.1
  • OBJ R5.1.1
  • OBJ R5.1.6
  • OBJ R5.1.3
  • OBJ R5.1.4
  • OBJ R5.1.5
  • OBJ R5.1.2

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