Residency
Neurology & Headache Clinics
Preceptor:
Kristen Jefferies, PharmD
Description of Practice Site:
This site is an ambulatory Neurology Clinic located in the CAMT Building in Research Park at the University of Utah and the new Neurology Clinic Building connected to the hospital. The clinic is staffed by physicians and nurse practitioners who focus in neurology sub-specialties such as multiple sclerosis, movement disorders, dementia, neuromuscular disorders, and headache as well as general neurologists. A clinical pharmacist also staffs the clinic Monday through Friday during normal business hours. The resident will staff the clinic with the pharmacist and independently during this rotation. The pharmacist typically sees 4-12 patients in clinic as part of their appointment with their neurology provider.
Rotation Description:
Patient Care Activities
- Perform medication reconciliation to ensure a complete and accurate medication list is obtained from the patient and any medication changes are communicated to the patient verbally and in writing and are documented in the chart. (R2.3, R2.8, R2.12, E7.2 - Model, Coach, Facilitate)
- Perform comprehensive medication histories of patients at their initial appointment with a Headache Specialist. This includes a list of medications previously and currently used to treat and prevent headaches, their efficacy, side effects, frequency and duration of use, and reasons for discontinuing past medications. (R2.2, R2.3, E7.1 - Coach, Facilitate)
- Recommend appropriate drug therapies for the treatment of various neurologic disease states (headache, stroke, PD, MS, ALS) based on patient specific information and current disease management guidelines. (R2.1, R2.6, R2.8 - Instruct, Model, Coach, Facilitate)
- Recommend appropriate monitoring for patients' medication therapies including effectiveness, adverse events, and laboratory tests.(R2.7 - Model the Facilitate)
- Provide accurate and timely education to patients regarding proper dosing and administration of their medications, potential side effects, drug interactions, etc. (R5.1 - Facilitate)
- Respond to drug information requests from providers, patients, and other clinic staff daily with accurate and timely responses. (R2.2, R5.1- Model, Coach, Facilitate)
- Appropriately document drug therapy recommendations, patient education activities, and reconciliation of the patients' medications in the electronic medical record. (R2.12 - Model then Coach and Facilitate)
Other Activities
- Appropriately report medication errors and adverse drug reactions using Patient Safety Net. (E7.5 - Facilitate)
- Lead topic discussions with the preceptor. Possible topics include headache, multiples sclerosis, Parkinson's disease, stroke, dementia, and neuromuscular diseases. (R2.2, E7.2 - Coach, Facilitate)
- Present a 30 minute in-service for clinic staff (nurses and medical assistants) including a handout. (R5.1 - Facilitate)
- Present a 30 minute in-service for neurology providers (physicians, medical residents, medical students, nurse practitioners) including a handout. (R5.1 - Coach, Facilitate)
- Lead a journal club presentation for the preceptor and/or other providers including a thorough discussion of strengths and weaknesses of the clinical trial and how the results will impact pharmacy practice. (R5.1 - )
- Prepare or update patient education materials, such as drug information handouts, as needed. (R5.1 - Model, Facilitate)
- Attend weekly Neurology and/or Pharmacy Grand Rounds presentations as needed. (R2.2 - Facilitate)
Activities Evaluated
| Rotation Activity | RLS Goal |
| As appropriate, establish collaborative professional relationships with members of the health care team. | R2.1 |
| Place practice priority on the delivery of patient-centered care. | R2.2 |
| As appropriate, establish collaborative professional pharmacist-patient relationships. | R2.3 |
| Collect and analyze patient information. (Taught only) | R2.4 |
| When necessary, make and follow up on patient referrals. (Taught only) | R2.5 |
| Design evidence-based therapeutics regimens. | R2.6 |
| Recommend or communicate regimens and monitoring plans. | R2.8 |
| Document direct patient care activities appropriately. | R2.12 |
| Provide effective medication and practice-related education, training, or counseling to patients, caregivers, health care professionals, and the public. | R.5.1 |
| Use information technology to make decisions and reduce error. (Taught only) | R.6.1 |
| Communicate effectively and with cultural and personal sensitivity. | E.7.1 & 2 |
Readings and Preparatory Work:
The resident will be given a binder which contains articles and/or practice guidelines relating to the neurologic disease states commonly encountered during the rotation. These include:
- Headache/migraine
- Multiples Sclerosis
- Parkinson's disease/movement disorders
- Dementia/Alzheimer's disease
- Amytrophic Lateral Sclerosis
- Myasthenia Gravis
- Stroke
- Neuropathy
- Seizure disorders
- Depression/psychiatric disease
- Sleep Disorders
The resident will be expected to complete these and/or other readings in preparation for topic discussions and patient care activities.
Project/Inservice Description:
Examples of previous in-service presentations are found in the resident binder. In-services should be approximately 30 minutes in duration and should include a written handout. Other audiovisual aids are available, but not required.
Journal club presentations should include a thorough evaluation of a published clinical trial and any implications the results should have on pharmacy practice. A handout is not required.
Typical Daily/Weekly/Monthly Activities:
The resident is expected to be in clinic Monday through Friday whenever patients are scheduled (from approximately 8:00 AM to 5:00 PM).
Project time or staffing on swing shifts will be allowed on Thursdays after 1:00 PM.
The resident may be required to attend Neurology Department Ground Rounds which are presented on Wednesday mornings at 9:00 AM
Evaluation:
The resident will receive regular feedback each week regarding their performance. A snapshot of R2.2.1 will be completed at midpoint to elicit discussion about performance to date. A formal summative evaluation will be done on the last day of rotation and submitted to ResiTrak.
