PHARMACY PRACTICE

I
PHPP 4216
OUTPATIENT PHARMACY SERVICES

DIPLOMA IN PHARMACY
COURSE LEARNING
OUTCOMES:
On successful completion of the module, students will be able to:
• Recognize the correct dispensing skills at outpatient pharmacy. (P2)
• Perform dispensing procedures independently and as a team under
supervision. (A4)
• Observe the latest digital system in performing pharmaceutical services
under supervision. (A4)

CONTACT HOURS
• Six (6) weeks of Pharmacy Practice I under supervision at the outpatient
hospital pharmacy at KPJ Group of Hospitals.
ASSESSMENT METHODS
ASSESSMENT % ASSESSOR
PRACTICE APPRAISAL 10 PRECEPTOR
REFLECTIVE PRACTICE 10 PRECEPTOR
BOOK PRESENTATION 30 LECTURER
COMPETENCY SKILLS (VIVA) 30 LECTURER
ORAL PRESENTATION 20 LECTURER (ML)
TOTAL 100
PRACTICE APPRAISAL 10%
The pharmacy preceptor is expected to grade the students’ level of work
performance and work attitude in carrying out their responsibilities in the
respective hospital setting based on 7 elements of evaluation.
• 1. Appearance
• 2. Knowledge and Understanding
• 3. Clinical Skills TO BE GIVEN TO
• 4. Responsibility PRECEPTOR AT
• 5. Personality Traits THE END OF
• 6. Time Management POSTING
• 7. Communicative Competence
REFLECTIVE PRACTICE LOG 10%
• Reflective practice refers to actions engaged in a
process of continuous learning which reflects the
characteristics of professional practice.
• It serves as an important tool in practice-based
learning settings where individuals learn from TO BE GIVEN TO
their own professional experiences, rather than PRECEPTOR AT
from formal teaching or knowledge transfer. It THE START OF
can be the most important source of personal
professional development and improvement.
POSTING
• Students learn best from experience and it has
wider relevance where they adapt and adhere to
a specific learning environment.
BOOK PRESENTATION 30%
• It is the student’s responsibility to ensure that
their book presentation includes the evidences
used to gain experience in any particular service.
• The book will contain more than a simple record • FORMAT
of clinical experiences. It must provide an
opportunity for trainees to record what they are • TASK
doing as well as how they are doing. CONTENT
• The typewritten assignment should present clear • DRUG
and concise information related to the expected
outcome. Details of types of tasks and general
WORKSHEET
information should be presented logically and in
sequence.
COURSEWORK
CONTENT
BOOK PRESENTATION
30%
Section A – FORMAT & CONTENT
SCORING 0 1
GUIDE Not followed / not available Followed / Available
Format SCORE Marks
1. Font : Trébuchet MS 1
2. Font size : 12 1
3. Line spacing : Single; Before / After- 2 pt 1
4. Margins: (Top/Bottom) : 1” / (Left/Right) : 1.25” / 1
(Header/Footer) : 0.5”
5. Binding: Tape bind / Comb bind 1
TOTAL 5
Content SCORE Marks
1. Table of Contents 1
2. Acknowledgement 1
3. Background of Hospital 1
4. Pharmacy Organization Charts 1
5. Outpatient Pharmacy Services 1
6. Conclusion 1
7. References 1
TOTAL 7
TOTAL - Section A 13
BOOK PRESENTATION 30%
Section B – TASK CONTENT Section C – DRUG WORKSHEET
1 2 3 4 1 2 3 4
Need Satisfactory Good Excellent Need Satisfactory Good Excellent
improvement improvement
 Less than 50%  More than 50%  More than 70%  More than 90%  Incomplete  Missing some  Most of the  Shows
SCORING content content required content content drugs drugs drugs additional drug
GUIDE required presented, but required required information information information information
presented and many presented, presented and SCORING  Wrong  Some error in completed  Well showed
somewhat inaccuracies in mostly accurate accurate with no GUIDE Calculation calculation, and  Showed calculation,
confusing. the content. with 1 or 2 factual error. not clear calculation, and organized and
factual errors.
 Incomplete
label and  Missing some organized clear
cautionary label, information in  Label and  Label and
missing many label and cautionary label cautionary label
information cautionary label mostly well well prepared
prepared
BOOK PRESENTATION 30%
Section B – TASK CONTENT
Task Content Required content Drug worksheet
1. Outpatient Pharmacy Services  Picture of hospital Nil
1.1 Introduction of the hospital  Organization chart –
1.2 Observation of organizational chart brief description
1.3 Aim and objective of outpatient pharmacy services
1.4 Types of services/activities
1.5 Role and responsibilities of pharmacy assistants
1.6 Pharmacy services operation hours
2. Prescription processing: Dispensing skill tasks  Workflow – need Nil
2.1 Prescription processing workflow for outpatient diagram
2.1.1 Receive prescriptions and method of prescribing  Attach sample Rx and
• Definition of prescription explanation
• Types of prescription in outpatient- examples of  Process details
prescription - Written (Manual) / e-prescription (KCIS)
2.1.2 Process workflow for outpatient pharmacy
2.1.3 Screening of prescription outpatient
BOOK PRESENTATION 30%
Section B – TASK CONTENT
Task Content Required content Drug
worksheet
3. Preparation and filling medication  Definitions Nil
3.1 Medications labelling and additional/ auxiliary labelling  Samples of available
3.1.1 Functions of medication labelling label in pharmacy
3.1.2 Types of additional/auxiliary labelling use in pharmacy  Description of selection
3.1.3 Examples of labels
3.1.4 Selection of appropriate labelling

3. Preparation and filling medication  Definitions 3.2.4

3.2 Oral solid medication  Pictures Oral solid
3.2.1 Types of oral solid medication  Description of selection medication –
3.2.2 Tools used in preparing the oral solid medication. 10 drugs (5
3.2.3 Selection of appropriate container and labels prescriptions)
BOOK PRESENTATION 30%
Section B – TASK CONTENT
Task Content Required content Drug worksheet
3. Preparation and filling medication  Definitions 3.3.4
3.3 Oral liquid medication  Pictures Description of Oral liquid
3.3.1 Types of oral liquid medication selection medication- 10
3.3.2 Tools used in preparing the oral liquid medication. drugs (5
3.3.3 Containers use for packing oral liquid medication prescriptions)
3. Preparation and filling medication  Definitions 3.4.5
3.4 Reconstitution of oral medication  Pictures Oral liquid
3.4.1 Examples of oral liquid medication needs reconstituting.  Description of labelling medication
3.4.2 Method of preparing oral liquid medication requirement reconstitution –
reconstitution. 3 Rx
3.4.3 Labelling for oral liquid medication reconstitution.
3.4.4 Storage and expiry date for oral liquid medication
reconstitution.
BOOK PRESENTATION 30%
Section B – TASK CONTENT
Task Content Required Content Drug worksheet
3. Preparation and filling medication  Definitions 3.5.6
3.5 Extemporaneous liquid oral medication  List of Drugs prepared Extemporaneous /
3.5.1 Examples of extemporaneous oral liquid medication as extemporaneous compounding – 3 Rx
3.5.2 Calculation to supply medications  Calculation method –
3.5.3 Method of preparing extemporaneous oral liquid attached form if
medication available
3.5.4 Tools used for filling an extemporaneous oral liquid  Pictures
 Description of selection
medication
3.5.5 Selection of appropriate container and labels

4. Psychotropic Drugs & Controlled Substances supply  Definitions 4.4 Psychotropic

 Process workflow - Drugs prescriptions -
4.1 Handling process of Psychotropic Drugs & Controlled responsibilities 4 Rx
Substances in accordance to the respective legislations  List of Drugs
4.2 List of Psychotropic Drugs & Controlled Substances  Pictures 4.5 Controlled
4.3 Record books requirement and content  Details of content Substances
prescriptions - 4 Rx
BOOK PRESENTATION 30%
Section B – TASK CONTENT
Task Content Required content Drug worksheet
5. Dispensing medications  Workflow – need 5.3.3
5.1 Dispensing procedures in outpatient pharmacy diagram LASA and High
5.2 Dispensing skills – 5 Rights of dispensing  Full description of skills Alert
5.3 Medication safety - recognizing LASA and High Alert  List drugs + pictures Medications
Medications  Requirement – prescriptions – 3
5.3.1 List of drugs, storage requirement and alert tag explanation, rationale Rx
5.3.2 Dispensing process
6. Patient education and counselling  Definitions 6.5
6.1 Types of medications required counselling / education  Process workflow Counselling
6.2 Counselling techniques  Type of Drugs - examples prescriptions - 3
6.3 Information given during counselling / education session  Details of content Rx
6.4 Documentation for counselling / education session  Attach form
7. Documentation rules and procedure  Definition Nil
7.1 Storage of documentation  Pictures of storage
7.2 Retention period  List of records + period
Summary Drug Worksheets
Task No of Rx Selection

1. Filling an oral solid medication 5 (10 Oral solid / oral liquid : pick different prescription with
drugs) different system or condition
2. Filling an oral liquid medication 5(10 e.g: respiratory (2 drugs), cardiovascular (2 drugs), GI
drugs) (2 drugs), pain (2 drugs), neuro (2 drugs)

3. Filling an oral liquid medication 3

reconstitution - 3 prescriptions
4. Extemporaneous / compounding 3 Others: 1 prescription 1 drug
preparation - 3 prescriptions
5. Filling Psychotropic Drugs prescriptions - 4
prescriptions
6. Filling Controlled Substances prescriptions
4

4
MORE No of RX 
- 4 prescriptions
7. Filling LASA / High Alert Medications 3 LESS No of RX 
prescriptions - 3 prescriptions
8. Filling prescriptions with required 3
counselling - 3 prescriptions
TOTAL RX 30
Drug Worksheets
Drug Worksheets
Rewrite the Rx T. Zinnat 500mg BD x 1/52

Brand name Zinnat

Generic Name Cefuroxime

Strength available 250mg

Indication/uses (2-3 indications) Treatments of infections caused by susceptible bacteria for

URTI, LRTI, SSTI, genito-urinary tract infections.
Dosage /Direction for use Adult: 250mg BD after food; severe LRTI: 500mg BD

Side effects/adverse reaction (minimum 4) Overgrowth of candida, eosinophilia, GI disturbances,

Headache or dizziness
Pregnancy category B (Either animal-reproduction studies have not demonstrated a fetal risk but there are no
controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect
(other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st
trimester (and there is no evidence of a risk in later trimesters).
Drug Worksheets
Pharmacology classification / MIMS class  Antibiotic / Cephalosporins

Storage  Temp not exceeding 30C

Calculation total supply  2 tabs x 2 times x 7 days= 28 tablets

Extemporaneous preparation calculation  nil

(if applicable)
Medication label - format ( Logo hospital attachment )
 
  Name : xxx Date: xxx
MRN :xxx Qty: 28 tabs
 
T. Zinnat ( Cefuroxime) 250mg
Take 2 tablets twice daily for 7 days after meal.

ANTIBIOTIC: Finish the course.

Storage: Keep in cool and dry place.
Submission:
At the end of posting, students are to submit the following documents to
lecturer:
a) Practice appraisal form - assessed and signed by student &
preceptor
b) Reflective practice log - assessed and signed by student &
preceptor
c) Attendance – by punch card – verified by signature and stamp of
the preceptor
d) Complete book presentation

Dateline: Within 2 weeks after completed posting period

COMPETENCY SKILLS 30%
• Competency skill assessment / Viva voce is a form of oral assessment
that helps students develop valuable communication skills.
• It is a part of practical assessment which means asking questions and
replying answers orally.
• Competency assessed by questions and answers session and/or written
test (WT) between lecturers and students about the tasks assigned.
Evaluation done based on the knowledge and skills demonstrated.

1 2-3 4-5
Poor Basic Good
No answer or inappropriate Have basic knowledge but Have sufficient knowledge
answer. insufficient to demonstrate and able to demonstrate
required skills required skills
 During viva session, assessors may request students to

Viva session:
present their book report for checking and comments.
Preceptors should check the book prior to viva session.

During posting period, lecturers/assessors will come to hospital and assessed

students on:
1. Dispensing skill task : total supply, extemporaneous calculation, labelling
2. Practical skill: Dispensing skill, diagnosis & indication, Communication skill
3. Patient counselling: Device counselling, technique, step by step use
4. Procedures:
a) Outpatient work scope: OP services/activities, Role of pharmacy assistant , OP
workflow, retention & storage of document
b) Prescription processing: Screening process, Labelling, 5 Rights of dispensing,
LASA & HAM, Psychotropic Drugs & Controlled Substances
c) Medication preparation: Methods, tools, processes

Date: To be confirmed later by Program Coordinator

PHARMACY PRACTICE
GUIDELINES
PHARMACY PRACTICE
ALLOCATION
1. The students are not allowed to be posted at the same hospital for more than twice
unless allocation is limited.
2. It is compulsory for the students to stay at hostel during the PP period. Request to
not reside in the hostel is based on the guidelines from the student affairs
department.
• Students need to fill the ‘Live Off Hostel’ form and obtain approval from
Coordinator of Program.
• Students must attach consent letter from parents.
• Photocopy of parent’s/ guardians Identification Card
3. Students shall be responsible to contact the nurse instructor (NI) / person in charge.
(during office hours).
4. Contact number of NI and flow of check in hostel can be seen in the website DSA as
per below.
https://dsakpjuc.wordpress.com/clinical-hostel/
LEAVE
1. Leave / Time Off is forbidden during PP attachment.
2. Except Emergency Matter: Please attach the valid document.
• Father / Mother ill
• Death (Parents/Siblings)
• Examination (Re-sit exam, Repeat module exam, SPA exam, Repeat SPM Exam-
Based on supporting document. (1 day before and on the date of exam).
3. Any other leave application shall be subjected to approval from the School of
Pharmacy and Preceptor.
4. If the student is unfit due to medical reasons, MC for outpatient cannot exceed 5
days for total attachment. MC has to be provided to Head of Department /
Preceptor within two (2) working days.
5. If Total MC for outpatient > 5days of total attachment period, students must
replaced the extra days.
• Example: Total MC per attachment is 6 days, so 1 day need to replace.
LEAVE
1. A valid Medical Certificate must be originated only from:
• Klinik Kesihatan Kerajaan
• Government Hospital
• KPJ Hospital
2. MC for inpatient department cannot exceed 14 days.
3. In case of inpatient MC > 14 days the students need to inform preceptor and
coordinator/cohort In charge. The School of Pharmacy shall discuss and decide the
best solution for the students (either defer the semester or repeat the pharmacy
practice).
4. In the event of a student need to chaperon a sick student, he/she shall inform the
HOD/ Preceptor and upon approval, he/she may do so. The chaperone has to
replace the hours if event happen during office hour.
OTHER MATTERS
1. Please bring your Insurance card along during clinical attachment. Student
insurance only cover inpatient only for RM 5,000 limit
https://dsakpjuc.wordpress.com/services-unit/
2. Student must always wear Identification card during clinical attachment and
(Please refer web DSA)
https://dsakpjuc.wordpress.com/studenthandbooks/
 ATTI
• RE
College
uniform and
white coat if
necessary
• (M) combed,
short hair
• (F) Neat hair –
tied in ponytail
/bun
• Black tudung
• Covered shoes
• Wear name tag
all the time
INCIDENT REPORTING

Preceptor will fill in the

form to informed about
incident misconduct:
Dress code,
Absenteeism,
vandalised hospital
property…
ORAL PRESENTATION
ORAL PRESENTATION 20%
• The oral group presentation should reflect the experiences during the
outpatient pharmacy attachment.
• Students as future service providers must be able to prepare and deliver
an effective presentation that is well designed and informative to the
rest of the class.
• Content of the power point should be not more than 30 slides and time
to present at college is not more than 15 minutes.
• All group members MUST contribute idea and DO presentation as well.
• Date: To be confirmed later by Module Leader
ORAL PRESENTATION 20%
• Task:
a) Introduction to the digital system used in the
outpatient pharmacy services i.e KCIS and HITS
b) Items on display in the digital system used in the • CONTENT –
outpatient pharmacy services ACCURACY &
c) Flow process for an outpatient prescription ORGANIZATION
when using the digital system used in the • FORMAT &
outpatient pharmacy services
d) Advantages and disadvantages of using the
GRAPHICS
digital system in the outpatient pharmacy • PRESENTERS
services • PRESENTATION
e) Sample of picture(s) or video demonstrating
using the digital system in the outpatient
pharmacy services
ORAL PRESENTATION - KCIS
IMPORTANT!!
• Show the
pictures of
systems used
• Differentiate
OP and IP
workflow
• Understand
the system
function
 When or which
system to use
during what
process?
• Show
integration
using KCIS 
HITS  BMS
ORAL PRESENTATION - HITS
ORAL PRESENTATION - BMS
 ALL THE BEST &
ENJOY YOUR POSTING!

THANK YOU