Pennsylvania Pharmacist July/August 2017

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Pennsylvania July/August 2017 z Volume 98 z Issue 4

The official publication of the Pennsylvania Pharmacists Association

“Putting Patients First” 2017 Legislative Day Successes!



CONTENTS Our Vision

On the Cover 2017 Legislative Day: Putting Patients First

Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as healthcare providers.

On April 19, more than 400 pharmacists and pharmacy students from all across Pennsylvania converged on the Capitol in Harrisburg to advocate on behalf of the profession and show how pharmacists are always putting their patients first!

Our Mission The Pennsylvania Pharmacists Association, as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.

DEPARTMENTS 5 Calendar of Events 7 President’s Message 8 Welcome! New Members 10 Campus Checkup 18 Member News 18 Congratulations! to Rich Ost

features 12 Member Profile 13 Student Member Profiles 14 Pharmacy Spotlight 16 How to Survive a DEA Inspection: Records Required for Inspection© 24 Legislator Profile 36 Strategies for Precepting Struggling Experiential Students: Suggestions for Enhancing Communiciation and Documentation

association news 7 Meet Your PPA President 19 Expedition 2017: Exploring the Healthcare Jungle 21 2016 Outstanding Students: Where Are They Now? 22 Congratulations to the 2017 Recipients of the PPA Outstanding Student Award! 27 Meet the 2017–2018 Student Advisory Board! 28 Meet the 2017–2018 PPA Board of Directors 29 Introducing the 2017 Committee Chair Volunteers 31 PPA’s Affiliated Counties Announce Their 2017-2018 Board of Directors 32 PPA Affiliated Counties Deliver Dispensing Guidelines CE Program

PPA Board of Directors PPA Officers President: Nick Leon, PharmD, BCPS, BCACP President Elect: Lauren Simko, PharmD Vice President: Rick Demers, RPh, MS FASHP Immediate Past President: Eric Pusey, RPh, CDE Regional Directors Central: Richard Seipp, PharmD Northeast: Thomas Franko, PharmD, BCACP Northwest: Nickolas Kernich, PharmD Southeast: David Stone, PharmD Southwest: Cory Krebs, RPh Practice Directors Academia: Nicole Pezzino, PharmD, CDE Chain Pharmacists: Stephen Pfeiffer, PharmD, MBA Community Independent Pharmacists: Shawn Nairn, RPh Community Independent Pharmacists: Chuck Kray, RPh Health System Pharmacists: Darryle Tillman, RPh MCO/Industry/Government/Other: John Barrett, MBA, RPh Associates: Greg Drew, RPh

Student Directors East: Amandeep (Amni) Kaur West: Tina Schuler PPA Office Staff CEO: Patricia A. Epple, CAE pepple@papharmacists.com | Ext. 3 Program Manager: Sara Powers spowers@papharmacists.com | Ext. 2 Government Relations Manager: Jeff Stuby jstuby@papharmacists.com | Ext. 6 Communications Coordinator: Danielle Adams dadams@papharmacists.com | Ext. 1 Membership Coordinator: Ashley Robbins arobbins@papharmacists.com | Ext. 5 Bookkeeper: Michele Dibble mdibble@papharmacists.com | Ext. 4 PPCN Executive Manager: Mindy Kozminski, PharmD, BCACP mkozminski@papharmacists.com PPCN Trainer: Brandon Antinopoulos, PharmD ppcntrainer@papharmacists.com

32 Bucksmont Pharmacists Association Meeting Summary May 17, 2017 33 The Lehigh Valley Pharmacists Association 34 Legislative Day 2017: Putting Patients First 38 Duquesne University Takes Steps to Fight the Addiction Crisis INDUSTRY news 33 Value Specialty Pharmacy Receives ACHC Accreditation 33 PRS Pharmacy Services Becomes Exclusive Broker for NCPA Members Looking to Sell or Buy a Pharmacy

Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com | ppa@papharmacists.com Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for non-members; for members it is included in the annual dues. Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA. Editorial Board Olufunmilola Abraham, PhD, MS, BSPharm Hershey S. Bell, M.D.,M.S.,FAAFP Kim Coley, FCCP, PharmD, RPh Michael Gionfriddo, PharmD, PhD Yardlee Kauffman, PharmD, MPH, BCACP Associate Editor: Danielle Adams Editor/Manager: Pat Epple

Pennsylvania MAGAZINE

papharmacists.com | ppa@papharmacists.com |

Published by Graphtech Alexis Kierce, Publications Manager (717) 238-5751 x119 alexis@thinkgraphtech.com For Advertising Information: Kristen Bergmaier, Account Manager (717) 238-5751 x129 kristen@thinkgraphtech.com designed by Graphtech Pharmacist State Board of Pharmacy Members Institutional: Gayle Cotchen, BSPharm., PharmD., MBA Independent Community: Rob Frankil, RPh Chain Community: Janet Hart, RPh Chain Community: Theresa M. Talbott, RPh Independent Community: Mark J. Zilner, RPh Board of Pharmacy Meeting Dates: July 11, 2017 August 22, 2017 October 3, 2017 November 28, 2017


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CALENDAR OF EVENTS | ADVERTISERS INDEX

JUly 10–11 PPA Leadership Retreat and Board Meeting State College, PA 15–19 AACP Annual Meeting Nashville, TN

SEPTEMBER 15–17 ACCP Annual Meeting San Diego, CA 21–24

21–24 PPA Annual Conference 2017 Kalahari Resorts ­— Pocono Manor, PA

24 Student Advisory Board Meeting Kalahari Resorts — Pocono Manor, PA

22 Foundation Board of Directors Meeting Kalahari Resorts ­— Pocono Manor, PA

OCTOBER

22 PPCN Board of Directors Meeting Kalahari Resorts — Pocono Manor, PA 24 PPA Board of Directors Meeting Kalahari Resorts — Pocono Manor, PA

14–18 NCPA Annual Conference Orlando, FL 16–19 AMCP Educational Conference Dallas, TX

For additional events including webinars, CE opportunities, and PPA committee meetings, be sure to see our Calendar of Events on the PPA website! 

ADVERTISERS INDEX PRS Pharmacy Services – 2 IPBG – 4 Pharmacist Mutual – 6 RDC – 9 S&L Solutions LLC – 12 LECOM – 17 Hayslip & Zost – 18 The Keystone Pharmacy Purchasing Alliance – 2o Value Drug Company – 25 R.J. Hedges – 26 AmerisourceBergen – 29 Cardinal Health– 30 Smart-Fill– 39 RDC – Back Cover 

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PRESIDENT’S MESSAGE I am humbled and honored to begin my term as PPA’s president. I would like to thank PPA’s past presidents for their vision and leadership, especially Eric Pusey, Donna Hazel, and Eric Esterbrook, who have mentored me through my time as board member, officer, and now president. I would like to use my first message to briefly outline what PPA’s priorities will be over the course of the next fiscal year. As any past president will tell you, these are not “my” priorities — they are the association’s priorities and are the result of years of groundwork that has been laid by our membership. PPA will continue addressing the needs of current members, and creating appeal and value for new members. PPA is a diverse community of pharmacists, students, and technicians who, together, represent the best of what our profession has to offer. PPA thrives when its current members are engaged and by adding new members from all aspects of the field. I invite you to experience the PPA community that I know

and love during the annual meeting at the famously fun and family-friendly Kalahari Resort in the Poconos from September 21–24, 2017 PPA will use its well established advocacy framework to advance our advocacy agenda. Promoting ONE VOICE and defeating proposed cuts to PACE and Medicaid prescription dispensing fees will be achieved by balancing short and longterm priorities and initiatives, and engaging our membership, state leaders, and other stakeholders at all levels of the process. PPA will continue to expand upon key, strategic initiatives, such as our efforts to combat opioid abuse, and advancing the practice and perception of pharmacy across the Commonwealth by successfully securing and implementing the first contract(s) for the Pennsylvania Pharmacists Care Network.

campaign to perform much needed renovations to our historic building, which is located just across from the Capitol Building in Harrisburg. We will need your help to start our next 140 years by having a building that reflects and projects the value of the profession of pharmacy. As you can see, there is a lot of work to do, and I invite you to join me in supporting the great work of the association. I sincerely look forward to working with all of you.  Nicholas Leon, PharmD, BCPS, BCACP PPA President 2017-2018

Lastly, PPA is proud to be celebrating its 140th anniversary next year. In addition to reflecting on our history, we will be ensuring our future by launching a capital

ASSOCIATION MEET YOUR NEWS PPA PRESIDENT What is the most important thing you would like to see accomplished in your term? I don’t think there is one thing. Over the course of the next year PPA needs to 1) work with PPCN to get and successfully execute a contract (preferably more than one); 2) we need to start and complete major renovations to our building; and 3) we need to continue to grow membership and engage members where they are. With that being said, we also need to stop the proposed cuts in PACE and Medicaid dispensing fees dead in their tracks.

Why did you decide to study pharmacy? Like most good things that have happened to me, the short answer is serendipity. At the end of my junior year in high school I needed to select an elective to take during my senior year. One of my closest friends (still) recommended I take pharmacology (yes, my high school offered pharmacology

as an elective course) because “... you’ll learn about drugs ... it’ll be cool.” Well, I wanted to be cool, so I learned about drugs. Turns out, I absolutely loved the course and it set me on my path towards pharmacy school so that I could learn more about the science behind how medications work and how they are used to help people and not hurt them.

What do you like most about being a pharmacist? It’s the best of all worlds! We get direct patient care. We get to study and apply science. You could focus on the business or policy sides if you wanted. We have the luxury of being able to dive deep into a specifically large topic (pharmacotherapy) that is also incredibly diverse — no one else gets to think about just medications all of the time. We get to play detective, educator, facilitator. We get to champion using medications for good and crusade to prevent harm. What’s not to like?

When did you join PPA & why? I joined PPA in 2009 after moving back to Pennsylvania. I joined for a few different reasons. First, PPA past-president Bruce Sigman introduced me to the organization when I was an APPE student by taking me to my first legislative day and preparing me to meet with legislators. It was a very positive experience that I will never forget. Additionally, I was looking for opportunities to get more involved in an organization and was trying to find a place to get started. PPA was (and is) in that “Goldilocks” zone in that it wasn’t overwhelmingly large but not too small either — it was just right to be able to get involved in meaningful work.

When you are not working, what can you be found doing? Playing with my infant son, Alexander, and going on adventures with him and my wife, Iris. There is absolutely nothing else I would rather be doing. 

www.papharmacists.com • 7


WELCOME! NEW MEMBERS

PPA Welcomes the following New Members who joined the association on March 24, 2017 – May 24, 2017. Please make these new members feel welcome and part of Pennsylvania pharmacy! Pharmacists Amy Amond, Greensburg, Giant Eagle Pharmacy Patricia Audet, Philadelphia College of Pharmacy Bob Berardocco, Port Richmond Pharmacy Richard Boahene, Hillrise Pharmacy Gregory Castelli, Pittsburgh, UPMC St. Margaret Adele Chatellier, Pittsburgh, UPMC Sheena Cherian, Eagleville, PerformRx Bruce Citsay, Lititz, Weis Markets Meghin Cocca, Harrisburg, Penn State Milton S. Hershey Medical Center Ardis Copenhaver, Aspinwall, UPMC ST. Margaret Gino Cordisco, Mars, Med-Fast Pharmacy Nicole D’Antonio, Irwin Meagan Decker, Harleysville, The Moses H. Cone Memorial Hospital James Demers, Brockie Healthcare Geethu Eype, Philadelphia Emily Fargo, McMurray, UPMC St. Margaret Dante Grassi, Danville, Geisinger Health System Nicole Hasson, Value Drug Company Ronald Higginbotham, Cranberry Township, Allegheny Health Network Barbara Hoffman, Scottdale Pharmacy Inc Mitchell Hughes, Fairless Hills, Penn Medicine Teresina Imbrogno, Pittsburgh, Duquesne University & St. Barnabas Health System

8 • Pennsylvania Pharmacist • July/August 2017

Patricia Klatt, Pittsburgh, UPMC St. Margaret Katie Krise, Johnstown, CVS Emilu Kryger, Hummelstown Michael Lehr, Mechanicsburg, Alert Pharmacy Services Jill Link, Value Drug Company Jarrod Macklin, Jay’s Hunting Park Pharmacy Amanda Martin, Hellertown Harshil Patel, Easton Specialty Pharmacy Inc James Pikarski, Williams Apothecary Fernando Rodriguez, Warminster Square Pharmacy Natalie Ryan, Northern Cambria, Value Drug/Value Specialty Drug Woole Schiller, US1 Pharmacy Kristian Shaw, Oak Lane Pharmacy Charlie Shea, Charlie’s Pharmacy Yolanda Spangler, Harrisburg, Steelton Pharmacy Miki Thierman, Port Allegany, Port Allegany Pharmacy Jason Turba, Pleasantville, Gaughn’s Pharmacy Thomas Wehrli, Irwin, Hometown Apothecary Drugs

Sa’ed Al-Olimat, Pittsburgh Erin Grover, Pittsburgh Benjamin Lackner, Pittsburgh Nisha Mallya, Richboro

Associates Annmarie McCarron, Philadelphia, Max-Well Pharmacy Services Christy Potts, Altoona, Walgreens

Philadelphia College of Pharmacy Isaac Abraham, Suffern Eishdeep Cattry, Syosset Namarta Kalia, Franklin Park Rebecca Vayalumkal, Congers

Students Duquesne University – Mylan School of Pharmacy Chelsey Adams, Cheswick

Jefferson School of Pharmacy Maria Budney, Chester Lloyd McKee, Philadelphia Shannan Street, Chadds Ford LECOM School of Pharmacy Anh Bui, Erie Marcus Ewane, Erie Pauline Kang, Erie Temple University Michael Arutunian, Havertown Besar Elezi, Philadelphia Andrew Finkelston, Trumbauersville Megan Henry, Prospect Park Sara Lee, Philadelphia Abby McCabe, Philadelphia University of Pittsburgh Kiana Green, Butler Courtney Roperti, Murrysville

Wilkes University Nikko Bonavoglia, Olyphant 


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CAMPUS CHECKUP

Duquesne University Contributed by: Danielle Taciuch, Communication Ambassador The Duquesne School of Pharmacy ended the semester with many events and activities. We had a great turn out for Legislative Day in the Spring with about 40 students in attendance. LKS, Kappa Psi, and the other pharmacy Greeks celebrated the past semester with their Spring Formal events. The pharmacy organizations had also been busy electing new executive board members for the 2017-2018 year and preparing for the fall. Before the summer began, APhA and PPA already began to promote and gain interest for their upcoming conferences in the fall. The pharmacy organizations continue to work hard over the summer to plan for the next year and develop more advocacy and pharmacyrelated events!

attended and participated in OPA and OSHP annual meetings.

TEMPLE University Contributed by: Harris Nguyen, Communication Ambassador The PPA Owls would like to start off with Congratulations to the Class of 2017 for graduating, with special recognition to Hamad Juboori and Rachel von Vital for their multiple positions held in PPA during their

Webber advocated for key legislative issues with a theme of “Putting Patients First”. Other big events for the semester included the APhA interprofessional health fair that included students from nursing, Prepharmacy, and the school’s organ donation challenge team. They educated patients on important topics such as vaccinations, STI prevention, mental health awareness, nutrition and performed blood pressure screenings. Other major events for Temple were Relay for life where Temple Pharmacy students were able to raise over $1,400 for the American Cancer society and mentor night, which is an opportunity for our

Ohio Northern University Contributed by: Foud Bahamdain, Communication Ambassador April was National Donate Life Month at Ohio Northern University. Many organizations took time to advocate about organ donation. Student Society of HealthSystem Pharmacists (SSHP) and NODAC held a organ donor presentation on April 16th to help raises awareness on campus. Moreover, student and faculty shared an active day in the 9th annual 5k to support cystic fibrosis on May 7th. Ohio Northern University also welcomed Tyson Crowmeens, manager professional and college relations at CVS Health, for the annual interview tips lecture. Also, the Ohio National Guard staff Sergeant Kenneth Vance gave an outstanding presentation about the importance of leadership to security and about the modern challenges to good leadership. This presentation was part of the first leadership speaker series held on campus. On April 19th-21st Earth Week was honored with many volunteer activities. Many student organizations joined the recycles competition and campus garden clean up. Finally, some ONU PPA members

10 • Pennsylvania Pharmacist • July/August 2017

Top: Relay for life Below: Mentor Night

time at Temple Pharmacy. We thank them for everything they’ve down for our chapter. Temple pharmacy has been busy in the spring semester; most importantly in regards to PPA we attended the annual Pharmacy Legislative Day in Harrisburg. 108 Temple Pharmacy students alongside faculty members Dr. Jennifer Andres and Leigh

students to meet and conduct roundtable discussions with pharmacists from different settings such as clinical, retail, and industry. I hope everyone has a wonderful summer, and it’s been a pleasure for me to have served as Temple’s Communication Ambassador for the 2016-2017 year.


University of Pittsburgh

deliberation of the Pennsylvania State Senate. This was a great opportunity for all who attended.

Contributed by: Kelly Jenniches, Communication Ambassador

Overall, it has been a successful year in PPA and at the University of Pittsburgh School of Pharmacy. We are looking forward to working on next year’s Dean’s Theme projects and having another rewarding and outstanding year.

This last month of the semester was busy for the University of Pittsburgh PPA chapter. The first event that occurred was the Spring Leadership Retreat hosted by the Pitt APhA-ASP and Phi Lambda Sigma chapters. It was a successful night of leadership, planning, and collaboration between all of the pharmacy organizations for the next academic year Dean’s Theme projects. The Dean’s Theme for next year is over the counter medications. Every organization is encouraged to promote this by educating the public on various aspects of this topic including safe storage of OTC medications, kid-friendly information, natural options, geriatric safety, sun safety, first aid and much more!

Wilkes University Contributed by: Kayla Bardzel, Communication Ambassador After a thrilling beginning to the Spring semester, Wilkes PPA continued on their Katy’s Kids marathon with more events through March and April. These events were promoted on our Facebook page to show our audience everywhere we have been taking the program.

Our main focus through these months was preparing for Legislative Day on April 19th. Felicia, our Government Relations Ambassador, has been getting our chapter ready and prepared by holding Legislative Day information sessions and teaching everyone about PPA’s priority legislative issues, so we were prepared when we talked to our legislators. We currently have seven members on their way to completion of the GRASP program. In April, we were excited to collaborate with our APhA-ASP chapter at Wilkes to bring Eric Pusey in as a guest speaker. Our chapter loves to bring PPA’s influential and well-known leaders to discuss with us the evolving nature of our profession. As we are closing out the end of the semester, this leads to the election of a new executive board for our chapter. Our 20162017 board loved serving the Wilkes PPA chapter and we can’t wait to see what the new board will do. Best of luck to them for next year! 

During the following week of the retreat was Legislative Day. Over 100 Pitt Pharmacy students attended, including the entire Class of 2019 and select students in the Class of 2018 and the Class of 2020. Every student in attendance was able to meet with their local legislators to discuss various current pharmacy issues such as the proposed cuts to Medicaid Reimbursement, expanding pharmacist-provided immunizations opportunities, and regulating pharmacy technician registration. As a result of these meetings, the pharmacy technician bill was passed by the Pennsylvania House of Representatives on May 9th and now awaits

Play golf to benefit PPA’s Educational Foundation & PharmPAC!

Thursday, September 21st, 2017 Pocono Manor Resort — Pocono Manor Lunch Buffet & Registration: 11 AM Shot Gun Start: 1 PM

www.papharmacists.com • 11


FEATURE ARTICLE

MEMBER PROFILE

PJ Ortmann, RPh, MBA — MedvisoRx, LLC What made you choose the profession of pharmacy? I grew up in my father’s pharmacy in Columbia, Pa, and though I never felt obligated to PJ Ortmann, RPh, MBA become a MedvisoRx, LLC Pharmacist or take over the family business, I learned the satisfaction of helping people that my father and Pharmacy taught me. I applied to several colleges outside the field of Pharmacy, but knew this is where I belonged. What was the most memorable experience of your career? While every day of my life as a Pharmacist has been a learning experience, I believe

my most memorable times were as a new 2nd Lt in the Army right after graduation. I was immediately challenged to manage budget, inventory and staff for a midsized Army hospital filling up to 1500 Rx/day in the outpatient pharmacy, running the inpatient Pharmacy and outlying clinics, as well as performing my military duties, all without computers. Where would you like to see the profession go in ten years? With more automation, increased use of skilled technicians, and better academic acceptance of Pharmacists on clinical teams, I believe Pharmacists working in ALL physician practices would be extremely beneficial and efficient toward further improving patient care. What do you like most about being a pharmacist? I am grateful for the attention and respect I receive when someone asks what I do for a living, and I really don’t mind the medication

questions from a fellow passenger on a plane when they discover what I do. I believe I have made contributions to Pharmacy in my career, but Pharmacy has been good to me as well, and has provided terrific opportunities both personally and professionally. I appreciate the vast knowledge, experience, and camaraderie of my colleagues. How has being a PPA member helped you professionally? The networking opportunities alone are invaluable, but PPA membership has made me aware of how much work needs to be done to improve and grow the profession. More importantly it demonstrates how we as Pharmacists can make those improvements working together. I especially appreciate learning about and participating in the legislative processes that are integral to long term changes. If you were not a pharmacist, what would you be doing? Working in a Food Bank. 

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FEATURE ARTICLE

STUDENT MEMBER PROFILES Zachary DeJames

Zachary DeJames, Duquesne University Mylan School of Pharmacy, PharmD Candidate 2020

Why did you choose to study pharmacy? I chose pharmacy for a few different reasons. My father has been a pharmacist since I can remember and one of my fondest memories from when I was younger was visiting him in the pharmacy. I can remember just being in awe at what the pharmacists were doing and how they were helping people. The second reason I choose pharmacy was because throughout elementary school and high school, science was always my favorite subject because I found it to be incredibly interesting. Therefore, I combined my passion for helping people and my love for science and decided that pharmacy was what I wanted to do. If you were not studying pharmacy, what would you be doing? If I were not studying pharmacy, I would probably be studying some subject in business, such as management or supply chain management. I love to talk to people and find out about their interests and I could definitely see myself in one of those two areas of study.

Christian Giovannini, Wilkes University Nesbitt School of Pharmacy, PharmD Candidate 2018

Christian Giovannini Why did you choose to study pharmacy? I knew I wanted to enter the medical field. I decided pharmacy was for me because I can directly help the people of my immediate community. If you weren’t in pharmacy school, what would you be doing? If pharmacy didn’t work out for me, I always said I would have wanted to become an optometrist. What is your favorite experience you have had since studying pharmacy? My favorite experience is being able to apply topics I learn in class, at work and during IPPEs. I like when I can actually use what I learn and apply it to a real patient setting. An example is with my Longitudinal care class, where I have my very own patient who I see every few weeks. What are your words to live by? No matter how difficult something in life can be, I learned from my parents to never give up, and that with hard-work, dedication, and determination, anything is possible.

Where do you see yourself in five years? In five years, I would like to believe I would be working in a pharmacy, hopefully still in the Pittsburgh area. In those five years, I hope I would have done research and actually decided which field of pharmacy I would like to pursue.

If you could only take three medicines with you to a deserted island, what would they be? Acetaminophen for pain. An Antibiotic for infection. EpiPen in case of severe allergic reaction, I would hopefully be able to survive. 

Who has been the greatest influence in your life? The greatest influence of my life has been my father. Growing up, he would always try to be at each of our events, whether that was baseball games or a school function. He has worked his entire life and what he has done for pharmacy is incredible. Each day I continue to learn more and more from listening to my father talk. His incredible knowledge is a trait I hope to emulate one day. I will always appreciate the things my father has done for not only me, but also my entire family.

“I like when I can actually use what I learn and apply it to a real patient setting. An example is with my Longitudinal care class, where I have my very own patient who I see every few weeks.”

What has been your favorite experience you’ve had since studying pharmacy? My favorite experience since studying pharmacy has been the work I’ve done at the Duquesne University Pharmacy on the Hill. To experience the information I have been learning in class in a real pharmacy setting is an experience I have loved. I enjoy the people I work with, the work we are doing and the relationship we are building with the community.

— Christian Giovannini www.papharmacists.com • 13


FEATURE ARTICLE

PHARMACY SPOTLIGHT

Moses Taylor Hospital By Christine Trusky, PharmD, PGY1 Resident Lebanon VAMC This article was contributed while Christine was on rotation with PPA.. Located in Scranton, PA, Moses Taylor Hospital is an acute care community hospital that is affiliated with Commonwealth Health Systems. Moses Taylor is a 217 bed hospital that contains a Level 3 NICU, pediatric unit, surgical unit, orthopedic floor, outpatient infusion center, and senior mental health unit, in addition to its standard inpatient care floors. Moses Taylor recently became the first hospital in the nation to receive Perinatal Certification by The Joint Commission. They are also a certified Primary Stroke Center and accredited Chest Pain center. Michele Musheno is the Director of Pharmacy at Moses Taylor Hospital. She has been at Moses Taylor for the past 13 years. She started her pharmacy career at Northeastern University in Boston, MA, and then went on to earn her Master’s Degree in Human Resources from the

University of Scranton. She worked at Geisinger Wyoming Valley for 19 years where she did an applied pharmacoeconomic fellowship, ran a Coumadin clinic, started the home infusion center, served as Assistant Director, and started various clinical pharmacy programs. Michele was president of both PPA and the Lackawanna County Pharmacy Association. She is currently heavily involved in the community, and serves as leader of the Northeast Chapter of the Pennsylvania Society of Health Systems Pharmacists (PSHP). She thinks it is important for pharmacists and pharmacy students to become members of PPA in order to gain leadership, learn more about the profession of pharmacy, and learn how the government affects the way pharmacists practice. PPA offers education and opportunities for lifelong learning that keep you up to date at the state level.

Moses Taylor Pharmacy Staff 14 • Pennsylvania Pharmacist • July/August 2017

“... it is important for pharmacists and pharmacy students to become members of PPA in order to gain leadership, learn more about pharmacy, and learn how the government affects the way pharmacists practice. PPA offers educa­tion and opportunities for lifelong learning that keep you up to date ... ” — Michele Musheno


Pharmacy staff daily safety huddle Narcotic waste management

Emergency crash cart kit check Michele said that one of her greatest accomplishments has been starting the PGY1 pharmacy residency program at Moses Taylor in 2008. They expanded to two pharmacy residency positions and fully accredited by ASHP. The residents play a crucial role on interdisciplinary rounds, and as members of various hospital committees where their medication expertise is valued by other health care professionals. Pharmacists are integrated into many areas of the hospital such as the NICU, ICU, telemetry unit, and OB unit. The pharmacy is an integrated model; pharmacists are stationed on each floor of the hospital to enter and verify orders, as well as, participate in interdisciplinary patient care rounds. The central pharmacy is open 24 hours a day, 7 days

TPN Compounder a week; while the nightshift pharmacist is centralized they are still involved in the dosing and monitoring of specific drug therapy and dosing protocols for inpatients and outpatients. Some of the committees that pharmacists participate in at Moses Taylor are antimicrobial stewardship, medication safety, P&T, surgical care and clinical quality. As a Level 3 NICU, the pharmacy recently implemented a new TPN software dosing program that is integrated with the NICU TPN compounder to calculate not only the baby’s parenteral nutrition requirements but considers the baby’s enteral feedings for correct caloric and electrolyte needs.

Moses Taylor’s pharmacy has introduced some unique aspects into their daily work routine to improve safety outcomes, such as, morning safety huddles, kit checks for crash carts, and controlled substance waste management. During the safety huddles, the pharmacy staff meet to talk about safety issues that have occurred over the past 24 hours, or issues that are expected to occur over the next 24 hours, like drug shortages, new therapies, or high risk patients/procedures. A safety feature of the emergency crash carts is that they are filled with kits that have both barcodes and chips on the medications to ensure that each item is correct for administration, to alert the staff of what is missing after a code so that it may be replenished, and to track expiration dates. Another initiative by the pharmacy

staff at Moses Taylor to decrease diversion of narcotic controlled substances, is that any controlled substance waste from the operating room or anesthesia is returned to the pharmacy where they ensure that the proper amount of drug was given to the patient, and note if the accurate amount of drug was wasted. Michele believes that just because an institution may have a small staff, that doesn’t mean that they cannot perform clinical services, and her staff has certainly proven that this is true. 

www.papharmacists.com • 15


FEATURE ARTICLE

HOW TO SURVIVE A dea INSPECTION: RECORDS REQUIRED FOR INSPECTION© Contributed by: Carlos M. Aquino, Compliance Consultant & Founder, PharmaDiversion LLC™

DEA Biennial Inventory

Should be done within two years of the previous DEA biennial inventory. The inventory must include expired controlled substances awaiting destruction. Schedule IIs must be reported separate from Schedules III through V. In some states like New York, it must be done on or about May 1st of each odd year.

DEA Forms 222

Whether it is a paper DEA Form 222 or the use of CSOS generating a DEA Form e222, it is recommended that each order form have the quantity received and the date received noted on the form. The paper or electronic order form can be stapled to the invoice. They should be filed monthly. The paper order forms should be filed by use to include: blank, executed, voided by pharmacy, and cancelled by supplier.

Invoices for Schedules III to V

Should be filed separate from all other invoices. Each invoice should note the quantity received and date received by the pharmacy. The invoices should be filed monthly.

Power of Attorney Letters

Should be maintained for each pharmacy staff member authorized to sign a paper DEA Form 222 or ordering with their personal CSOS password Schedule II controlled substances. The original letters should be maintained in a separate folder.

Expired Drugs

All expired or unsaleable controlled substances should be maintained in a box or container marked EXPIRED and a continuous inventory should be kept until they are transferred to a DEA registered reverse distributor.

Perpetual Inventory

All schedule II controlled substances must be exact when doing a physical inventory. It is recommended that Schedule II be maintained with the use of a paper or electronic perpetual inventory. Selected Schedules III to V should be maintained as exact count to include Suboxone, Tramadol, Zolpidem, and selected benzodiazepine.

Drug Destruction

All destructions for the last two years should be available for inspection by DEA or state regulatory entity. All Copy 1 and 2 (DEA Copy) received from DEA reverse distributor must be noted with the quantity of Schedule II shipped and date shipped to the reverse distributor. Generally, invoices for Schedule III to V received from the DEA reverse distributor will note quantity shipped and date shipped to the reverse distributor. If not, these invoices should have the quantity shipped circled or checked and the date shipped to the DEA reverse distributor noted by the pharmacist.

16 • Pennsylvania Pharmacist • July/August 2017

Theft or Significant Loss Reports (DEA Form 106)

Any theft or significant loss must be reported to DEA within one business day of discovering such theft or significant loss. Once the quantity has been established, a DEA Form 106 must be done electronically through the DEA Diversion website. If more than 30 days are needed contact the local DEA Diversion Office.

Combat Methamphetamine Epidemic Act (CMEA)

Any pharmacy selling OTC products containing must annually certify that their pharmacy staff is familiar with the CMEA regulations. This includes maintaining a paper or electronic record of purchases and valid identification for each transaction. Both the certificate and booklet are required to be available for inspection.

Prescriptions

All paper or electronic controlled substance prescriptions must be available for inspection. Paper prescriptions need to have all the required information on the front of the prescription. Most errors found includes patient’s address, and prescriber’s DEA number. Pharmacist are permitted to fill in such information but they should contact the prescriber and to have them concur with the placing of the information on the front of the prescription.

Use of Perpetual Inventory

It is important for a pharmacy and their staff pharmacists to maintain a complete and accurate inventory of controlled substances to prevent their theft or a significant loss. The best method would be to maintain a paper or electronic perpetual inventory of at least Schedules II and significant Schedules III and V. All such records noted above must be readily retrievable and be available for inspection. DEA requires at least two years of records for their inspection, but some states like New York may require up to five years of records to be available for inspection. Failure to maintain a complete and accurate inventory and inventory records may cause a pharmacy registrant to be the subject of a criminal, civil or an administrative DEA investigation. Failure to maintained complete and accurate DEA required records may result in a $10,000 civil fine for each violation found during their inspection. Generally, civil fine amounts may begin at a $200,000 level and may go up to a $1 million dollars. 


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MEMBER NEWS

Congressman Brian Fitzpatrick visits Sellersville Pharmacy at Penn Foundation US Congressman Brian Fitzpatrick, representing the 8th Congressional District in PA (Bucks County) visited Sellersville Pharmacy at Penn Foundation. As a direct result of the NCPA Fly-in and at an invitation, Congressman Fitzpatrick was able to arrange a visit where he was showed all of the special things that Sellersville Pharmacy does that sets them apart from the big-box chains, including personalized delivery, compliance packaging (both single dose and multi-dose), service to ACT teams, group homes, the homebound, immunizations, and more. The tactics of the PBM’s that threaten the ability to continue providing these needed services to the elderly and disabled were discussed. Penn Foundation was recognized as a Center of Excellence in the treatment of addiction by Governor Wolf. 

Pictured from left to right: Adie Defrancesco, Rob Frankil, Congressman Brian Fitzpatrick and Mike Brown

Congratulations Rich ost! Richard Ost has been selected to receive the Community Person Award at the Mayor’s Drug and Alcohol Executive Commission’s 20th Annual “Making a Difference” Recognition Dinner. This award recognizes the work he does to fight against the opioid crisis in Philadelphia and the unique program to dispense Naloxone. 

18 • Pennsylvania Pharmacist • July/August 2017


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ASSOCIATION NEWS

2016 Outstanding Students: Where Are They Now? Mariah Deibert, PharmD — Duquesne University

I am currently working as a clinical pharmacist at Geisinger Community Medical Center (GCMC) in my hometown of Scranton, PA. I have enjoyed working close to home because I get to spend more time with my family. Over this past year, I have created many new trusting relationships with other healthcare professionals and patients. One of my favorite parts of this job has been getting to talk to patients whether it is to counsel or just to listen to a story they want to tell. I look forward to continue working at GCMC and to continue my involvement with PPA.

Trina Patel, PharmD — Wilkes University Mariah Deibert, PharmD

Kelsey Moss, PharmD

Since graduating from Wilkes University last May, I have been completing a PGY1 residency at the Wilkes-Barre Veterans Affairs Medical Center (VAMC). During my time at the VAMC, I have learned a lot about ambulatory care and have immensely grown as a pharmacist. In the future, I hope to work at a VA as an ambulatory care pharmacist as I have seen first-hand the direct impact pharmacists can make to a veteran in order to improve their health.

Jamie Shepherd, PharmD — LECOM After graduating from LECOM, I have been working at Geisinger Holy Spirit Hospital as a night shift pharmacist near my home town of Mechanicsburg, PA. Being on night shift has taught me to adapt quickly and be innovative in order to provide the best patient care possible. The time I have spent here has been invaluable in jump-starting my career as a pharmacist and I look forward to what lies ahead.

Kelsey Moss, PharmD — University of Pittsburgh Trina Patel, PharmD

Breanna Kester, PharmD

It was an honor receiving the Pennsylvania Pharmacists Association Outstanding Student Award in 2016. Since then, I have completed an amazing and rewarding year of training as a PGY – 1 Pharmacy Resident focused in Ambulatory Care at Allegheny General Hospital. Throughout this past year, I have been able to enhance my knowledge surrounding drug-therapy, skills in providing direct patient care, and ability to work collaboratively with the health care team. After graduating from my current residency program, I plan to pursue a career focused in chronic disease state management and transitions of care.

Breanna Kester, PharmD — Philadelphia College of Pharmacy

Jamie Shepherd, PharmD

Nissa Tasnim, PharmD

I can’t believe it’s been a year since graduation! They say time flies and that is so true. Since receiving last year’s outstanding student award, I have been working as a floating pharmacist at various Walmart pharmacies in the central PA area. It is nice to have a variety of settings so as not to get too bored! My favorite part of my job would be counseling patients to help them gain a deeper understanding of why they’re taking certain medications and to motivate them to be more compliant. It is also quite rewarding to answer any questions that the doctor may not have gotten to in a short office visit. Providing over the counter recommendations is extremely important as well and something I take pride in doing.

Nissa Tasnim, PharmD — Temple University

After graduation from Temple University School of pharmacy, I have completed a PGY1 pharmacy practice residency at The Reading Hospital and Medical center. This year had served as a huge growth in my career, which allowed me to acquire a multitude of valuable skills that I couldn’t have gained otherwise. My residency allowed me to identify my current interest areas, while devolving an appreciations for a broad range of pharmacotherapy. Currently, I am looking for job opportunities in the area, so I can stay and advocate for pharmacy with more PPA involvement. 

www.papharmacists.com • 21


ASSOCIATION NEWS

Congratulations to the 2017 Recipients of the PPA Outstanding Student Award! This award honors and recognizes one graduating student at each school of pharmacy in Pennsylvania who has been most active in PPA during his/her academic years!

LECOM: Emily Petrak I am extremely honored to have been chosen for the 2017 Pennsylvania Pharmacists Association Outstanding Student of the Year from LECOM! I feel that PPA has given me an experience that is invaluable while I was a student, and I hope to take what I learned from this Association and use my advocacy skills in any state I end up in. I learned what it’s like to work alongside my peers and colleagues to advocate for changes and/or improvements to the law that will improve the profession not only for ourselves but for our patients. I’ve met some amazing people from PPA simply by being part of the Student Advisory Board over the years and by attending various conferences and Legislative Days. Thank you PPA for providing opportunities for pharmacists, technicians, and students to take part in legislation and advocacy for pharmacy. As for my future, I have been matched with a Community Pharmacy Residency Program in Augusta, GA starting this July. My focus during this residency will consist of patient care

projects, public health events and/or classes, and improving my knowledge of pharmacy practice in long term care. I plan on joining the Pharmacy Associations for both South Carolina and Georgia since I will live along the border. I will also remain a member of PPA and hope to make it back for conferences in the coming years. I will continue to advocate for pharmacists, technicians, and students by being an active member of all these organizations!

Wilkes University: Jennifer Smith I am honored to be one of the recipient’s of PPA’s Outstanding Student Award. I have thoroughly enjoyed my experiences as a student member and leader in PPA at Wilkes and as a member of the Student Advisory Board. These experiences have helped me to grow as a person and future pharmacist. After graduation, I will be working as a pharmacist with CVS/Health in the Harrisburg, PA area and look forward to continued involvement with PPA. Thank you for this honor!

22 • Pennsylvania Pharmacist • July/August 2017

Temple University: Hamad Juboori I’m incredibly humbled and honored to receive the 2017 PPA Outstanding Pharmacy Student Award. My involvement in PPA at Temple, on the Student Advisory Board, and on the Board of Directors has provided me with invaluable experience and insight into the pharmacy world. It has garnished me with support and strong relationships that will last throughout my professional career. I am excited to begin my career as a PGY1 Managed Care Resident with PerformRx and to continue promoting public health through my profession. I plan to support PPA through advocacy in the years to come. Thank you, PPA, for all you do!

Philadelphia College of Pharmacy: Nirali Patel I feel overwhelming joy and honor to be given the recogni­ tion of PPA outstanding student award for the class of 2017. My involvements in this organi­ zation and collaborative work with faculty and fellow class­ mates has afforded me the opportunity to understand issues holistically and on a personal scale. The poster presentations and annual team project allowed me to foster innovative spirits, address prominent issue on both an individual and community level. These experiences were unparalleled, as were my interactions and dialogue with other healthcare practitioners and professionals both and outside of the pharmacy realm. I am incredibly humbled by the support of my peers and profes­ sors and realized one pivotal lesson to carry throughout our journeys. Learning is never wasted.Learning has no limit; it has no threshold. Learning is an insurmountable act. And with each step, thought, written word, and vocalized idea we all are learners irrespective of our stage in life. Learning is invaluable. Here’s to those who dream.


growth and success by staying an active member and inspiring young student pharmacists to find their passion in pharmacy. Thank you again for this wonderful recognition!

Duquesne University: Rachael Richter It is a true honor to be the recipient of the Pennsylvania Pharmacists Association’s 2017 Outstanding Student Award. I owe my many successes in PPA to the former upperclassmen that encouraged my involvement, my amazing Duquesne peers and advisors that sat on the chapter’s executive board, and finally the student advisory board and PPA staff that supported me throughout pharmacy school. I was blessed with a great group of friends and mentors that allowed me to grow personally and professionally within the organization. I will always cherish my time as a student pharmacist in PPA and I plan to continue my professional

organization. This summer I will begin my PGY-1 Pharmacy Practice residency program at Thomas Jefferson University Hospital. I plan to continue my involvement with PPA as a new practitioner, serving the pharmacy community, giving back to future pharmacists, and trying my best to live up to the example set by my mentors. Thank you so much for awarding me with this honor, as well as for the privilege of working with such a wonderful organization as PPA.

Jefferson College of Pharmacy: RJ LaCoursiere It was an incredible honor to receive the Jefferson College of Pharmacy Pennsylvania Pharmacists Association Outstanding Student Award, especially when considering the impressive accomplishments of my peers. I was extremely fortunate to have several faculty mentors who are actively involved in PPA and were therefore able to show me many different ways to become more involved in this valuable

past 4 years, all of which have allowed me to become further involved with the profession of pharmacy. Not only did this enhance my learning and experiences while at the University of Pittsburgh, but it also taught me the importance of being an active member of professional organizations. The relationships and memories I have made through conferences and other activities hosted by PPA are irreplaceable and will stay with me throughout my career. As I start my residency program with Auburn University, I am looking forward to being an active member of the Alabama Pharmacists Association and encouraging students to get involved with their state association early in their pharmacy education. I am truly honored to have received this award and am excited to continue my relationship with PPA for many years to come! 

University of Pittsburgh: Jennifer Fever I cannot thank the Pennsylvania Pharmacists Association enough for the many opportunities it has presented me with these

PPA Dues Easy Monthly Payment Options—Now Available! Pharmacist members now have the option to pay their PPA dues in convenient, low monthly payments. How to switch to the monthly installment plan online: • Visit www.papharmacists.com when it is time to renew your membership • Enter your User Name and Password in the Sign In box on the right side of the page. Click Sign In. • Select Renew Membership Now • Verify that all of your information is correct and update anything that needs updated, Click Save Changes. • Check the box for Pharmacist Dues-Monthly Installment Plan, fill in your payment information and click Submit *You can contact the PPA office at 717-234-6151 ext. 5. to renew your membership over the phone or if you have forgotten your username or password.

www.papharmacists.com • 23


LEGISLATOR PROFILE

Representative Mark Longietti (D-7) What are the key issues you would like to see addressed this session? Additional state investment in highquality, early childhood education. Every dollar invested returns between $7 and $17, according to peer-reviewed studies. Aligning workforce development initiatives with the jobs of the 21st Century. Continuing to address the Heroin and Opioid epidemic. Tell our members a little about your background and why you are a legislator? I practiced law for 18 years in my home community prior to running for office. I ran for State Representative to help transform the economy of my community and to improve the quality of life for our citizens.

How do you see pharmacy and its role in health care evolving in the in the future? I believe that pharmacists will play an increasing role in interacting with patients and managing medications. I also believe that technological advances will permit more remote communications between pharmacists and patients. Advice for pharmacists about the political process? I am a strong advocate for professionals becoming active in their statewide association. The association provides the best opportunity to advance policy initiatives at the state level and is truly the most powerful voice for issues affecting your practice.

What do you do for relaxation or enjoyment? I enjoy traveling and seeing and experiencing new and different places. I also enjoy snow skiing. Unfortunately, work commitments significantly limit these opportunities. 

Representative Stan Saylor (R-94) Member of the Pennsylvania Community Pharmacy Caucus What are the key issues you would like to see addressed this session? As the Appropriations Chairman my main focus this legislative session will be to ensure the passage of a balanced on-time budget. We must ensure that we pass a budget that is respectful to the taxpayer while still providing for the needs of the citizens of Pennsylvania. For the 2017-18 fiscal year, Pennsylvania is facing a large deficit and we will have to work together in order to solve this fiscal challenge. This budget will require many hard choices, but I am confident that the General Assembly can come together to solve this problem. Tell our members a little about your background and why you are a legislator? I was first elected to the Pennsylvania House of Representatives in 1992 to represent the southeastern part of York County. I have had the honor of serving in many roles here including as Majority Chairman of the Local Government Committee, Majority Chairman of the Education Committee, Republican Policy Chairman, Majority Whip, and now the Chairman of the House Appropriations Committee. During my time in the House, one of my main passions has been Pennsylvania’s education systems. I have 24 • Pennsylvania Pharmacist • July/August 2017

been a strong proponent of giving our Pennsylvania students the best possible education. Prior to my service in the House, I was a small businessman. How do you see pharmacy and its role in health care evolving in the in the future? As Pennsylvania continues to see an increasing senior population, our pharmacies will continue to be critical to the welfare of Pennsylvania citizens. One challenge that is confronting our state, and indeed the country, is the abuse of opioids. Many people who start down this path and become an addict begin with abusing prescription drugs. Pharmacies have been a strong partner with the state to stop these abuses and we must continue to work together to help combat opioid abuse. Advice for pharmacists about the political process? Understandably, many Pennsylvanians are frustrated with the political process whether it be on the local, state, or federal level. The political process can be frustrating because it requires us to find consensus among many different people with different ideas and different backgrounds. Consensus is not easy. Just think how hard it is to

come to agreement on politics during a Thanksgiving dinner with extended family. Pennsylvania is an extremely diverse state both geographically and culturally. That requires a certain give and take in order to get things done. It is important that local pharmacists stay in touch with their local, state, and federal representatives so that we know what issues are important to you. What do you do for relaxation or enjoyment? I am an avid baseball fan and I enjoy going to various different baseball stadiums. I also like taking short trips to historic sites. I enjoy relaxing on the beach when I can usually with a good book. 


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ASSOCIATION NEWS

Meet the 2017–2018 Student Advisory Board! Each school of pharmacy is entitled to have one student representative and one student alternate serve on the Student Advisory Board. Additionally, each school has a Communications Ambassador, Government Relations Ambassador, and Membership Ambassador, which work to promote and plan events in their area. 

Amandeep (Amni) Kaur Director East

Tina Schuler Director West

Sophia Cothrel Foundation Director School

Shannon Ye Corresponding Secretary

School

Amanda Schwenk Recording Secretary

Communications

Colleen D’Amico Chair

Sarah Bova Vice Chair

Director

Alternate

Duquesne

Olivia Erickson

Elizabeth Leonard

Jefferson

Shannan Street

TBD

LECOM

Brianna Kousin

TBD

Ohio Northern

Joey Muscarella

Mimi Jakes

PCP

Lauren Stabler

Andrej Quatrone

Pitt

Philipp Kappes

Abigail Kois

Temple

Ali Shahbaz

JJ Lapin

Wilkes

Allie Grudeski

Dylan Fox

Government Relations

Membership

Duquesne

Kaelly Mazzei

Jamie Celento

Danielle Taciuch

Jefferson

Nicole Leshko

Jose Fernandez

Jordan Asam

LECOM

Clare Dyczkowski

Shannon Haberman

Michael Coulter

Ohio Northern

Connor Rowan

Ryan Waldschmidt

Nick Bileck

PCP

Brooke Witmer

Samantha Frear

Jacob Gambo

Pitt

Kelly Jenniches

Shannon Ye

Ashley Blazewick

Temple

Andrew Finkelston

JJ Lapin

Ali Shahbaz

Wilkes

Kara Cooper

Nikko Bonavoglia

Rachel Wood

www.papharmacists.com • 27


ASSOCIATION NEWS

Meet the 2017–2018 PPA Board of Directors Elections for the 2017-2018 Board of Directors were held in the spring of 2017, and new Officers and Directors will assume their position on July 1, 2017. Officers and Directors will be formally installed during the Annual Business Meeting on Saturday, September 23rd at the 2017 Annual Conference. PPA would also like to thank the 2016–2017 Officers and Directors for their hard work and dedication over the past year! Specifically the following who are leaving Board service: Marissa Badzick, Donna Hazel, Bob Killoran, Mark Lawson, Roshni Patel, Stephanie Smith Cooney, Julene Vidic, and Rachel Vonvital

Officers: President: Nicholas Leon, PharmD, BCPS, BCACP; President Elect: Lauren Simko, PharmD; Vice President: Richard Demers, MS, RPh, FASHP; Immediate Past President: Eric Pusey, RPh Directors: Academia: Nicole Pezzino, PharmD, CDE; Chain Pharmacists: Stephen Pfeiffer, PharmD, MBA; Community Independent: Shawn Nairn, RPh; Community Independent: Chuck Kray, RPh; Health System Pharmacists: Darryle Tillman Jr., RPh; MCO/Industry/ Government/Other: John Barrett, MBA, RPh; Associates: Greg Drew, RPh; Student Director East: Amandeep (Amni) Kaur; Student Director West: Tina Schuler; Central Region: Richard Seipp, PharmD; Northeast Region: Thomas Franko, PharmD; Northwest Region: Nickolas Kernich, PharmD; Southeast Region: David Stone, PharmD; Southwest Region: Cory Krebs, RPh, Central Region: Richard Seipp, PharmD.

President: Nicholas Leon, PharmD, BCPS, BCACP

President Elect: Lauren Simko, PharmD

Vice President: Richard Demers, MS, RPh, FASHP

Immediate Past President: Eric Pusey, RPh

Academia: Nicole Pezzino, PharmD, CDE

Chain Pharmacists: Stephen Pfeiffer, PharmD, MBA

Community Independent: Shawn Nairn, RPh

Community Independent: Chuck Kray, RPh

Health System Pharmacists: Darryle Tillman Jr., RPh

MCO/Industry/ Government/ Other: John Barrett, MBA, RPh

Associates: Greg Drew, RPh

Student Director East: Amandeep (Amni) Kaur

Student Director West: Tina Schuler

Northeast Region: Thomas Franko, PharmD

Northwest Region: Nickolas Kernich, PharmD

Southeast Region: David Stone, PharmD

Southwest Region: Cory Krebs, RPh

Central Region: Richard Seipp, PharmD

28 • Pennsylvania Pharmacist • July/August 2017


introducing the 2017 committee chair volunteers PPA would like to thank the following individuals for volunteering to serve as committee chairs for 2017–2018. These committees are vital to the success of our organization! If you are interested in serving on a PPA committee, please contact ppa@papharmacists.com to express interest.

Awards Committee Missy Krause

2017 Conference Committee Jennifer Malinowski

2018 Conference Committee To Be Determined

Constitution and Bylaws Michele Musheno

Education Committee Pat Keys

Finance Committee Chuck Kray

Health Policy Jim Reed

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Nominations Donna Hazel

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ASSOCIATION NEWS

PPA’s Affiliated Counties Announce their 2017–2018 Board of Directors Allegheny County Pharmacists Association President

Kyle McCormick, PharmD

President-Elect

Angelo (AJ) Greco, PharmD

Vice President

Nicholas Wytiaz, PharmD

Secretary

Corinn Floyd, PharmD

Treasurer

Renee Richardson, PharmD

Director

Katherine Sulkowski, PharmD

Director

Elizabeth Bunk, PharmD

Director

Amy Woods, PharmD

Director

Amy Haver, PharmD

Director

Michele Hebda, PharmD, TTS

Director

Ravi Patel, PharmD

BucksMont Pharmacists Association President

Stephen Pfeiffer, PharmD, MBA

Vice- President

Robert Frankil, RPh

Treasurer

David Cunningham, RPh

Secretary

D Scott Himler, RPh

Event Manager

Vacant

Past President

D Scott Himler, RPh

Montgomery County Director

Jan Kitzen, RPh, PhD

Montgomery County Director

John Gatto, RPh

Montgomery County Director

John Barrett, RPh, MBA

Bucks County Director

Alan Vogenberg, RPh

Bucks County Director

Michael Brown, RPh

Bucks County Director

Vaishali Rawani, PharmD

Lehigh Valley Pharmacists Association President

Edward Bechtel, RPh

President-Elect

Howard Cook, RPh, BCNSP, FASHP

Treasurer

Gary Fields, RPh

Secretary

Kristen Hartzell, PharmD, BCACP

Director

Vacant

Director

Leslie Johnson, PharmD

Director

Pauline Vargo, RPh

Director

Nicole Pezzino, PharmD

www.papharmacists.com • 31


ASSOCIATION AFFILIATED NEWS COUNTY NEWS

PPA Affiliated Counties Deliver Dispensing Guidelines CE Program All three of PPA’s affiliated counties – the Allegheny County Pharmacists Association (ACPA), the BucksMont Pharmacists Association (BMPA) and the Lehigh Valley Pharmacists Association (LVPA) — have provided or will provide the Addressing Opioid Abuse and Addiction CE to members! This program, available for pharmacist and pharmacy technician CE credit, aims to inform attendees about the current guidelines available from various allied health care provider organizations. Jan Kitzen, BMPA’s Event Manager, stated “As far as this one goes — it was a total success.” ACPA will present this program on July 25th. LVPA held this presentation on May 16th and BMPA held this presentation on May 18th. 

BucksMont Pharmacists Association Meeting Summary May 17, 2017 excellent presentation on the topic “Addressing Opioid Abuse and Over thirty BMPA members and guests gathered at Maggio’s Addiction: Opioid Dispensing Guidelines.” PPA provided us with the restaurant in Southampton, PA for our spring meeting which was slides for the presentation and Rob’s expertise and knowledge of sponsored by Eli Lilly and Company. Four students were present the topic made it easy for him to review the material and answer representing Temple, Jefferson and USP/PCP. Our venue was all questions from the audience. Based on this experience we would excellent and the food was delicious. The spacious environment highly recommend that made for an ideal setting other regional chapter PPA for all of us to network, affiliates consider taking socialize and learn about advantage of this program Lilly’s new product as it continues to expand Basaglar, a new form of with new CE topics in the glargine insulin. Kenneth future. Hoellein, MD, delivered an interesting presentation Our meeting concluded describing the clinical with a brief open business development of Basaglar meeting. One topic of and how it compares to importance that was Lantus. Although the two discussed is that the BMPA products are identical scholarship program in molecular structure has been combined with and similar in terms of the PPA endowment glucose and HgA1c control, scholarship and we are in the USA Basaglar is still seeking applicants for considered a follow-on next year. The application biologic (NDA filing) and deadline is being extended cannot be substituted for to August 1, 2017. The Lantus without consent evening concluded from the prescriber. Third with a welcome to our party payers are gradually new officers and board Pharmacy students from Temple, Jefferson and USP/PCP along with pharmacy making a switch from directors. Board member technician Denise Good enjoying the CE program that followed the Lilly Lantus to Basaglar. Lilly is Melinda Williams presented sponsored dinner presentation. offering coupons and other all outgoing officers with gifts financial assistance for of appreciation on behalf of patients when switching to this product. BMPA and these were much appreciated. Our association is still in search of a new event manager and Jan Kitzen, the outgoing event After the Lilly presentation our meeting turned to a CE program manager will be staying on as a board director to facilitate the provided by PPA. PPA has prepared the first a new series of 30 transfer of this role to whoever becomes the next event manager. minute programs that offer 0.5 CE units and are designed to be Jan also mentioned that there is a sponsor (Abbvie) in place for tacked on to the end of a corporate-sponsored event, as well as any supporting a meeting to be held in late October-early November.  other dinner meeting. Our first experience with this program was very successful as BMPA board director Rob Frankil delivered an

32 • Pennsylvania Pharmacist • July/August 2017


The Lehigh Valley Pharmacists Association The Lehigh Valley Pharmacists Association has been meeting monthly since the beginning of this year. Our most recent meeting on May 16th featured Sherri O’Donald from Value Drug Company, who gave a presentation on the responsibility of wholesalers to identify and report suspicious orders of controlled substances and how Value Drug complies with the DEA requirements. After dinner, Howard Cook presented a ½ hour CE Program developed by PPA on the Pharmacists Role in Addressing Opioid Abuse and Addiction.

On June 20th, LVPA will have Pat Epple come to the Valley to give us an update a Legislative Update CE program. We have had some social and networking events as well. In March, members of the association attended a Lehigh Valley Phantoms hockey game and on July 26th, we will have an outing at CocaCola Park to see an Ironpigs baseball game. More information and registration can be found online! 

INDUSTRY NEWS

VALUE SPECIALTY PHARMACY RECEIVES ACHC ACCREDITATION Value Specialty Pharmacy announced that effective March 20, 2017, it was awarded accreditation from Accreditation Commission for Health Care (ACHC) in Specialty Pharmacy Services for compliance with industry standards and best practices, containing costs, and practicing performance improvement. Nationwide, only 26% of specialty phar­ma­cies have achieved both URAC and ACHC accreditation, and Value Specialty Pharmacy is proud to be included in this exclusive group. The accreditation process involves a comprehensive review of a pharmacy’s organizational structure, policies and procedures, and compliance with federal, and state laws. To achieve ACHC accreditation is to demonstrate the ability to meet regulatory requirements and accreditation standards established by a recognized accreditation organization. Accreditation reflects Value Specialty Pharmacy’s dedication and commitment to meeting standards that demonstrate a higher level of performance and patient care. 

PRS Pharmacy Services Becomes Exclusive Broker for NCPA Members Looking to Sell or Buy a Pharmacy PRS Pharmacy Services, the pharmacy consulting experts, announced its partnership with the National Community Pharmacists Association (NCPA). As NCPA’s trusted partner for many years, PRS Pharmacy Services will be the exclusive seller/buyer action arm recommended by NCPA to over 22,000 independent community pharmacies via the PRS Seller/Buyer Offering Plan. The Seller/Buyer Offering Plan will match the interest of potential buyers to owners interested in selling their pharmacy using a customized, focused marketing plan and PRS’s extensive network of buyers and contacts. Additionally, NCPA will offer, on a non-exclusive basis, the PRS Seller Prep Plan and the PRS Closing and Transfer Plan services to NCPA-affiliated pharmacy owners. The Seller Prep Plan will ascertain a pharmacy’s current operations, analyzing how to make improvements that will normalize the potential selling price and provide maximum value to the owner. Upon the sale of a pharmacy, PRS provides the expertise and support to plan and execute the transfer of pharmacy ownership by way of the Closing and Transfer Plan. These three services will assist members in every aspect of the preparation, sale and transfer of a pharmacy business. Each of the plans is available separately or as a package depending on where an owner is in the selling process. 

www.papharmacists.com • 33


ASSOCIATION LEGISLATIVE DAY NEWS 2017

Putting Patients First On April 19, more than 400 pharmacists and pharmacy students from all across Pennsylvania converged on the Capitol in Harrisburg to advocate on behalf of the profession and show how pharmacists are always putting their patients first! Attendees held over 170 appointments with legislators and staff, armed with the message to oppose cuts to pharmacy reimbursement in both the PACE and Medicaid programs. Additionally, pharmacists asked their legislators to support expanding pharmacistprovided immunization opportunities, medication synchronization, and pharmacy technician registration. The day began with a continental breakfast in the East Wing of the Capitol that also included screenings, displays, and information provided by Pennsylvania’s schools of pharmacy. Students offered guidance on overall wellness and better medication management while providing free health screenings to legislators, staffers, and the public: • Duquesne University Mylan School of Pharmacy: Tanita body fat composition • Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy: Asthma • Jefferson University College of Pharmacy: Naloxone Training Kits

• University of Pittsburgh School of Pharmacy: Script Your Future - Medication Adherence • USciences/Philadelphia College of Pharmacy: Blood Glucose • Wilkes University Nesbitt College of Pharmacy: Effects of caffeine and stimulants • Temple University: Blood Pressure In addition to meetings with legislators or staff, several special meetings were scheduled for small groups of attendees at the PPA office. These informal meetings included presentations and discussions with: Dr. Rachel Levine ----Physician General, Pennsylvania Department of Health, who spoke on standing orders for naloxone, Department of Health initiatives and more. Josh Shapiro ----Pennsylvania’s Attorney General, who spoke on efforts within his department to combat the opioid epidemic.

In less than eight hours, we made a huge impact in on legislators and staff. PPA thanks everyone who took the time to travel to Harrisburg for Pennsylvania Pharmacy Legislative Day. We hope you will consider adding your voice to the more than 400 pharmacists and student pharmacists next year! More photos of the event can be viewed on PPA’s Facebook page. 

Kerry Maloney ----Legal Counsel, Pennsylvania State Board of Pharmacy, who spoke on the regulatory process and provided updates on the State Board of Pharmacy.

Julie Malone, Judith Kristeller and pharmacy students meeting with Senator Lisa Baker 34 • Pennsylvania Pharmacist • July/August 2017

Later in the day, attendees filled the grand staircase in the Main Rotunda for the “Putting Patients First” rally and press conference. Eric Pusey, PPA’s President, discussed the opposition to the proposed cuts in pharmacy reimbursement; Nick Leon, PPA’s President-Elect, discussed the need to expand pharmacist-provided immunization opportunities in Pennsylvania; Lauren Simko, PPA’s Vice President, discussed the need for and benefits of medication synchronization; and Donna Hazel, PPA’s Past Immediate Past President, discussed the need for pharmacy technician registration in Pennsylvania.

President Elect Nick Leon speaking at the rally


Students advocating for pharmacy at the rally

Pharmacy students joined Senate Mario Scavello on the Senate floor

Dr. Rachel Levine addressing interested pharmacists and pharmacy students

Temple University pharmacy student measuring an attendees blood pressure.

Pharmacists and pharmacy students filled the Capitol steps to rally to put patients first!

Representative Eric Nelson met with faculty and pharmacy students from LECOM. Continued on page 37 www.papharmacists.com • 35


FEATURE ARTICLE

Strategies for Precepting Struggling Experiential Students: Suggestions for Enhancing Communication and Documentation By Shirley Bonanni, PharmD; Andrea S. Joseph, MS, RPh; Ellena A. Anagnostis, MS, PharmD, BCPS

Introduction

Continuing Education Activity Details Activity Type: Knowledge -based Target Audience: Pharmacists Cost: Free for PPA members (not available to non-members) Contact Hours: 1.0 CEUs: 0.10 UANs: 0159-0000-17-032-H04-P Release date: February 23, 2017 Expiration date: February 23, 2020 The entire article and exam can be found at: http://www. papharmacists.com/CEHomeStudies. The Pennsylvania Pharmacists Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. To receive CE credit for this activity, participants must read the article in its entirety, complete an evaluation survey on the activity, and earn a grade of 70% of higher on a short exam.

Learning Objectives • Identify practical methods to successfully manage experiential students who are struggling to meet the expectations of the rotation. • Outline a framework to maintain open communication with the school of pharmacy. • Discuss techniques to maintain documentation to prepare for midpoint and final evaluations. • Discuss strategies to create an action plan that documents and clearly defines the knowledge, skills, attitudes and values a student must demonstrate in order to successfully pass a rotation. • Review methods to effectively communicate feedback throughout the rotation with the struggling student.

Introductory Scenario Justine Beeber is a pharmacy student in her final year of pharmacy school. She will complete six 6-week advanced practice pharmacy experience (APPE) rotations. Justine is currently on an inpatient general medicine rotation at a university hospital. Her preceptor is Dr. Newbie, a new pharmacist practitioner who has experience co-precepting students for the past two years. Justine will be the first student for whom Dr. Newbie is the primary preceptor.

36 • Pennsylvania Pharmacist • July/August 2017

In the vast majority of cases, precepting can be a very rewarding and enjoyable process. Preceptors devote hours of time and energy to training our next generation of pharmacists and preparing them for practice. Typically, much satisfaction is derived from this process. Occasionally, a preceptor is faced with a student who is struggling to meet the expectations of the experiential rotation. While the exception, rather than the rule, these scenarios can pose many challenges. It seems that there is a “mystique” surrounding the difficulty of dealing with a student who is not meeting expectations. Simply put, it can be an arduous task to provide constructive feedback. Navigating through this unchartered territory can be time intensive and uncomfortable, particularly for individuals who have limited experience in this arena. Difficult learning situations have been described not only in the pharmacy literature but also in the medical literature and nursing literature. While it may at times appear to be daunting, it is a preceptor’s responsibility to identify students who do not exhibit the knowledge and skills necessary to successfully meet the rotation objectives. It is important to keep in perspective that as Cuellar and Ginsburg offer in The American Society of Health-Systems Pharmacists Preceptor’s Handbook for Pharmacists, “preceptors do not assign failing grades; students earn them. Students fail because they are not meeting the requirements of the rotation.” Allowing underperforming students to pass a rotation defeats the purpose of the learning opportunity. Passing such students sends a message that their knowledge and skills are acceptable, when in fact they are lacking. With prompt attention and thoughtful guidance from the preceptor and the pharmacy school, struggling students can be guided to take the opportunity to “rise to the occasion” and improve their performance to ultimately meet and/or exceed the expectations necessary to successfully complete the experiential rotation. In other cases, when students remain unsuccessful in their ability to pass the rotation, remediation and a repeat of this same experience will be required. Some students simply need more time to develop their knowledge and skills in a particular practice setting. This educational program draws from both our personal experience and published research that has proven useful to us in the process of offering techniques and suggestions to equip preceptors in guiding a student who is performing below the minimum standards. We will review how to set expectations, document student progress, prepare an action plan, and finally, how to effectively communicate with a student who is struggling to successfully meet the expectations of an experiential rotation. Dr. Newbie has been noticing that Justine has been ten minutes late on a daily basis and often does not have a name tag on her white lab coat. She is very casual in her communications with the medical team by making


jokes when the medical intern is presenting a patient. Her responses to questions have been lacking in depth and Dr. Newbie is growing concerned about Justine’s foundational knowledge base.

Conclusion Inevitably, an occasional student will fail a rotation. With prompt attention and thoughtful guidance from the preceptor and the pharmacy school, struggling students can be given the opportunity to “rise to the occasion” and improve their performance to ultimately meet and/or exceed the expectations necessary to successfully complete the experiential rotation. Frequent feedback with

documented specific examples is essential elements in this process.1 In cases where students remain unsuccessful in their ability to pass the rotation, remediation and a repeat of the experience will be required. Some students simply need more time to develop their knowledge and skills in a particular practice setting. Remediation and another opportunity at a similar practice site will hopefully ultimately result in a student who is well equipped to progress through the pharmacy school program. It is our obligation to identify these students and involve them in this process of determining how they may improve, providing effective feedback along the way, so they will ultimately become capable, successful practitioners in our trusted profession. 

LEGISLATIVE DAY 2017 continuedfrompage35

Temple University

Duquesne University

University of Pittsburgh

Jefferson College of Pharmacy

Wilkes University

Philadelphia College of Pharmacy

LECOM www.papharmacists.com • 37


ASSOCIATION NEWS

Duquesne University Takes Steps to Fight the Addiction Crisis By Chelsey Adams, Duquesne University School of Pharmacy Pharm D Candidate, 2018 Living in the heart of Downtown Pittsburgh has its many known advantages: a plentiful number of restaurants, easy walking accessibility, cheap public transportation and an abundant stream of activities. What seems to be frequently left out when speaking of the “City of Bridges” are the non-stop sirens and the ever-growing opioid overdose epidemic engulfing the city. Unfortunately, with a campus so close to such constant activity, the effects of overdose do not stop at campus borders. College campuses across the country are seeing an increase in drug experimentation and prescription misuse leading to an escalation in overdoses. Although the awareness of naloxone being an available opioid antidote is well-known in today’s society, where to receive naloxone and how to execute the standing order for this medication is often misunderstood. Duquesne University School of Pharmacy faculty, staff, and students are actively taking a stand to fight the addiction crisis and promote the road to recovery. Students

“As student pharmacists, it is our job to impact public health in a positive way, including fighting the addiction crisis starting with our own campus.” — Chelsey Adams 38 • Pennsylvania Pharmacist • July/August 2017

enrolled in their Introductory Pharmacy Practice Experience (IPPE) III in the spring semester invited campus and community partners to join them for the first annual Addiction and Recovery Education Wellness Event held on Duquesne’s campus on April 7. The event provided a welcoming environment for all students and employees to voluntarily receive information regarding addiction, recovery and opioid rescue. Placebo naloxone devices were available for those who wanted brief training lead by third professional year student pharmacists along with information regarding the signs and symptoms of opioid overdose. Furthermore, detailed information regarding the standing order for naloxone and the availability of the medication to the general public was provided. Community partners were able to spread awareness of their existing services — information that students may not be able to receive without this type of event. Participating local partners included the following: Gateway Rehab, IRETA (Institute for Research, Education and Training in

Addictions), ONALA, Drug Enforcement Agency, and Pittsburgh Poison Center. Although the event took place on an unexpectedly snowy day in April, the event was well attended and feedback from participating students showed that they were pleased with the opportunity to reach out to others on campus and spread the facts about addiction. Many were thankful to learn about organizations in the local areas that are available to provide help and guidance for those who are fighting through recovery. Overall, the event was a successful way to educate the campus community. As student pharmacists, it is our job to impact public health in a positive way, including fighting the addiction crisis starting with our very own campus. By spreading awareness wherever possible, we can advocate and educate in an effort to halt the ever growing opioid epidemic and reduce the incidence of overdose related deaths in Pittsburgh and neighboring areas. 


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We’re independent pharmacists—like you. When you have questions that are specific to your store, you need people who are in tune with you and understand the industry. With Smart-Fill owning 21 stores, you have a plethora of people that you can rely on. I believe that the team Smart-Fill has assembled is the best in the business.” — Bob Beeman, Pharmacist

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