Stress ulcer prophylaxis in the absence of guidelines: An exploratory study of different student perspectives from an Advanced Pharmacy Practice Experience (APPE)
Keywords:
Stress-Ulcer Prophylaxis (SUP), Advanced Pharmacy Practice Experience (APPE), Student Perspective, Evidence-Based Practice (EBP), Clinical GuidelinesAbstract
Background: Guidelines for the use of stress-ulcer prophylaxis (SUP) do exist in the Intensive Care Unit (ICU) setting, but not in the non-ICU setting.
Aims: The objective was to analyse how fourth-year pharmacy students transfer knowledge acquired during didactic course work into clinical practice during an Advanced Pharmacy Practice Experience (APPE) in Adult Medicine, in the absence of such guidelines.
Methods: Three fourth-year pharmacy students completed an APPE in a non-ICU Adult Medicine setting. Part of this experience was hospital rounds with a medical team, which included a clinical pharmacist and a post-graduate year one (PGY1) pharmacy resident. The students reviewed the ASHP guidelines from 1999 and discussed the evidence-based recommendations in the ICU and non-ICU settings. During the rotation students completed journal club assignments about the challenges associated with SUP outside the ICU. At the end of the rotation, each student developed and documented their opinion on the use of SUP in the non-ICU setting.
Results: The opinions provided by the students ranged from opposing SUP in the non-ICU setting, over using clinical judgment for each patient, to overall uncertainty.
Conclusion: The opinions formed by the students varied, even though they participated in the same didactic coursework and APPE. Further studies could help determine the impact of didactic education and APPEs in the absence of clinical guidelines on pharmacy students.
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