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Continuing Pharmacy Education

Faculty of Health

Assessment and Prescribing for Respiratory Tract and Ear Infections Training Program

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Looking to gain education and training on assessment, diagnosis, and treatment of bacterial pharyngitis, sinusitis, and ear infections? This education will be delivered as a series of recorded modules covering pathophysiology, etiology, clinical presentation, diagnosis, and management of these conditions.

These modules were made possible through a research project led by Emily Black, Associate Professor at HÂþ»­ University, and funded by a grant from the Shoppers Drug Mart Collaborative Advisory Group.

Modules will provide foundational knowledge which can be applied through additional training opportunities. This program does not assess competency. Pharmacists are expected to take reasonable steps to assess their competency to perform these assessments asÌýoutlined by the Standards in their province.Ìý

Modules can be purchased as a complete package, or in smaller sections. The Learning Objectives for each module are listed below.

See OpenDal for more details:Ìý

Online modules

Online Modules

Rhinosinusitis

Leads: Emma Reid, PharmD and Paul Bonnar, MD (1 CEU)

  1. Review the pathophysiology and etiology of sinusitis.
  2. Explain the reasoning for the inclusion and exclusion criteria for pharmacist prescribing of sinusitis in Nova Scotia.
  3. Identify steps to making a diagnosis for a patient presenting to the pharmacy with suspected sinusitis by interviewing the patient as well as conducting a physical examination.
  4. Evaluate a patient for complications secondary to sinusitis and be able to refer appropriately according to their severity.
  5. Explain how to therapeutically manage sinusitis while considering patient specific factors.
  6. Discuss the importance of delaying antibiotics at a patient level.
  7. Develop a counselling strategy that ensures that patients are provided with proper education regarding both sinusitis and its therapeutic management.

Please note at this time, only pharmacists at designated Community Pharmacy Primary Care Clinics are approved to prescribe for acute bacterial sinusitis, acute otitis media, and acute otitis externa. Pharmacists practicing outside these clinics should refer to the NSCP 

Introduction to Upper Respiratory Tract and Ear Infections

Lead: Tasha Ramsey, PharmD, ACPR (.5 CEUs)

  1. Describe an approach to assessing patients who present with a complaint of the upper respiratory tract and ear in community pharmacies
  2. Identify upper respiratory tract and ear infections that can be managed by community pharmacists
  3. Recognize signs and symptoms associated with common and serious upper respiratory tract and ear infections.
  4. Compare the symptoms of respiratory tract and ear infections to allow differentiation between illnesses.
  5. Based on clinical presentation, determine when referral to another healthcare provider is necessary.

 

Antimicrobial Stewardship Principles, Bugs and Drugs Overview, and Communication Strategies

Lead: Jennifer Curran, PharmD, ACPR, ACPR2  (.75 CEUs)

  1. Explain factors contributing to the development of antimicrobial resistance.
  2. Demonstrate how a pharmacist could clearly and effectively discuss the risk of antimicrobial resistance with patients.
  3. Cultivate ideas on decreasing antimicrobial resistance associated with pharmacist prescribing in a community setting.
  4. Develop a communication strategy to discuss antibiotic allergies with patients.
  5. Develop a structured approach to communicating with patients about viral respiratory illnesses and management without antibiotics (i.e. DART method).
  6. Discuss the advantages and disadvantages of microbiology tests commonly used in upper respiratory tract infections.
  7. Review the antibiotic spectrum of activity in relation to bacteria commonly associated with upper respiratory tract infections.

Management of Pharyngitis

Lead: Emily Black, PharmD, ACPR (.75 CEUs)

  1. Review the pathophysiology and etiology of pharyngitis.
  2. Explain the reasoning for the inclusion and exclusion criteria for pharmacist prescribing of pharyngitis in Nova Scotia.
  3. Identify steps to making a diagnosis for a patient presenting to the pharmacy with a sore throat by interviewing the patient, conducting a physical examination, and completing relevant tests as appropriate.
  4. Recognize complications secondary to pharyngitis and be able to refer appropriately.
  5. Demonstrate how the use of decision support tools aid in diagnosing a patient presenting to the pharmacy with a sore throat.
  6. Compare the differences in therapeutic management for a patient presenting to the pharmacy with a viral infection vs. a bacterial infection.
  7. Explain how to therapeutically manage bacterial pharyngitis while considering patient specific factors.
  8. Develop a counselling strategy that ensures that patients are provided with proper education regarding both pharyngitis and its therapeutic management.

Introduction to Physical Examination of the Head and Neck

Lead: Laurie Graham, NP (.75 CEUs)

  1. Discuss the steps associated with conducting a general examination of a patient presenting to the pharmacy. 
  2. Recognize the importance of assessing vital signs when examining a patient.
  3. Describe anatomy of the upper respiratory tract and lymph nodes.
  4. Describe how to properly palpate a patient’s lymph nodes.
  5. List the steps associated with visual inspection of the throat.
  6. Describe steps to conducting a throat swab.
  7. Recognize signs of sepsis in a patient presenting with suspected infection that warrant referral for urgent care
  8. Compare the differences in physical examination between children and adults and discuss challenges associated with different demographics

 

 

Assessment and Physical Examination of Ear Complaints

Lead: Paul Hong, MD (2 CEUs)

  1. Describe normal anatomy of the ear
  2. Describe pathophysiology of acute otitis media and acute otitis externa
  3. Recognize signs and symptoms of acute otitis media and acute otitis externa
  4. Identify steps to making a diagnosis for a patient presenting to the pharmacy with ear pain by interviewing the patient as well as conducting a physical examination.
  5. List the steps associated with conducting an ear examination with an otoscope and tympanometer.  
  6. Evaluate a patient for complications secondary to acute otitis media or acute otitis externa and be able to refer appropriately according to their severity.
  7. Recognize signs of other possible diagnoses of patients presenting with ear complaints and refer as appropriate.

Management of Acute Otitis Media and Acute Otitis Externa

Lead: Emily Black, PharmD, ACPR (.75 CEUs)

  1. Review the pathophysiology and etiology of acute otitis media and acute otitis externa
  2. Recognize signs and symptoms of pharyngitis
  3. Explain the reasoning for the inclusion and exclusion criteria for pharmacist prescribing of acute otitis media and acute otitis externa in Nova Scotia.
  4. Explain how to therapeutically manage acute otitis media and acute otitis externa while considering patient specific factors.
  5. List the criteria associated with when to use the watch and wait strategy for patients presenting with acute otitis media
  6. Discuss the role of the watch and wait strategy with patients to improve their understanding.
  7. Develop a counselling strategy that ensures that patients are provided with proper education regarding ear infections and their therapeutic management.

Please note at this time, only pharmacists at designated Community Pharmacy Primary Care Clinics are approved to prescribe for acute bacterial sinusitis, acute otitis media, and acute otitis externa. Pharmacists practicing outside these clinics should refer to the NSCP 

Note that in order to be prepared to assess and prescribe for acute otitis media and acute otitis externa additional in person training to learn to use the recommended devices and physical assessment of the ear is required.

Monitoring, Follow-up, and Referral

Leads: Jeanna Parsons-Leigh, PhD and Emily Black, PharmD, ACPR (.5 CEUs)

  1. Create a monitoring plan to assess for clinical improvement and recognize adverse effects of drug therapy
  2. Understand the important role of community pharmacists in timely identification of early sepsis.
  3. Recognize patient populations that are at higher risk for sepsis (e.g., children ≤ 1-year, elderly individuals, those with chronic conditions, or those who recently had surgery).
  4. Recognize signs of sepsis in patients presenting with suspected infections 
  5. Help patients with worsening infection or suspected sepsis navigate referral pathways
  6. Educate patients and/or caregivers about expected course of illness and early signs of sepsis that warrant follow up