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Policies,Administrative,UWHC,Department Specific,Pharmacy,Residents

Pharmacy Resident Duty Hours and Moonlighting (18.5)

Pharmacy Resident Duty Hours and Moonlighting (18.5) - Policies, Administrative, UWHC, Department Specific, Pharmacy, Residents

18.5

POLICY & PROCEDURE





Effective Date:
August 2011

Administrative Manual
 Nursing Manual
 Other: Pharmacy

Policy #: 18.5

Original
Revision 5/14
Page 1
of 3
Title: Pharmacy Resident Duty Hours and
Moonlighting


I. PURPOSE: To outline expectations for pharmacy resident duty hours and procedures
for monitoring and documentation to be consistent with standards of the
Accreditation Council for Graduate Medical Education (ACGME) as directed by
the American Society of Health-System Pharmacists (ASHP).

II. DEFINITIONS:
a. Duty hours: all clinical and academic activities required of the residency
program; i.e., patient care (both inpatient and outpatient), administrative
duties relative to patient care, the provision for transfer of patient care, time
spent in-house during call activities, and scheduled activities, such as
conferences. Duty hours do not include reading and preparation time spent
away from the duty site or Master’s degree requirements.
b. Fatigue management: recognition by either a resident or supervisor of a level
of resident fatigue that may adversely affect patient safety and enactment of a
solution to mitigate the fatigue.
c. Fitness for duty: mentally and physically able to effectively perform required
duties and promote patient safety.
d. Scheduled duty periods: assigned duty within the institution encompassing
hours which may be within the normal work day, beyond the normal work
day, or a combination of both.
e. Home call (pager call): Scheduled patient care assignments beyond the
normal work day that are taken from outside the assigned institution. It
generally involves residents providing coverage to a population of patients
from their home, with the expectation that they may need to come into the
hospital upon being called, or via the telephone direct other health
professionals in providing patient care. This also includes administrative
resident technician sick call pager coverage.
f. In-hospital call: scheduled patient care assignments beyond the normal
workday where residents are required to be immediately available in the
assigned institution (generally from evening until the next morning).
g. Moonlighting: Compensated patient care activities outside of the educational
program that residents engage in at sites used by the educational program
(“internal” moonlighting) or other clinical sites (“external” moonlighting).
Most often this takes the form of “overload” shifts.

III. POLICY:
a. Pharmacy resident duty hours
i. Duty hours must be limited to 80 hours per week, averaged over a
four-week period, inclusive of all in-hospital call and moonlighting
activities.

POLICY & PROCEDURE





Effective Date:
August 2011

Administrative Manual
 Nursing Manual
 Other: Pharmacy

Policy #: 18.5

Original
Revision 5/14
Page 2
of 3
Title: Pharmacy Resident Duty Hours and
Moonlighting


ii. Home call does not count toward this limit unless the resident is
required to come in to the hospital.
iii. Academic coursework toward degree programs that residents may be
pursuing do not count toward this limit.
iv. Residents must be provided with one day in seven free from residency
required educational and clinical responsibilities averaged over a
four-week period, inclusive of any on-call activities, both home and
in-hospital.
v. A maximum shift length of 16 hours is preferred for any non-home
call shift. An 8-hour time off period between duty hour periods is
required.
b. On-call Activities
i. In-hospital call:
1. Prior to the start of the call activities residents will be trained
on napping or other sleep deprivation management
techniques.
2. Can occur no more frequently than every third night, averaged
over a four-week period.
3. Continuous on-site duty, including in-house call, must not
exceed 24 consecutive hours. Residents may remain on duty
for up to two additional hours to participate in educational or
transition of care activities.
4. A 14-hour time off period following 24 hours of in-house
duty is required.
ii. Home call (or pager call)
1. The frequency of home call is not subject to the every-third-
night, or 24+2 limitation. However home call must not be so
frequent as to preclude rest and reasonable personal time for
each resident.
2. Residents taking home call must be provided with one day in
seven completely free from all required residency program
responsibilities, including home call, averaged over a four-
week period.
3. When residents are called into the hospital from home, the
hours residents spend in-hospital are counted toward the 80-
hour limit.
c. Moonlighting
i. External moonlighting is not permitted for pharmacy residents.
ii. Internal moonlighting, excluding emergent situations, must be
approved by the resident’s program director and not interfere with the

POLICY & PROCEDURE





Effective Date:
August 2011

Administrative Manual
 Nursing Manual
 Other: Pharmacy

Policy #: 18.5

Original
Revision 5/14
Page 3
of 3
Title: Pharmacy Resident Duty Hours and
Moonlighting


ability of the resident to achieve the goals and objectives of the
educational program.
iii. Any internal moonlighting must be considered part of the 80-hour
weekly limit on duty hours, exceeding 1 shift per month must be
approved by the program director.

d. Fatigue
i. Program directors, preceptors and residents must be educated to
recognize the signs of fatigue and sleep deprivation and must adopt
and apply policies to prevent and counteract its potential negative
effects on patient care and learning.

IV. PROCEDURES
a. Monitoring and Documentation
i. Residents will document their compliance or non-compliance with
duty hours as part of their summative evaluation process.
ii. False documentation will be subject to resident disciplinary policies.
iii. Innuendos/rumors of unreported non-compliance will be followed up
with a formal investigation by the Residency Advisory Committee.
iv. The Residency Advisory Committee will review all variances across
programs to identify structural changes that may be necessary for
specific rotations and/or programs to comply with the policy.
v. New resident and new preceptor orientation will include time to
review this policy and procedure and training on recognition of
fatigue and mitigation strategies.
vi. The scheduler will verify with the resident’s RPD prior to any
moonlighting hours being accepted by the resident.


Approved By: ____________________________
Director of Pharmacy Services

Date: ________________