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Clinical Rotations

Pediatrics

Preceptor: Lela Hernandez, PharmD, BCPS

Pediatrics is a 4 week rotation in the PGY1 pharmacy practice and PGY1 pediatrics residency programs. Daily activities include multidisciplinary rounds, patient and family education regarding asthma and other disease states and their associated medications. Residents will be exposed to a wide variety of disease states in the pediatric population and become familiar with standards of care. They will build drug information skills by evaluating inconclusive and limited published pediatric literature and also work closely with the medical team to provide optimal care to patients in the unit.

Cardiovascular Intensive Care

Preceptor: Joe Slechta PharmD, BCPS

The Cardiology rotation offers the resident the opportunity to build and expand upon their current knowledge of cardiovascular diseases and the principles of pharmacotherapeutics in cardiology. The goal of this rotation is to allow the resident to gain confidence in applying therapeutic knowledge and decision-making skills that will have a direct impact on patient care in a multidisciplinary environment. Using an evidence-based approach, the resident will develop therapeutic care plans for the patients of the Coronary ICU and serve as a resource for all cardiovascular health care team members. The majority of the time will be spent in the 26-bed Coronary ICU providing direct patient care. Afternoons will involve evaluation of the resident’s care plans, follow-up of patient care issues and pertinent topic discussions.

Pediatric Intensive Care

Preceptor: Chris Durham, PharmD

The resident will round daily with the PICU team, consisting of pediatric intensivists, pediatric residents, medical students and nurses. Additional resident activities include; monitoring PICU patients in a problem-based format, providing recommendations to covering physicians and educating pediatric residents and medical students on specified topics. The resident will also participate in pediatric code blues and traumas and will attend Pediatric Residency Lectures on Tuesday afternoons. The resident will have the opportunity to tailor his or her rotation to his or her specific interests.

Surgical/Trauma Critical Care

Preceptor: Kathy Hall, PharmD, BCPS

The Surgical/Trauma Critical Care rotation is a four week rotation where pharmacy residents gain experience managing critical care patients. The diverse surgical patient population includes general surgery, neurosurgery, urologic surgery, gynecological and cardiovascular surgery. As an American College of Surgeons certified Level I trauma center, residents will work with a multidisciplinary trauma team comprised of board-certified trauma surgeons, critical care intensivists, physician assistants, pharmacists, care coordinators, and many other healthcare providers to care for their patients. The pharmacy resident will function as member of this multidisciplinary critical care team. The resident will also be expected to participate in Level 1 trauma, code blue and massive blood transfusion response when the opportunity arises.

Adult Internal Medicine

Preceptor: Allie Harshberger, PharmD, BCPS

The Adult Internal Medicine rotation is a required, four week learning experience for the PGY1 pharmacy practice resident. This learning experience takes place on the Ortho/Neuro Unit (9T) at Wesley Medical Center (WMC), which is a 29 bed unit dedicated to the care of patients admitted to WMC for orthopedic or spinal surgeries. Residents will attend daily rounds with the preceptor. Likewise, residents will also be expected to work alongside respiratory therapists, clinical dietitians, therapists (physical, occupational & speech), as well as the primary nurse.

The resident will be responsible for providing clinical pharmacy services for the team. The resident is expected to be familiar with patients, their medical history, disease states, and home medication regimens. The resident will be expected to provide drug therapy recommendations based on current evidence based guidelines and individual patient needs, provide drug therapy monitoring recommendations, answer drug information questions, and document patient progress in written progress notes daily. The resident will provide patient education when needed, assist in clarifying patients’ home medication regimens for medication reconciliation, and manage pharmacy consults. The resident is expected to actively participate with all members of the health care team.

Infectious Diseases

Preceptor: Stephanie Kuhn, PharmD, BCPS

The infectious diseases rotation is a four-week required rotation designed to give the pharmacy resident experience with antibiotic stewardship and infectious diseases. The primary responsibilities of the rotation include active participation and management of the antimicrobial stewardship efforts for the hospital, which includes critical care areas and pediatrics. Additional learning opportunities available throughout the rotation include spending time with infectious diseases physicians during clinical rounds, the microbiology laboratory, and infection prevention. Throughout the rotation and year, the resident will also develop practical knowledge of various pharmacokinetic considerations in a wide variety of patient populations.

Hospital Medicine

Preceptor: Sarah Fogg, PharmD, BCPS

Hospital Medicine (HM) is a required, four week learning experience for the PGY1 pharmacy practice resident. During this rotation, the resident will be expected to work closely as part of the WMC multidisciplinary hospitalist team, providing evidence based patient-centered care for patients admitted to the Hospitalist/Stroke Unit. The resident will attend rounds with the team on a daily basis to provide drug therapy & monitoring recommendations and answer drug information questions. The resident will also provide patient education as needed, assist in medication reconciliation and assist in managing pharmacy consults.

Medical Critical Care

Preceptor: Amber Meister, PharmD, BCPS

The Medical Critical Care rotation is a 4 week rotation for PGY1 pharmacy practice residents and an 8 week rotation for PGY2 critical care pharmacy residents. The residents will be expected to spend the majority of their time in the clinical setting where direct interaction with patients and also with multiple physicians, nurses, residents, students, mid-level practitioners and other health care providers is required. The purpose of this rotation is to increase the knowledge and skills required in specialized areas necessary in managing critically ill patients.

Practice Management/ Medication Safety

Preceptors: Jack Bond, RPh, MHS, Leslie Eidem, RPh, PharmD, Kelly Guhr, PharmD, BCPS, and Joan Kramer PharmD, BCPS

The Practice Management rotation is a one-month, required rotation for pharmacy practice residents. This rotation covers key aspects of practice management including an overview of communication styles, Change Theory, Medication Distribution Systems, Clinical Systems Development, Regulatory Standards, and Financial Systems Overview. This rotation will allow the resident to interact with an inter-disciplinary team of nursing, physicians, senior management leaders, Pharmacy management, quality, risk, supply chain, corporate, and other ancillary health departments. The resident will be responsible for development of policy statements, preparation and oversight of regulatory requirements, participation in management meetings and decision making and in meeting management. The resident will be expected to complete and compile data for regulatory requirements during the month, including reporting of findings to Committee for Safe Medication Practice and Pharmacy and Therapeutics Committee.

In addition, the resident will complete assigned readings, participate in the evaluation of all significant medication events, participate in medication safety improvement projects and structure an improvement process, and prepare and conduct meeting with follow up. The resident will also have the opportunity to participate in the Committee for safe Medication Practice, Hospital Quality and Patient Safety Committee, Senior Leadership, Pharmacy Management, Clinical Specialist, and Pharmacy and Therapeutics Committee meetings. The preceptor serves as a role model and a learning resource for the resident, but also provides the opportunity for independent practice. The resident is encouraged to take initiative in assisting to direct the learning experience during the rotation to optimize his/her personal development.

Adult Internal Medicine

Preceptor: Marwa Buser, PharmD, BCPS

Adult Internal Medicine is a required, four week learning experience for the PGY-1 pharmacy practice resident. This learning experience will expose the resident to a variety of patients with a focus on cardiology and internal medicine. Residents will be expected to work closely with cardiologists and cardiology mid-level practitioners as well as, but not limited to, internal/family medicine residents and hospitalists. Likewise, the resident will be expected to work alongside the primary nurse and other health care providers. Expectations include being familiar with the patient, their medical history, disease states, and home medication regimens so the resident can fully provide clinical pharmacy services for the team. The resident will be expected to provide drug therapy monitoring recommendations based on current evidence based guidelines, answer drug information questions, and document patient progress notes daily in the electronic medical chart. The resident will provide education when needed, assist in clarifying patient’s home medication regimens, and manage pharmacy consults. In the event of sharing a learning experience with a pharmacy student(s), the resident will be expected to assume preceptor responsibilities.

Trauma-Medical

Preceptor: Lauren Frasier, PharmD, BCPS

The trauma-medical rotation for pharmacy residents focuses on internal medicine/common disease states encountered including diabetes, infectious diseases, hypertension, etc. The resident will also have the opportunity to be involved in the care of our lower level trauma patients, as well as round with the trauma team on a frequent basis. Communication with all persons of the healthcare team including physicians, midlevels and nursing are expected throughout the rotation, as well thoroughly evaluating patients’ disease states, home medications and making appropriate recommendations to provide optimal care to our patients. Common tasks include antibiotic renal dosing, IV to PO changes, pharmacokinetic services (e.g pharmacy to dose vancomcyin), ordering of labs, and pain management among many others.

Medication Safety Elective

Preceptor: Leslie Eidem, RPh, PharmD

The Medication Safety Rotation is a one month rotation for pharmacy practice residents. This rotation covers key aspects of medication safety including an overview of patient safety and taxonomy, human factors engineering, and quality improvement process. This rotation will allow the resident to interact with an inter-disciplinary team through participation in Committee for Safe Medication Practice, Hospital Quality Committee and Pharmacy and Therapeutics Committee. In addition, the resident will complete assigned readings as well as participate in the evaluation of all significant medication events and medication safety improvement projects. The preceptor serves as a role model and a learning resource for the resident, but also provides the opportunity for independent practice. The resident is encouraged to take initiative in assisting to direct the learning experience during the rotation to optimize his/her personal development.

Internal Medicine at Galichia Heart Hospital

Preceptor: Carolyn Mayle, PharmD, BCPS

This internal medicine rotation is a 4-week elective in the PGY1 pharmacy residency program. This rotation includes clinical monitoring of critical care, cardiovascular, and internal medicine patients. The resident will also have the opportunity to oversee and manage distributive aspects of patient care, including inventory control, compounding patient-specific medications, and troubleshooting technological issues.

Neonatal Intensive Care Unit

Preceptor: Lela Hernandez, PharmD, BCPS

A rotation in the neonatal intensive care unit (NICU) is available as an elective. Experience in the NICU will expose the residents to various complications associated with preterm birth. Through daily review of patients, multidisciplinary rounds, and discussions with the preceptor, residents will become familiar with strategies to optimize pharmacologic therapy in patients with unique therapeutic needs.

Nutrition Support

Preceptor: Joanne Applegate RPh, BCNSP

The goal of the nutrition support rotation is to have the resident become familiar with the clinical pharmacist’s role in nutrition support. The resident will learn to assess patients’ nutrition needs, develop a nutrition formula to meet those needs, and monitor nutrition therapies to optimize patient outcomes for patients on parenteral nutrition. The nutrition support pharmacist provides recommendations and monitoring services to all adult patients, pediatric patients, and neonatal patients on parenteral nutrition. The resident will work with clinical pharmacists, dietitians, physicians, and nurses in providing nutrition support.

Anticoagulation Service

Preceptor: Jamie Anderson, PharmD

The Anticoagulation Service rotation is a 2 week elective rotation for the PGY1 pharmacy practice resident. The resident will serve as the anticoagulation pharmacist for the assigned patients receiving antithrombotic medications. They will be responsible for the monitoring, dosing, ordering of labs and education of patients referred to the Pharmacy Anticoagulation Service as outlined in the Anticoagulation Service Policy. Care for these patients shall include becoming knowledgeable of the patient’s history, indication for anticoagulation, medications, and therapeutic plan. The resident will have the opportunity to participate in a variety of interdisciplinary activities and meetings.

Drug Information

Preceptor: Lauren Morton, PharmD, BCPS

The Drug Information (DI) rotation is a required experiential component for all pharmacy practice residents at Wesley Medical Center. During the rotation, the resident will have the opportunity to assist in all areas of drug information services. These activities may include, but are not limited to, responding to drug information requests, preparation and presentation of agenda items for the Pharmacy and Therapeutics (P&T) Committee meeting, policy development, and participation in the drug utilization evaluation process. Upon completion of the rotation, the resident will have also gained a working knowledge of various aspects of drug information, such as proper utilization of various drug information resources, the formulary process, critical literature evaluation, and biostatistics.

Informatics

Preceptors: Kelly Guhr, PharmD, BCPS, Bob Ragan, RPh, MHS, Jim Rosendale, BS

Informatics is a 4-week rotation for a pharmacy resident that focuses on drug database maintenance, data querying, report writing, computerized provider order entry, clinical decision support, pharmacist clinical monitoring software, system interfaces and systems assessments, Pharmogistics, and spreadsheet/database training. Projects and problem-solving sessions will be assigned as appropriate. The resident will meet with individual preceptors as needed, and all 4 participants will meet together at least weekly.

Preceptorship, Ambulatory Care

Preceptor: Joan S. Kramer, PharmD, BCPS

In this advanced learning experience, the resident will be expected to take a lead role in precepting and educating pharmacy students. The resident will provide drug information, evidence-based drug therapy recommendations and patient education on a daily basis displaying the leadership skills of a pharmacist with teaching responsibilities. The resident will be in charge of teaching, signing off student progress notes and participating in evaluating the student(s) at the end of the month. The resident will have a firsthand experience of the responsibilities of precepting students while conducting patient care activities. The resident will be responsible for developing topics of discussion to present to pharmacy students and for discussing patient issues on a daily basis. Students will check out with the resident daily, and all student activities will be coordinated by the resident.

Research and Grantsmanship

Preceptor: Joan S. Kramer, PharmD, BCPS

In this elective rotation learning experience, the resident will be able to design and implement a research project. Modeled from the ASHP Foundation’s Fostering Young Investigators Research Tips for Pharmacy Residents, this learning experience will introduce the resident to the various aspects of research and grantsmanship, potentially building the foundation for future pharmacy research in hospital pharmacy or other clinical pharmacy practice arenas. Learning opportunities also include Medidata Rave® certification and advanced statistical preparation.