The goal of this rotation is to allow the resident to become proficient in acute adult cardiac care. On this rotation, the resident will become familiar with providing pharmaceutical care to patients admitted to the coronary care unit (CCU) and cardiovascular surgical unit (CSU). Common conditions encountered in CCU include acute coronary syndromes, atrial fibrillation, acute decompensated heart failure, and care of the post cardiac intervention patient. The CSU provides care to patients post cardiovascular surgery, including coronary artery bypass graft, thoracotomy, and valvular surgeries. Upon completion of the rotation, the resident should be comfortable in providing pharmaceutical care for acute cardiac patients and interacting with other cardiovascular team members, including cardiothoracic surgeons, physician assistants, nurse practitioners, and the bedside nurse.
The resident will begin each day monitoring their assigned patients through profile and laboratory review. All medical regimens are to be assessed for appropriateness and residents are expected to take a proactive approach in selecting, modifying and monitoring drug therapy. As the rotation progresses, the Resident will assume complete responsibility for ensuring optimal evidence-based drug therapy outcomes for all patients in the cardiac units and is expected to maintain an active presence in the unit throughout the day. In addition, the resident will be responsible for following up on clinical consults as well as an order entry component. The afternoons will be spent following up on drug information questions, updating new and current patient profiles, discussing assigned topics and patient care problem lists with the preceptor, and addressing any patient care medication need in the units.
- Evaluate and monitor drug therapy for patients and make recommendations to optimize pharmaceutical outcomes including renal/hepatic dosing, drug interactions, therapeutic duplication, antibiotic usage, and allergy review.
- Identify, interpret, and apply current medical literature and evidence-based medicine practices to maximize patient care inquires, goals, and resolution of problems.
- Monitor and make therapeutic recommendations for all pharmacokinetically monitored drugs.
- Evaluate patients for drug-induced disease and make appropriate recommendations.
- Assist physicians and nurses with drug information questions using appropriate resources.
- Provide continual surveillance for adverse drug events and report per department policy.
- Document therapeutic interventions in the clinical decision support software, TheraDocã.
- Respond to and participate in medical emergency codes.
- Required hours 7 am to 4 pm. The times may vary based on patient care and team needs
- Formal topic discussions with preceptor. The resident will be prepared for the topic with current literature and application to our patient population
- Advanced Cardiovascular Life Support (ACLS) certification, which will be provided early in the residency
- Maintain all therapeutic monitoring logs in TheraDocã. according to department policy
- Document patient care interventions into TheraDocã.
- Document any adverse drug events according to department policy
- Provide drug information in the form of in-services for the nursing staff on drug therapy, as needed or requested. Typically includes a 5-10 minute verbal presentation and written information for the nurses, but may require more frequent, small group discussions in order to disseminate new information or procedures thoroughly to the teams.
Jennifer Schmeding, Pharm.D., BCPS
Kelly Slack, Pharm.D., BCPS