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Critical Care Medicine Rotation

Rotation Goal

The goal of this rotation is to allow the resident to become proficient in adult critical care pharmacy practice.  On this rotation the resident will become familiar with providing pharmaceutical care to medical, surgical, trauma, and neurological patients admitted to the intensive care unit. The commonly occurring disease states and conditions include the following, but are not limited to: sepsis, sedation and analgesia, trauma, pneumonia, cerebral vascular accidents, gastrointestinal bleeding, and renal failure. All drug therapy used will be monitored for therapeutic effect, appropriateness, and adverse events. The primary focus for all activities will be on the delivery of evidence-based pharmaceutical care to patients to achieve optimal outcomes in a safe, therapeutically and cost-effective manner.

 

Rotation Description

The Intensive Care Unit is a 26-bed state-of -the-art unit dedicated to the care of critically ill adults and their families. The ICU multi-disciplinary team is comprised of an Intensivist, respiratory therapist, dietitian, pharmacist, charge nurse, and nurse manager.

The ICU provides comprehensive services for patients with single or multi-organ system failure, complex chronic illness, respiratory failure, neurologic emergency, poisoning and toxic ingestion, severe infection, severe traumatic injury, hemodynamic instability and shock states, and those recovering from orthopedic, neurologic and general surgeries. 

The resident will begin the day by preparing for ICU multi-disciplinary rounds which begin approximately at 9:45 am Monday through Friday. The resident is responsible for monitoring their patients daily in addition to following up on clinical consults and order entry. 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 ICU. As the rotation progresses, the Resident will assume complete responsibility for ensuring optimal evidence-based drug therapy outcomes for all patients in the intensive care unit.   

Rotation Activities

  • Attend and participate in patient care rounds. Rounds begin promptly at 9:45 am on the 5th Floor of the Critical Care Tower.
  • Evaluate and monitor drug therapy for patients and make recommendations to optimize pharmaceutical outcomes including renal dosing, drug interactions, therapeutic duplication, 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.
  • Respond to and participate in medical emergency codes.

Rotation Requirements

  • 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 is provided early in the residency
  • Maintain all therapeutic monitoring logs in the clinical decision support software, 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. This typically includes a 5-10 minute verbal presentation and written information for the nurses. It may require more frequent, small group discussions in order to disseminate new information or procedures thoroughly to the teams.

Preceptors

Jennifer Schmeding, PharmD, BCPS
Kelly Slack, PharmD, BCPS
Jill Mautner, PharmD



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