The goal of this rotation is for the resident to foster the development of clinical skills and the knowledgebase necessary to provide comprehensive pharmaceutical care to critical patients in the Neonatal Intensive Care Unit (NICU).
St. Joseph's Children's Hospital's is a 64 bed, Level II and Level III licensed Neonatal Intensive Care Unit. The unit provides services for an average of 700 infants a year. The patient population includes premature infants from 23 weeks gestation to full-term neonates with critical issues.
- Daily patient profile review for identification and resolution of patient pharmacotherapy issues
- Develop an in-depth knowledge of the basics of neonatal pharmacotherapy
- Monitor and provide pharmacokinetic consultations
- Provide drug information services to the NICU team
- Gain knowledge of the Neonatal Resuscitation Program (NRP) guidelines and participate in neonatal codes.
- Develop an understanding of the numerous issues in managing a critically ill neonate including:
- Medication dosing and adjustments
- Fluid and electrolyte adjustments
- Neonatal sepsis
- Congenital heart defects
- Neonatal seizures
- Respiratory distress syndrome (RDS)
- Apnea of prematurity
- Bronchopulmonary dysplasia (BPD)
- Pulmonary hypertension
- Neonatal necrotizing enterocolitis (NEC)
- Neonatal abstinence syndrome
- Pain management
- Immunization guidelines/ administration schedules
- Craniofacial and musculoskeletal defects
- Hematologic diseases of the newborn
- Genetic disorders
- Daily collection and review of patient data in preparation for physician rounds
- Make appropriate recommendations to the NICU team
- Assess each patient for needed weight based dosing adjustments, duplication of therapy and lab value/monitoring adjustment recommendations.
- Monitoring for drug-drug interactions, medications events and adverse reactions.
- Documentation of medication events and adverse reactions in the clinical decision support software, TheraDoc©
- Meet with the preceptor daily to discuss patient care issues, therapeutic goals, topic discussions and personal progress throughout the rotation.
- Provide four formal discussions to the preceptor on Neonatal topics. These must contain evidence-based information and apply to the NICU patient population. The
- Resident may present the topics to the other residents, pharmacy students and nursing staff.
- Participate in weekly NICU Interdisciplinary Grand Rounds at 11:00 am on Thursdays and be able to communicate professionally and effectively to enhance pharmacy-related outcomes.
- Provide evidence-based, concise and timely responses to all drug information questions from the preceptor or NICU multidisciplinary team members.
- Conduct NICU nursing in-services regarding pharmacotherapy in the NICU, upon request.
- Update the NICU communication form daily to inform incoming pharmacists of patient related issues, pending drug levels and other pharmacotherapy related issues for patients in the NICU.
- Attend the monthly NICU Advisory Board Meeting, NICU Safety committee meeting, the Pediatric Medication Use Safety Team (Kids MUST) meetings and all Pharmacy Departmental meetings.
Christina Peteretich-Elgendi, B.S. Pharm.