The goal of the NICU rotation is for the resident to develop the clinical skills and knowledge base necessary to provide safe and appropriate medication therapy management in the neonatal patient.
St. Joseph's Children's Hospital's is a 64 bed, Level II and Level III licensed Neonatal Intensive Care Unit. The patient population includes premature infants from 23 weeks gestation to full-term neonates.
- 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:
- Fluid and electrolyte adjustments
- Intraventricular Hemorrhage (IVH)
- Cholestatic Jaundice
- Perinatal Asphyxia/Hypoxic-Ischemic Encephalopathy (HIE)
- Retinopathy of Prematurity (ROP)
- Ophthalmia neonatorum
- Osteopenia of Prematurity/Rickets
- Neonatal sepsis
- Neonatal seizures
- Respiratory distress syndrome (RDS)
- Apnea of prematurity
- Bronchopulmonary dysplasia (BPD) / Chronic Lung Disease (CLD)
- Persistent pulmonary hypertension
- Neonatal necrotizing enterocolitis (NEC)
- Neonatal abstinence syndrome (NAS)
- Daily collection and review of patient data
- Making 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.
- The resident will complete formal topic discussions throughout the rotation. These must contain evidence-based information and apply to the NICU patient population.
- 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.
Jenny Donald, PharmD.