The primary emphasis of the rotation is to develop problem-solving skills in pediatric pharmacotherapy. This may include the establishment of a strong knowledge base in pediatric pharmacology and pharmacokinetics; and the ability to provide therapeutic interventions to enhance the overall management of pediatric patients.
The resident will begin the day by obtaining an update from overnight pharmacist of any problems or issues overnight. The resident will be responsible for monitoring at least 4-5 patients and is responsible for developing a monitoring plan (SOAP note) for each patient that will be discussed with the preceptor. The primary role of the pharmacist managing medication therapy on this service is to streamline antibiotics, renally adjust medications, minimize adverse drug reactions, maximize drug therapy outcomes and provide education to the team and patient caregivers. The resident will become familiar with various pediatric specific disease states (i.e. cystic fibrosis, sinusitis, otitis media, meningitis, etc) and become familiar with the medication therapy involved with each disease. The afternoons will be spent following up on drug related inquiries, updating new and current patient profiles, discussing assigned topics and patient care problem lists with the preceptor, and provide any patient care medication needs on the general pediatric floors, as needed. As the rotation progresses, the Resident will assume complete responsibility for ensuring optimal drug therapy outcomes and monitoring pharmacokinetics for the general pediatric patients.
- The resident will begin the day at 7am and receive an update from overnight pharmacists
- Be professional and punctual. The resident is responsible for monitoring at least 4 to 5 patients provided by the preceptor.
- Prior to preceptor discussions, the resident will efficiently collect all patient-related information from multiple resources (E-MAR, H&P, nursing input, patient information, etc) in order to develop a patient therapeutic regimen and make appropriate recommendations
- The resident will have all pertinent past and current medication therapies for the patient and monitor progress throughout the patient's admission. The resident will have access to a laptop to access information, give documentation, and provide pharmacy services.
- Evaluate the use and benefit of the patient's chronic home medications, current list of medications initiated in the hospital, and possible future medication regimens.
- The resident will become proficient in processing physician orders for patients on general pediatric patients. Each medication ordered will be assessed based on (but not limited to): age appropriateness, indication, dose (mg/kg), frequency for age/renal status, route, formulation (liquid vs tablet), drug interactions, and drug duplications.
- Gain experience in pediatric oral and topical compounding formulations.
- Participate in verifying/checking pediatric oral syringes.
- Understand the dispensing, compounding, and verifying of pediatric intravenous formulations.
- Assess each patient on service for any negative drug interactions. This will be reported to the preceptor, medical team and documented in the clinical decision support software, TheraDoc©.
- Professionally and effectively communicate with interdisciplinary team members and patients, in order to enhance pharmacy-related outcomes.
The resident will provide concise timely responses to all drug information inquiries from the preceptor, physicians, or patient/family members.
- Identify, interpret, and apply current medical literature and evidence based medicine to maximize patient care inquires, goals and resolution of problems.
- Make recommendations for appropriate drug therapy, including renal dosing, drug interactions, and allergy review.
- Recommend alternative formulary agents when receiving request for non-formulary agents
- Respond and participate in all Pediatric CODE BLUE (B) emergencies in SJCH and SJH.
- Update the Pharmacokinetics section of the SJCH Daily Pharmacist Communication Form. This form is used as a quick reference for the Pediatric Pharmacy Team to be aware of any/all issues in SJCH. This may include any specialty drips/medications the patients may be receiving, the presence of organ failure, impending drug levels, or medication-related alerts that require attention.
- Become familiar with and ensure adherence to the policies and procedures of medication distribution, use and monitoring at St. Joseph's Children's Hospital.
- Required hours 7 am to 4 pm. These times may vary based on patient care and team needs.
- Provide 4-5 formal discussions to the preceptor on General Pediatric Topics. The resident will be prepared to present the topic with current literature and application to our patient population. (See Topic Discussion requirements).
- Meet with the preceptor daily to discuss patient problem lists, therapeutic goals, topic discussions, and personal progress through rotation.
- PALS certification, which is provided early in the residency
- Document 10 patient care interventions into TheraDoc© weekly.
- Document two adverse drug event reports per week.
- Attend the monthly meeting for the Pediatric Medication Use Safety Team (MUST) and Pediatric Workgroup meetings at Women's Hospital
- Participate in monthly nursing meetings to provide current medication and/or Pharmacy Department information to the team. This 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.
Ijeoma Muforo, Pharm.D
Marroyln Simmons, Pharm.D., MS, BCPS