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Pediatric Cardiac Intensive Care Rotation

Rotation Goal

The goal of this rotation is to allow the resident to become a specialist in pediatric cardiac care.  The resident will become proficient at optimizing the treatment of pediatric cardiac patients by providing evidence-based, patient centered medication therapy and will assume complete responsibility for patient care.

Rotation Description

The resident will begin the day by preparing for PCICU multi-disciplinary rounds which start at approximately 9 am Monday through Friday, and may last up to 2 hours. The resident is responsible for developing a monitoring plan for each patient that will be discussed on rounds. The primary medication management role of the resident on this service is to streamline antibiotics, adjust medications for renal and/or hepatic impairment, identify and resolve potential adverse drug reactions, maximize drug therapy outcomes, and provide drug education to the team and patient caregivers. The resident will become familiar with congenital heart defects, related surgical procedures, and potential complications. The afternoons will be spent following up on drug related inquiries, updating new and current patient profiles, and presenting assigned topics as well as patient care issues to the preceptor.

Rotation Activities

  • Be professional and punctual at all times. Daily attendance of multidisciplinary rounds is mandatory and the preceptor must be notified in advance (preferably the day prior) of any anticipated absence.
  • Begin the day in the PCICU at 7am and spend the morning efficiently collecting all necessary patient-related information from multiple resources for rounds in order to develop a patient therapeutic regimen and make appropriate recommendations to the team.
  • The resident is responsible for monitoring all patients followed by the Pediatric Cardiac Surgical Team. Patients include those admitted into the PCICU (max of 7 patients), those transferred to PICU for monitoring, as well as the floor-status patients preparing for discharge. The total cardiac census may range from 7 to 16 patients.
  • Evaluate the use and benefit of the cardiac patient's prior home medications, current medications initiated in the hospital, and possible future medication regimens to develop a customized plan for each patient.
  • Assess each patient on service for any possible drug interactions, medication events, or adverse reactions. This will be reported to the preceptor, medical team and documented in the clinical decision support software, TheraDoc? pharmacy monitoring system.
  • Provide concise timely responses to all drug information inquiries from the preceptor, PCICU team, patient or caregivers.
  • Professionally and effectively communicate with interdisciplinary team members, patients, and caregivers in order to enhance pharmacy related outcomes.
  • Complete the SJCH Pharmacist Communication form daily to notify incoming pharmacists of any patient issues including, but not limited to, pending drug levels and special medication instructions.
  • Respond and participate in all Pediatric CODE BLUE (B) emergencies in SJCH and SJH.
  • Become familiar with and ensure adherence to the policies and procedures regarding medication management, distribution, use, and monitoring at St. Joseph's Children's Hospital.

Rotation Requirements

  • Generally, PCICU rotation hours are 7 am to 4 pm. However, required hours may vary based on patient care and team needs.
  • Meet with the preceptor daily to discuss patient care issues, therapeutic goals, topic discussions, and personal progress through rotation.
  • Provide 4 to 5 formal discussions to the preceptor on Pediatric Cardiac topics. The resident will be prepared to present the topic with current literature and application to our patient population. (see Topic Discussion requirements). The Resident may present this topic to the fellow resident(s) and pharmacy students.
  • Attend Monday morning Pediatric Cardiac Cath Conference in the Command Center.
  • Attend the Pediatric Medication Use Safety Team (Kids MUST) monthly meetings in the command center.
  • Participate in monthly nursing meetings to provide current medication and/or Pharmacy Department information to the team which may include a brief (5 to10 minute) verbal presentation to the nurses. More frequent, small group discussions may be necessary in order to disseminate new information or procedures thoroughly to the teams.
  • Pediatric Advanced Life Support (PALS) certification, which is provided early in the residency
    Document all patient care interventions and adverse drug interactions in TheraDoc? daily. A minimum of 10 interventions should be documented weekly.

Preceptor

Cathy Storms Pharm.D.



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