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Pediatric Intensive Care Rotation

Rotation Goal

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

Rotation Description

The Pediatric Intensive Care Unit is a Level I, 16-bed state-of -the-art unit dedicated to the care of critically ill children and their families. The PICU multi-disciplinary team is comprised of several pediatric intensivists, surgeons, nurse practitioners, respiratory therapists, dietitians, pharmacists, child life specialists, and pastoral care members.
The PICU provides comprehensive services for infants, children and adolescents 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, metabolic and genetic diseases, cardiac failure and acute rhythm problems, oncologic problems and those recovering from cardiac, orthopedic, neurologic and general surgeries.
The resident will begin the day by preparing for PICU multi-disciplinary rounds which begin approximately at 9 am Monday through Friday, and may last up to 3 hours. The resident is responsible for developing a monitoring plan for each patient that will be evaluated on rounds and will actively participate in patient care discussions. 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 in the PICU as needed. As the rotation progresses, the resident will assume complete responsibility for ensuring optimal drug therapy outcomes in concert with PICU team goals for patient.

Rotation Activities

  • The resident will begin the day at 7am to prepare for PICU multidisciplinary rounds which begin at approximately 9am daily, Monday through Friday. Daily attendance on rounds is mandatory and the preceptor must be notified in advance (preferably the day prior) of any anticipated absence.
  • Be professional, courteous and punctual.
  • Prior to rounds, 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 to the team.
  • The resident will have available for rounds all pertinent past and current medication therapies for the patient and monitor progress throughout the admission in PICU. The resident will have access to a Computer Workstation-on-Wheels (WOW) to access information, give documentation, and provide pharmacy services to the team and patients during rounds.
  • Evaluate the use and benefit of the PICU patient's chronic home medications, current list of medications initiated in the hospital, and possible future medication regimens.
  • Develop a customized plan for each patient; may require medication education and assistance in obtaining specialty and/or compounded medications.
  • The resident will assess each patient in PICU 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, PICU team, 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.
  • Respond and participate in all Pediatric CODE BLUE (B) emergencies in SJCH and SJH.
  • Update the PICU 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, 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.

Rotation Requirements

  • Required hours 7 am to 4 pm. The times may vary based on patient care and team needs.
  • Provide 6 to 8 formal discussions to the preceptor. 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 interns.
  • Pediatric Advanced Life Support (PALS) certification, which is provided early in the residency
  • Document 10 patient care interventions into Theradoc© weekly.
  • Document two adverse drug events per week.
  • Attend the monthly meeting for the Pediatric Medication Use Safety Team (MUST)
  • Participate in at least one monthly nursing meeting 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.

Preceptor

Pamela DeLuna, Pharm.D.



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