The goal of this rotation is for the resident to develop the clinical skills and knowledge base necessary to provide safe and appropriate medication therapy management in the obstetrical, perinatal, gynecological and neonatal patient.
The Women's Health and NICU Rotation is an elective rotation for the PGY1 Resident. St. Joseph's Women's Hospital (SJWH) is located on the south campus of St. Joseph's Hospital. It is licensed for 192 adult beds. Also located at SJWH is a 64 bed Level II and Level III NICU. SJWH provides care for obstetrical, high risk, gynecological as well as neonatal patients.
- The resident is responsible for daily patient profile review for identification and resolution of patient pharmacotherapy issues.
- The resident will monitor and provide pharmacokinetic consultations.
- The resident will develop an understanding of the basics of obstetrical, perinatal/high-risk, gynecological and neonatal pharmacotherapy.
- The resident will provide drug information services to interdisciplinary team members.
- The resident will develop an understanding of the numerous issues in managing obstetrical, perinatal and gynecological patients, including but not limited to:
- Medication dosing and adjustments in these special patient population.
- Prepartum and Postpartum Obstetrical Patient- vaginal/cesarean delivery.
- Perinatal and Postnatal care of the High Risk Obstetrical patient:
- Preterm Labor (PTL), Gestational Diabetes, Pregnancy Induced Hypertension (PIH), Premature Rupture of Membranes (PROM), Preeclampsia
- Gynecological Surgeries:
- Hysterectomy (LAVH, TAH), Pelvic Organ Prolapse, Laproscopic Surgeries, Breast Reconstructive Surgery, Endometrial Ablations, Urinary Incontinence, Abnormal Uterine Bleeding, Postmenopausal Hormone Replacement Therapy.
- The resident will develop a basic knowledge of neonatal pharmacotherapy and the issues managing a critically ill neonate, including:
- Medication dosing and adjustments
- Neonatal sepsis
- Respiratory Distress Syndrome (RDS)
- Bronchopulmonary Dysplasia (BPD)
- Neonatal Necrotizing Enterocolitis (NEC)
- Neonatal Abstinance Syndrome (NAS)
- Immunization of the Newborn
- Craniofacial and Musculoskeletal Defects
- Hematologic Diseases
- Genetic Disorders
- Professionalism and punctuality are required at all times
- Collect and review patient data daily to be accessible during physician rounds and to make appropriate recommendations to the various specialists
- Assess each patient for needed weight based doing adjustments in the NICU patients
- Monitor for duplication of therapy and lab value/monitoring for drug-drug interactions, medication events and adverse reactions
- Assess the appropriateness of medications in the pregnant patient, review pregnancy categorization of medications, and make recommendations for alternative therapies during pregnancy. These will be reported to the preceptor and the appropriate physician will be consulted. Interventions will be documented in the Theradoc© pharmacy monitoring system
- Provide evidence based, concise and timely responses to all drug information inquiries from the preceptor or multidisciplinary team members throughout SJWH
- Conduct nursing in-services regarding pharmacotherapy issues upon request
- Update the NICU communication form daily as well as the adult communication board to inform incoming pharmacists of patient related issues, pending drug levels and other pharmacotherapy related issues for patients throughout SJWH
- Meet with the preceptor daily to discuss patient care issues, therapeutic goals, topic discussions and personal progress throughout the rotation
- Accompany the preceptor to attend any unit meetings, the NICU Advisory Board Meeting, NICU Safety Committee meeting, Pediatric Medication Use Safety Team (Kids MUST) meetings and all Pharmacy Departmental meetings
- Provide at least four formal discussions to the preceptor relating to OB-GYN or NICU related topics. These must contain evidence-based information and be applicable to the special patient population. The resident may present the topics to the Pharmacy team, as well as to the nursing staff.
Christina Petretich-Elgendi, B.S. Pharm.