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Psychiatric Rotation

Rotation Goal
The goal of this rotation is to allow the resident to become proficient in psychiatric pharmacy practice.  The resident will become familiar with providing pharmaceutical care to both pediatric and adult mental health patients. Commonly occurring disease states and conditions include schizophrenia, schizoaffective disorder, bipolar disorder, depression, ADHD, substance abuse, dementia, and personality disorders. All drug therapy will be monitored for therapeutic effect, appropriateness, and adverse events. The primary focus for all activities will be on the delivery of evidence-based pharmaceutical care to achieve optimal patient outcomes.

Rotation Description
St. Joseph’s Behavioral Health Center (BHC) is a free-standing 60-bed state-of -the-art facility dedicated to the care of mental health patients. There is an acute adult unit, a progressive adult unit, and a pediatric unit, each with 20 beds.  The BHC multi-disciplinary teams are comprised of a psychiatrist, pharmacist, nurse, social worker, and discharge planner.
The resident will begin the day by preparing for BHC multi-disciplinary rounds, which begin promptly at 8:30 am Monday through Friday.  The resident is responsible for monitoring their patients daily.  Specific areas of focus should include medication changes, medication compliance, PRN/ETO medications received, hours of sleep, lab values, and nursing narrative notes.  The resident is also responsible for following up on clinical consults and completing order verification.  As the rotation progresses, the resident will assume complete responsibility for ensuring optimal evidence-based drug therapy outcomes for one of the adult units and half of the pediatric unit.  The afternoons will be spent following up on drug information questions, discussing assigned topics, and reviewing patient care problem lists with the preceptor.  Diagnostic criteria and treatment guidelines for common psychiatric disorders will be reviewed.  The resident will also become responsible for leading patient medication education groups as the rotation progresses. 

Rotation Activities
• Attend and participate in patient care rounds.  The schedule is as follows:
       - Acute adult unit:  8:30 am, Family Therapy room
       - Progressive adult unit:  9:15 am, Family Therapy room
       - Pediatric unit:  9:54 am, Pediatric Intake room
• Evaluate and monitor drug profiles for interactions, duplication of therapy, allergies, therapeutic indication, and appropriate dosing.
• Identify, interpret, and apply current medical literature and evidence-based practices to maximize patient care.
• Monitor and make therapeutic recommendations for all pharmacokinetically monitored drugs.
• Evaluate patients for drug-induced movement disorders and make appropriate recommendations.
• Assist physicians and nurses with drug information questions using appropriate resources.
• Lead medication education groups for the patients.
• Document therapeutic interventions.

Rotation Requirements
• Required hours: 7 am to 4 pm. The times may vary based on patient care and team needs.
• Formal topic discussions with preceptor. The resident will be prepared for the topic with current literature and application to our patient population.
• Lead medication education groups for the patients.
• Maintain all therapeutic monitoring logs in the clinical decision support software, TheraDoc®, according to department policy.
• Document patient care interventions in TheraDoc®
• Document any adverse drug events according to department policy.
• Provide drug information in the form of in-services for the nursing staff on drug therapy, as needed or requested. This typically includes a 5-10 minute verbal presentation and written information for the nurses. It may require more frequent, small group discussions in order to disseminate new information or procedures thoroughly to the teams.

Katherine McMichael, PharmD, BCPS
Phone: 813-870-4858

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