Practical - Bronson Healthcare

Practical

Description:

Preceptor: Amanda Hult, Pharm.D.

Hours: 8:00-5:00

Phone: (269)341-7072

Email: hultam@bronsonhg.org

General Description:

Internal Medicine 2 (IM2) is an elective four week learning experience at Bronson Methodist Hospital. The resident will be responsible for monitoring all patients admitted to the floor. The resident will be responsible for identifying and resolving medication therapy issues, and will work toward assuming
care of all patients throughout the learning experience. During the learning experience, the resident will develop and monitor pharmaceutical care plans, participate in multidisciplinary rounds, provide antibiotic and anticoagulation dosing services, initiate and monitor TPNs, provide renal dosing, and make recommendations to providers.

Disease States:

Common disease states in which the resident will be expected to gain proficiency through literature review, topic discussion, and/or direct patient care experience may include, but not limited to:

○    Cardiovascular Disease: HTN, Congestive heart failure, CAD

○    Infectious Disease: CAP, HCAP, UTIs

○    Endocrine Disorders: Diabetes mellitus, thyroid disorders

○    Gastrointestinal Disorders: Stress-ulcer prophylaxis, upper/lower GI bleeds, IBD

○    Hepatic Diseases: Acute alcoholic hepatitis and cirrhosis

○    Neurologic Disorders: stroke, seizure disorders

○    Renal Failures (acute/chronic)

○    Respiratory Disorders: Asthma and COPD

○    Acute alcohol withdrawal and substance abuse management

○    Pain management

○    Thromboembolic disorders: DVT and PE

 

Preceptor Interaction

Daily: 07:55 Check with preceptor for morning information/pre-rounds 08:00 Attend morning conference

09:00 Work-up patients 10:30 Round with team

14:00 Meet with preceptor for topic discussions, patient reviews, journal club, etc Day 1: Preceptor to review IM/AC learning activities, schedules, and expectations

Week 1: Resident to work up assigned patients and present to preceptor and students. Preceptor will participate in rounds (modeling the pharmacist's role in the healthcare team).

Week 2: Resident to work up assigned patients and present to preceptor and students. Preceptor may

attend/participate in team rounds (coaching the resident to take on more responsibility as a pharmacist on the team).

Week 3-4: Resident to work up assigned patients and present to preceptor and students. Preceptor may attend and observe the resident's participation in team rounds, and/or may expect a summary report from the resident regarding rounding activities and use of recommendations made by the resident. Preceptor will be available for questions and will follow patients independently to monitor resident skill development in all aspects of the learning experience (facilitating the resident as the pharmacist on the team).

 

[The length of time the preceptor spends in each of the phases of learning will depend BOTH on the resident's progressions in the current rotation and where the rotation occurs in the residency program]

Evaluation Strategy

The resident will receive on-going, regular formative verbal feedback throughout the rotation. At the completion of the rotation the resident and preceptor will independently complete the Summative Evaluation in PharmAcademic, then will meet and compare the evaluations prior to cosigning. The resident will also complete the Learning Experience Evaluation and a Preceptor Evaluation for each preceptor.

Expectation of Residents:

The resident is responsible for identifying and resolving medication therapy issues for patients and will work toward assuming care of assigned patients on the service throughout the learning experience. The resident will be responsible for assigning patients, drug information requests, topic reviews, and journal clubs. They will also be responsible for providing and documenting therapeutic drug monitoring services for patients on their team.

Residents will also be expected to lead patient discussions and in conjunction with the preceptor is ultimately

responsible for the patients on service.

The resident will personally or direct a student to talk with the patient/patient's family to clarify all medication related issues (e.g. allergies, doses, home medications, adherence, etc.)

All interventions will be documented in a timely manner by the resident, decentralized pharmacist, and/or

preceptor.

Taught and Evaluated Objectives

Activities

Goal R1.1

In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process

 

OBJ R1.1.1

(Applying) Interact effectively with health care teams to manage patients' medication therapy

Document recommendations in the chart in the form of Ivents

Participate in multidisciplinary rounds and make appropriate
evidence-based recommendations

 

OBJ R1.1.2

(Applying) Interact effectively with patients, family members, and caregivers

Clarify with patients when necessary to ensure accurate allergy and medication information

Educate patients on selected medications

OBJ R1.1.3

(Analyzing) Collect information on which to base safe and effective medication therapy

Collect data via chart review and patient interaction in order to make the most appropriate medication recommendations

Present care plans to preceptor based on collected information

OBJ R1.1.4

(Analyzing) Analyze and assess information on which to base safe and effective medication therapy

Collect pertinent data in preparation for multidisciplinary rounds

Evaluate patient specific data to make recommendations to optimize care

OBJ R1.1.5

(Creating) Design or redesign safe and effective patient- centered therapeutic regimens and monitoring plans (care plans)

Evaluate patient specific data to make recommendations to optimize care
Present care plans to preceptor before rounding with the team

Use evidence-based guidelines/literature when making recommendations

OBJ R1.1.6

(Applying) Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions

Maintain ownership of patients by following them on a daily basis

Provide detailed instructions for follow-up between shifts

OBJ R1.1.7

(Applying) Document direct patient care activities appropriately in the medical record or where appropriate

Categorize interventions appropriately and utilize Ivents for documentation

OBJ R1.1.8

(Applying) Demonstrate responsibility to patients

Clarify with patients when necessary to ensure accurate allergy and medication information

Follow up on patients' questions and educational needs

Goal R1.2

Ensure continuity of care during patient
transitions between care settings

 

OBJ R1.2.1

(Applying) Manage transitions of care effectively

Follow patients with the complex care team when appropriate

Resolve any medication related issues prior to discharge

Evaluations:

Evaluation

Evaluator

Evaluated

Timing

Summative Evaluation

All Preceptors

Each Resident Taking this Learning Experience

Ending and Quarterly if Needed

ASHP Learning Experience Evaluation

Residents

All Preceptors of this Learning Experience

Ending and Quarterly if Needed

ASHP Preceptor Evaluation

Residents

Learning Experience

Ending and Quarterly if Needed

Summative Evaluation

Residents

Each Resident Taking this Learning Experience

Ending and Quarterly if Needed

Positivity Icon

Have you experienced Bronson Positivity?
Share your story now.

Share your Positivity

View Additional Section Content

Internal Medicine

  • Practical