Pharmacy Residency - Rotation Description, Pediatrics - Bronson Healthcare

Pharmacy Residency - Rotation Description, Pediatrics

General Pediatrics Rotation 

 
Preceptor: Brandon Evans, Pharm.D., and Bonnie Riddle, Pharm.D. 
Office: W-371 
Hours: 8:00am - 4:30pm. 
Phone: 269-341-7977 
Email: riddleb@bronsonhg.org and evansbr@bronsonhg.org 
General Description: General pediatrics is an elective 1-month learning experience at Bronson Methodist Hospital. The resident will be assigned to general pediatrics team for the selected month. The team is composed of attending physicians, various medical residents, interns, and/or students, nurses, and case manages. Walking family-centered care rounds occur daily Monday through Thursday with the Physician Referral Service (PRS) attending physicians (Bronson’s pediatric hospitalist group) and WMED attending physicians. Other disciplines may consult with or round with the team, including, but not limited to, pharmacy students, respiratory therapy, and dieticians. The resident is responsible for monitoring patients admitted to the general pediatrics ward at the Children’s Hospital. The resident will identify and resolve medication therapy issues for patients and will work toward assuming care of assigned patients on the service throughout the learning experience. The resident will become proficient in pediatric patient monitoring, while utilizing diagnostic and laboratory tests in pediatric patient therapy evaluations and the clinical use of serum drug concentrations. Emphasis will be placed on the resident demonstrating an understanding of common pediatric disease states in hospitalized patients and the treatment of those diseases. Good communication skills and interpersonal relationships will be essential in this practice setting. The resident will participate in several academic activities during the rotation. These activities include, but are not limited to, journal club; disease state topic discussions; patient presentations; and assisting with precepting and evaluating Doctor of Pharmacy students from Ferris State University who are also assigned to general pediatrics that month. 
Expectations:  The resident must be able to develop methods for accomplishing the above listed activities within this 4 week time frame. A patient case presentation to pharmacy or medical staff will be required sometime during or immediately following completion of the rotation.
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 are not limited to: 
  • Pediatric pharmacokinetics
  • Community-acquired pneumonia
  • Asthma exacerbations 
  • Diabetes mellitus including diabetic ketoacidosis
  • Cystic fibrosis
  • Sickle cell disease
  • Pediatric seizure disorders
  • Pain management
  • Gastroesophageal reflux 
  • Bronchiolitis 
  • Neonatal sepsis 
Goals Selected: R1.4 R2.1 R2.2 R2.4 R2.6 R2.8 R2.10 R7.3 Activities and associated goals: Accurately and efficiently gather, organize, and analyze patient-specific information-R1.4, R2.2, R2.4, R2.10 Attend checkout and morning report-R2.1 Actively participate in patient rounds-R2.1, R2.6, R2.8, R2.10 Meet with preceptor for post-rounds discussion on patients-R2.4, R2.6, R2.8, R2.10, R2.12 Complete a journal club review and lead discussion resulting from the article- R7.3 Complete a topic review and lead discussion resulting from review- R7.3
Schedule:
0700 Attend checkout with medical team -- Doctor's Lounge near the Atrium.  Peds team sits immediately to the right  when you first walk in the door. 
0800 Monday through Thursday -- Morning Report E352A Room of Magic (aka Peds Conference Room)
0800 - 0900 (Fridays only) Pediatric Grand Rounds -- Gilmore Center Auditorium
1000 - 1130 Monday through Thursday -- Pediatric Family-Centered Care (Walking Rounds)
Meet with preceptor, if needed, to discuss patient issues prior to 0900. Work-up patients until 1000 when you will round with the medical team. 
1130-1230 Assist clinical pharmacist with order entry, pharmacokinetic interps, drug information questions, reports, etc. 
1230 Lunch Break
1300 Tuesdays through Fridays -- Meet with Heather VandenBussche (Ferris State University Faculty) for topic discussions, journal club, etc.
1400-1530  Assist clinical pharmacist with order entry, pharmacokinetic interps, drug information questions, drug dosing/monitoring, etc.  Project time if other activities are complete.
Day 1 Preceptor to review Peds learning activities, schedules, and expectations. Discuss potential participation in attending a pediatric sedation, shadowing a medical resident or attending, participation in the medication reconciliation process at admission, attending various medical procedures, taste testing of oral liquid medications with the medical residents, 5-min topic presentation to the pediatric team, medication reconciliation at admission activities, etc. Please bring a copy of your Outlook calendar on Day 1 of your rotation.  The following items need to be scheduled during day 1 of your rotation:  midpoint evaluation (done together), snap shots (Week 1 and 3), resident self evaluation (independent), preceptor and resident review self evaluation (together), preceptor to complete final evaluation (together).  Schedule 5 minutes at the end of every week to review goals for the following week of the rotation: preceptor's goals and resident's goals (include desired experiences or focused areas of improvement).
Week 1 Resident to work up assigned patients and present to preceptor. Preceptor will participate in rounds and resident will observe modeling of 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 and will coach 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. Preceptor will attend and observe the resident’s participation in team rounds. Preceptor will be available for questions, will follow patients independently to monitor resident skill development in all aspects of the learning experience, and will facilitate 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 - ResiTrak will be used for documentation of formal evaluations. For formative evaluations, the resident will perform the activity appropriate to the snapshot with the preceptor. Resident and preceptor will then independently complete the snapshot. After both have signed the evaluation, the resident and preceptor will compare and discuss the evaluations. This discussion will provide feedback on both their performance of the activity and the accuracy of the self-assessment.
End of week 2 - Snapshot (R2.4.2 - Determine the presence of any of the following medication therapy problems in a patient's current medication therapy...)
End of week 3 - Snapshot (R2.8.1 - Recommend or communicate a patient-centered, evidence-based therapeutic regimen and corresponding monitoring plan to other members of the interdisciplinary team and patients in a way that is systematic, logical, accurate, timely, and secures consensus from the team and patient. )
End of week 4 - Summative, Learning Experience, & Preceptor Evaluations