The antimicrobial stewardship (AMS) service is an informational resource for health care providers, in addition to coordinating antimicrobial-focused educational and administrative initiatives within Providence. Daily patient rounds with infectious disease (ID) physicians facilitate prospective audits of antimicrobial use and real-time feedback for health care providers. Residents will spend time reviewing treatment regimens and finding ways to optimize therapy, as well as delving deeper into specific ID topics discovered during global assessment of antimicrobial therapy. Time will be divided between global treatment plan assessment, individualized learning and discussion of ID topics and work on specific ID initiatives AMS pharmacists have on-going at the time of rotation.
The critical care service has two full-time pharmacists (Cardiac ICU pharmacist and Medical/Surgical ICU pharmacist) at all times to provide pharmacy services to a 26 bed medical/neuro/surgical ICU and a 22 bed cardiac ICU. The resident will work alongside the internal medicine residents and attending intensivist through daily rounding and pharmacy consults. Time will be divided between identifying and resolving medication therapy issues for patients, discussion of critical care topics and providing pharmacy support to the medical residents. The resident will spend time in both specialty and units.
The primary goal of the pediatric rotation is to familiarize self with appropriate pediatric drug therapy and dosing in order to provide safe and effective pharmaceutical care for our pediatric and neonatal patients. Residents will spend time covering patients on the general pediatric ward, and the neonatal ICU. The pharmacy resident is responsible for identifying and resolving medication therapy issues for patients and will work toward assuming care of all patients on one unit by the end of the learning experience. The pediatric ICU can be chosen as an elective and completed separately for more focus on pediatric medicine.
The cardiology rotation is a floor-based service where the preceptor and pharmacy resident will work together consulting with physicians, nurses and patients. The resident will be responsible for attending all codes in the hospital, with the exception of the ICU and pediatric floors. Residents will focus on topics such as anticoagulation, heart failure, arrhythmias and ACLS. The pharmacy resident is responsible for identifying and resolving medication therapy issues for patients and will work toward assuming care of all patients on one unit by the end of the learning experience.
The oncology rotation is a floor-based service where the preceptor and pharmacy resident will work together to provide daily therapeutic drug monitoring and resolve medication related issues while working closely with physicians and nurses. The resident will be expected to gain proficiency through literature review, topic discussions and direct patient care on a number of oncology disease states.
This learning experience has two components; a block component with focus on various activities with leaders such as attending meetings, leading safety huddles, presenting at P&T committee, etc., and a longitudinal component that allows residents to work on leadership skills such as managing various initiatives, working on longer term projects, and implementing long term initiatives. During the longitudinal portion of this rotation, residents also get to participate in administration huddles and journal clubs focused on various leadership topics taking place every other week throughout the year. Through completion of a series of seminars and educational activities for the department, and working on a teaching philosophy, the residents qualify for a Providence Experiential Teaching Certificate.
The emergency medicine rotation covers both pediatric and adult emergency departments and is staffed by a pharmacist for 18 hours a day. The goal of this rotation is for residents to get hands on experience at bedside obtaining and preparing medications for administration, gain confidence answering drug information requests, and to be able to prioritize workflow throughout the day in a fast-paced environment. Residents will work alongside the preceptors to respond to a variety of emergent activations (e.g., traumas, cardiac arrests, strokes, and rapid sequence intubations) to improve their skills. The ED pharmacist is also responsible for following up on cultures for discharged patients and adjusting antimicrobials if indicated. Residents are expected to participate in this activity during their rotation.
The teaching rotation focuses on various precepting and teaching activities through a block rotation. The pharmacy resident on this block, under supervision of the teaching preceptor, is responsible to lead patient care activities such as rounds with the internal medicine team, guideline and topic discussion, journal club and other teaching activities with APPE pharmacy students. The resident will practice their soft skills in teaching and precepting by acting as the primary preceptor for the pharmacy students. Our collaboration with the Washington State College of Pharmacy & Pharmaceutical Sciences affords the residents the opportunity to participate in more formal didactic teaching experiences and classroom activities, with the option to pursue an Advanced Teaching Certificate in Academia.
