(PGY1 Required Rotation - Longitudinal Learning Experience)
Residents will be assigned to preceptors who work every third weekend with them in their clinical decentralized staffing area. The preceptor will coordinate comments from staff pharmacists who work with the resident on other staffing shifts when evaluating their progress.
University Hospital is a 430 bed acute care academic medical center with many critical care units (surgery, medicine, neurosurgery, newborn, burn), a regional trauma center, and receives many patients from referring healthcare providers in the intermountain area. The inpatient division also cares for patients in the Emergency Department and Infusion Center. The pharmacy is highly automated with bar code dispensing, automated dispensing cabinets, and the hospital has computerized prescriber order entry and electronic medical records and medication administration records. Pharmacists are highly integrated into unit-based care of the patients and have an integrated model of practice that fosters an exceptional patient experience.
Residents select a decentralized staffing area to work every third weekend as the pharmacist responsible for the unit. The units include one of the following:
- Ortho-Trauma Surgical Services (OTSS on the 6th floor)
- Surgical Specialties and Transplant Unit (SSTU on the 5th and 6th floors)
- Acute Internal Medicine A&B (AIMA&B on the 4th and 5th floors)
- Cardiology and Vascular Medicine Unit (CVMU on the 4th floor)
- Intermediate Care Unit and Neuro Acute Care (IMCU & NAC on the 2nd and 3rd floors)
The resident will be oriented to a primary work area and a secondary work area during orientation and will continue to train for their weekend shifts through part of August or until they are both licensed as a pharmacist and can perform the basic medication reviews required of a pharmacist on the weekend staffing shifts. The resident is responsible for 4 shifts per month and can also work shifts in the central pharmacy doing order verification or in the IV Center if adequately interested or trained. These additional shifts can be requested as each new schedule is rolled out on line from a list of "open shifts".
R1.3 Prepare and dispense medications following existing standards of practice and the organization’s policies and procedures.
- Interpret the appropriateness of a medication order before preparing or permitting the distribution of the first dose.
- Follow the organization's policies and procedures to maintain the accuracy of the patient’s medication profile.
- Prepare medication using appropriate techniques and following the organization's policies and procedures.
- Dispense medication products following the organization's policies and procedures.
R1.4 Demonstrate ownership of and responsibility for the welfare of the patients by performing all necessary aspects of the medication-use system.
- Display initiative in preventing, identifying, and resolving pharmacy-related patient-care problems.
R2.11 Communicate ongoing patient information.
- When given a patient who is transitioning from one health care setting to another, communicate pertinent pharmacotherapeutic information to the receiving health care professionals.
- Ensure that accurate and timely medication-specific information regarding a specific patient reaches those who need it at the appropriate time.
R2.12 Document direct patient care activities appropriately.
- Appropriately select direct patient-care activities for documentation.
- Use effective communication practices when documenting a direct patient-care activity.
- Explain the characteristics of exemplary documentation systems that may be used in the organization’s environment.
E7.4 Manage time effectively to fulfill practice responsibilities.
- Use time management skills effectively to fulfill practice responsibilities.
|Rotation Activity||RLS Goal||Teaching Method|
|The resident will use PowerChart and PharmNet to determine the appropriateness of drug orders based on each patient’s medication profile, labs such as organ function, vital signs, potential interactions, therapeutic duplication, etc.||R1.3||I, M, C, F|
|The resident will use dispensing technologies correctly and per policy to ensure speed in patients receiving the correct medication. Examples of these technologies include Omnicell machines, tube system, PharmNet (print label), and AutoMed.||R1.3, R1.4||C, F|
|The resident will review each patient’s chart and medication list to determine appropriateness of therapy for all floor patients in the assigned unit(s).||R1.3||F|
|The resident will appropriately apply what they learned about medication management and policies during orientation and rotations to their staffing shifts. The resident will adhere to policies and guide other health professionals in using these policies.||R1.3, R1.4||C, M, F|
|The resident will identify and follow-up on medication problems for each patient on their assigned unit(s) by the end of shift. The resident will document their key interventions in PowerChart or in the pharmacy notebook as appropriate.||R1.4, R2.11, R2.12||M, F|
|The resident will leave a clear and concise list of follow-up items for the next pharmacist when working decentralized shifts. The list will include items appropriate for follow-up the next day by the clinical pharmacist. Problems, medication reconciliation, vaccine screening/orders, and other forms of documentation and follow-up will be completed appropriately during their shift and not left for the next shift.||R1.4, R2.11, R2.12||C, M, F|
|The resident will work to manage their time well and efficiently so they complete all tasks during the typical shift length of 8.5 hours whenever possible.||E7.4||M, F|
|The resident will show exceptional patient care and communication skills when working with other pharmacists, physicians, nurses, ancillary staff, patients, and their families.||R2.11||C, M, F|
Reading / Resources:
Orientation training and handouts.
Pharmacy Help Book*: https://pulse.utah.edu/site/dirc/Pages/Help-Book.aspx
Eccles Library Resources: http://www-medlib.med.utah.edu/
Hospital Medication Policies and Guidelines*: https://pulse.utah.edu/policies/FilteredFor/Medication%20Management.aspx
* not available to the public
The resident is asked to use appropriate literature, drug information resources, help from other pharmacists, policies, excellent time management, and common sense to ensure their patients receive adequate care during their shift.
Project or Presentation Description:
None required unless an inservice is requested by decentralized staff.
Typical Daily/Weekly/Monthly Activities:
Typical work schedules are as follows:
Weekend Days: 0700-1530, though the resident should ensure all patient medication issues are resolved before leaving.
Swing Shifts: 1500-2330 (unless they have rotation at 0700 the following morning – then they must leave at 2300 to ensure duty hours are not compromised.)
The resident must clock in and out for all staffing shifts as part of the ongoing assessment of their time and efficiency.
The preceptor will conduct an evaluation quarterly, but will give constructive comments as any issues arise in the resident’s performance (ie, missed items, follow-up, or recommendations, etc.) The resident will conduct a self-evaluation on the same schedule. The preceptor will conduct an end of rotation evaluation with the resident. The resident will complete the preceptor and learning experience evaluations. The evaluations will be documented in ResiTrak.