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 and one resident 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.
There are two IMR teaching teams. Each team consists of an attending physician, R1 and R2 medical resident, internal medical teaching fellow, a clinical pharmacist, medical students and pharmacy students. The patient population served by IMR varies greatly. The resident actively participates in daily rounds, offers education for physicians, nurses, patients and family members, and tracks interventions. During this rotation, the resident will work closely alongside Washington State University faculty pharmacists to facilitate journal clubs, topic discussions and advanced pharmacy practice experiences for fourth-year pharmacy students.
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 pediatrics 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 a 4 week long 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.
Residents will spend dedicated time with pharmacy department leaders. On the first day of rotation, the resident will meet with pharmacy leaders to make a list of projects to work on completing with the management team and determine specific activities and meetings to attend. Leaders discuss management topics as they arise related to projects, meeting attendance and other departmental activities. A more formal management huddle focused on various leadership topics will take place every other week throughout the year.
The nephrology rotation is a floor-based service where the preceptor and pharmacy resident will attend daily nephrology rounds, field questions from health care providers and identify and recommend solutions to problems found in the patient’s pharmacotherapy. The resident will gain experience with all types of kidney disease and its complications.
This is an additional pediatric elective rotation, primarily focusing on managing inpatient and outpatient chemotherapy orders for the Children’s Hospital. Emphasis on pediatric oncology diseases will be covered during this rotation as well as other pediatric specialty topics, such as cystic fibrosis.
This rotation is located on the Adult Geriatric Psych Unit (AGPU) and Psychiatric Center for Children & Adolescents (PCCA). The patient population served is a wide variety of psychiatric patients. Residents will spend approximately half of their time rounding with a physician and the other half working on projects, attending committee meetings and other residency requirements.
Three weeks will be spent with the Cardiac Transplant team, and three weeks will be spent with the Renal/Pancreas Transplant team. There is team rounding on both services. In addition to patient care rounding, residents will spend time seeing patients in clinic and performing medication education for patients post-transplant. Each transplant team is made up of a wide variety of health care professionals including, but not limited to, surgeons, physicians, nurse coordinators and pharmacists.