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Objectives: RJH Residency Rotation Outline – ED

So I just realized I had no actually posted all my ER reflections! They were in my draft box for some reason! So my last two reflections are in posted today as well!

NEPHROLOGY ROTATION

Personal objectives:

1) To understand the pathophysiology of mineral metabolism disorders in ESRD, the MOA of medications used to treat this disorder and to apply this knowledge to patients (treatment recommendations, monitoring plans).

2) To do pharmacokinetic monitoring for vancomycin and aminoglycosides in ESRD and be able to make dosing recommendations and develop monitoring plans for actual patients.

Objectives: ICU Pharm Res Rotation G&O (Feb 2010)

Personal Goals:

1) Acid/Base Disorders: be able to assess patients with acid/base disorders and using a stepwise approach, make appropriate treatment recommendations and develop monitoring plans for at least 3 patients.

2) To become more efficient in patient work ups,  make appropriate therapeutic recommendations and complete a monitoring plan in a timely manner. By the end of the rotation, be able to efficiently manage a ward on my own.

3) Shock: be able to assess patients with shock and recommend appropriate therapies (vasopressor,inotropes, etc)  and develop monitoring plans for at least 4 patients.

Objectives

CHPRB Standard 2010
The resident shall demonstrate a working knowledge of medication use system(s) as well as pharmacy and other care provider roles within the system, in order to manage and improve medication use for individual patients and groups of patients.

Levels of expectations

1.    Clearly, concisely, and completely describe the functioning of the drug distribution system and medication prescribing processes within the health care organization to another health professional.
2.    Assess prescriptions for accuracy, appropriateness, and adherence to health care organizational policies and practices.
3.    Consistently identify and complete medication incident reports.
4.    Explain & educate others about health care organizational practices and policies related to preparation of sterile products (such as cytotoxic agents, parenteral nutrition, injectable medications), and narcotic & controlled drugs. Independent preparation of sterile products is beyond the expected level of the standards, but active participation in preparing sterile products can help the understanding of aseptic technique.
5.    Document prescriptions and prescription changes clearly and completely.

Overall Goal

To introduce the resident to the area of intravenous admixture by increasing their knowledge, skills and abilities in the following areas:
1.    Aseptic Technique
2.    Aseptic compounding policies & clinical concepts.
3.    Technology in sterile product preparation
4.    Chemotherapy
5.    Total Parenteral Nutrition

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Objectives/Activities

1.    The resident will spend 1-2 day in Medical Microbiology to introduce them to the functions and processes of the medical microbiology laboratory. At the end of the week they will compose a ½-1-page reflection document summarizing what they saw and what they learned during the day and review it with the preceptor.

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Objectives: Pediatric Rotation

I just finished my first week on the pediatric ward at VGH. I admit it is a totally different world and I no longer can work up patients as quickly as I did in internal medicine and geriatrics. My first patient had multiple complicated disease states such as seizures, hypertension, GERD and short bowel syndrome. I’ve had to do a lot of reading because we did not get a lot of exposure to pediatrics during school.

The H1N1 flu is also a bit of a concern on the ward. There has been a few patients who have been admitted with flu-like symptoms and any patient who is influenza A positive gets put on Tamiflu. To get H1N1 confirmation, we have been sending the samples to Vancouver (BCCDC) and this usually takes ~ 1 week. However, starting Monday the labs in Victoria should be able to run the tests.

I’m faciliating a journal club on Tuesday so I will post a copy of my handout after it is done!

Goals
The goal in the one-week drug information rotation is to develop an understanding of how a pharmacist can serve as an effective provider of drug information. An effective provider combines information retrieval skills with clinical knowledge, and applies them towards the care of individual patients.

Drug Information Rotation Objectives (please go to end of post to see personal learning objectives)
Upon completion of the one-week drug information rotation, the pharmacy resident should have improved their skills in three general areas:

Information retrieval:

  1. Identify the question.
  2. Describe the types, functions, and limitations of commonly available drug information resources and demonstrate effective use of these resources.
  3. Demonstrate efficient search strategies.

Knowledge translation: Analyze, summarize or distill the information into a solid piece of knowledge, and communicate it effectively

  1. Critically analyze and evaluate information.
  2. Interpret and combine information from multiple sources.
  3. Distinguish what is known from what needs to be known.
  4. Formulate an accurate written and verbal response.

Application: Apply the knowledge to an individual patient

  1. Take the knowledge distilled from the best information available and combine it with personal clinical experience, specific patient history and concerns of the patient, local knowledge and society’s values in order to provide the best recommendation and outcome.

Personal objectives: DPICobjectives


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