Critical Care
Overview
Critical care rotation gives residents an opportunity to provide pharmacist
patient care to critically ill patients at Mercy Hospital. The resident will
design, recommend, monitor and evaluate patient-specific therapeutic regimens
for selected critically ill patients. The patient population includes a mix
of medical and surgical ICU patients.
Preceptor
Primary: Gary Sundeen, RPh
Contact information
Phone: (763) 236-7538
Fax (763) 236-7540
E-mail gary.sundeen@allina.com
Rotation location
Mercy Hospital Intensive Care Unit
Hours
Monday – Friday
(Approximate) 0730-1600
Goals
Goal S1: Take personal responsibility for attaining excellence in one’s own ability to provide pharmaceutical care.
Goal S2: Demonstrate ethical conduct in all job-related activities.
Goal S3: Demonstrate the characteristics of a professional.
Goal S5: Appreciate the need to adapt direct patient care to meet the needs of diversity.
Goal S6: Use an organized system for staying current with pertinent literature.
Goal S7: Communicate clearly when speaking or writing.
Goal S9: Solve practice problems efficiently.
Goal S10: Function effectively as a member of the health care team.
Goal S15: Understand direct patient care delivery systems in multiple practice settings.
Goal S19: Manage time effectively to fulfill practice responsibilities.
Goal P2: Design, recommend, monitor, and evaluate patient-specific therapeutic regimens that incorporate the principles of evidence-based medicine
Goal P3: Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients, health care providers, and the public.
Goal P4: Document direct patient-care activities appropriately
Goal P5: Provide inservice education to physicians, nurses, and other practitioners.
Goal P8: Prepare and dispense medications following existing standards of practice and the health system's policies and procedures.
Goal M2: Prepare and disseminate written drug information.
Goal M16: Utilize pharmacy technical and clerical personnel effectively.
Goal M18: Provide instruction to pharmacy technicians, pharmacy students, pharmacy residents, and pharmacists.
Daily rotation activities
- Review existing patients
- See new patients (preparation for ICU rounds and Infectious Disease rounds)
- ICU Rounds
- ID Rounds
- Pain Team Rounds
- TPN monitoring
- Pharmacokinetics
- Patient discussions with preceptor
- Topic discussions with preceptor
- Other: nursing inservice, drug information for medical and nursing staff,
precepting pharmacy students, special projects (DUE, data collection)
Interaction with health care providers
The resident will actively participate in daily ICU rounds with other members
of the ICU multi-disciplinary team (includes house physician, nursing, pharmacist,
social worker, respiratory therapy, dietitian, and chaplain).
Meeting attendance
The resident will set up a meeting weekly with the preceptor for 30 minutes.
These meetings will allow time for the preceptor to review rotation activities
from the previous week and provide feedback on performance. The resident will
also set up a meeting on the last day of the rotation to complete the preceptor
and resident evaluations. Additional meetings include:
- Weekly Cardiology Noon Conference
- Weekly Grand Rounds
- Monthly Neuro-Critical Care Case Conference
Potential topics/disease states for discussion
- Hemodynamic monitoring
- Shock
- Inotropes/Vasopressors
- ACLS guidelines
- Hypertensive emergencies
- Mechanical ventilation
- Acute respiratory distress syndrome (ARDS)
- Nosocomial/ventilator associated pneumonia
- Acidosis/alkalosis
- DVT prophylaxis
- Stress ulcer prophylaxis
- Nutrition
- Fluid and electrolytes
- Sedation of the mechanically ventilated patient
- Analgesia in critically in patients
- Delirium/Agitation
- Neuromuscular blockade
- Alcohol withdrawal
- Disseminated intravascular coagulation (DIC)
- Acute renal failure/CRRT
- Adrenal insufficiency in critical illness
- Intensive insulin therapy
- Diabetic ketoacidosis (DKA)
- Non-ketotic hyperosmolar state
- Patient specific topics
Orientation to the rotation - the preceptor will:
- Provide the resident the goals and objectives for the learning experience
- List the activities the resident will be engaged in during the month to
accomplish the goals and objectives (see step 7 of the RLS process)
- Describe how the preceptor will evaluate the resident (e.g., objective data,
criteria based checklist)
- Provide the resident with self evaluation forms (e.g., rotation evaluation
from, criteria based checklist), and
- Communicate how will the resident evaluate the preceptor
- Establish routine meetings during the month to provide feedback and allow
time for clarifying expectations. Monitor the growth and development of the
resident during this time.
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