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Course Approval
Pediatric Intensive Care Elective Rotation PHR XXXX
Syllabus
Course Title: Pediatric Intensive Care Elective Rotation
Course Number: Pharmacy XXXX
Team Leader: Mark Haase, Pharm.D.
Team Members: Mark Haase, Pharm.D.
Rotation Coordinator(s): TBA
Clerkship Coordinator:
Loree Allen
School of Pharmacy
1300 Coulter, Rm. 206
Amarillo, TX 79106
Phone: 806/356-4000 Ext 306
Fax: 806/356-4018
Email: loree@cortex.ama.ttuhsc.edu
Daily Schedule: Students should participate in clerkship activities for a minimum of 40 hours per week. Schedule depends on clerkship rotation and site needs. Monday through Friday, generally 8 am - 5pm (site specific)
Textbook/Course Materials:
- Takemoto CK, Hodding, JH, Kraus DM. Pediatric Dosage Handbook, 2001-2002, 8th edition, Lexicomp
- Behrman RE, Kliegman RM, eds. Nelson's Textbook of Pediatrics, 16th edition, W.B. Saunders, 1999.
Prerequisites:
- P-4 standing as per Student Credentialing Committee
- Completed General Pediatric Clerkship (PHAR 4677) - rare exceptions to be evaluated on individual basis by preceptor
Catalog Description: An advanced clerkship with a focus in pediatric critical care for the student with a special interest in pediatric pharmacotherapy. Each student will be responsible for the drug and non-drug therapy of critically ill children (under supervision of preceptor).
Course Mission: The mission of the course is to build upon the concepts covered in the general pediatric clerkship to develop skills in the care of critically ill children. This would entail experience with the unique needs of critically ill children including respiratory and ventilatory support, fluid and electrolyte management, resuscitation basics and pediatric advanced life support, infectious diseases, and pain control and sedation, among others.
Objectives:
- Recognize problems encountered with medication administration in the critically ill pediatric patient and identify potential solutions to these problems.
- Describe major differences in monitoring drug therapy in the pediatric critical care patient by use of physical and laboratory monitoring.
- Provide pharmacokinetic consultation for all drug serum concentrations drawn in the pediatric ICU patient.
- Understand the changes with age of the pediatric patient as it relates to systems such as, but not limited to:
- Fluid & electrolytes
- Renal function
- Hepatic function
- Cardiovascular hemodynamics
- Pulmonary development
- Neurologic development
- Morbidity/mortality
- Understand the pathophysiology and pharmacologic management of the pediatric patient with disease states such as, but not limited to:
- Head trauma Arrhythmias
- Burn Hypertension urgency / emergency
- Toxicology Shock
- Pneumonia DKA
- Sepsis GI hemorrhage
- Meningitis Severe dehydration
- Status asthmaticus Hydrocephalus/VP shunt infections
- Status epilepticus / febrile seizures DIC
- Respiratory failure Hepatitis/ Liver failure
- Renal failure Drowning
- Congestive heart failure
- Understand the fluid/electrolyte and nutritional needs of the critically ill pediatric patient and demonstrate the ability to develop a parenteral nutrition regimen.
- Identify risk factors for bacterial and fungal nosocomial infection
- Manage narcotic dosing, develop plans for narcotic weans, and identify patients at risk for narcotic withdrawal.
- The student should be able to discuss the role of mechanical ventilation in the management of the critically ill pediatric patient.
- The resident should be able to discuss the supportive drug therapy for the patient in the PICU including:
- sedation/paralysis spasticity
- analgesia antimicrobial prophylaxis /stress ulcer prophylaxis
Tech's Top Ten
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COMMUNICATION
Competency Definition: Pharmacists effect patient care and the delivery of health care using timely, efficient, and appropriately targeted communication skills. Communication skills provide the foundation for patient - pharmacist relationships as well as relationships with other health care providers and payers.
The P4 clerkship student shall be able to:
- Communicate an educational message to a patient appropriate to a selected clinical situation
- Communicate with a patients or patient's agent at an appropriate level
- Validate the understanding of the knowledge transmitted to patients, patients' agents, and other health care providers
- Communicate a complex principle or idea in simple terms
- Establish rapport with patients and patients' agents
- Establish professional rapport with other members of the health care team
- Establish him/herself as an integral member of the health care team
- Impart a sense of control of a selected clinical situation
- Impart a sense of urgency in a selected clinical situation
- Impart a personal feeling of respect for the values of others
- Impart a personal feeling of respect for the opinions of others
- Present an idea/proposal persuasively
- Impart a feeling of receptivity to a selected communications partner
- Demonstrate depth of understanding in oral and written form
- Assert his/her objectives in the best interest of quality patient care in a professional manner
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USE OF BASIC SCIENCE
The P4 clerkship student shall be able to:
- Perform pharmacokinetic calculations
- Develop a disease management strategy
- Create an appropriate drug regimen for a selected patient
- Define non-drug treatment for a selected patient
- Define a therapeutic goal for a selected patient
- Define a therapeutic endpoint for a selected patient
- Monitor drug therapy for a selected patient
- Manage adverse drug reactions for a selected patient
- Adjust drug therapy for a selected patient
- Assess progress to a defined therapeutic goal or endpoint for a selected patient
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PROBLEM PREVENTION AND SOLVING
The P4 clerkship student shall be able to:
- Organize the essential elements given an unarticulated problem in a patient care setting
- Define the problem associated with a selected health care scenario in a patient care setting
- State the consequences of not solving the problem associated with a selected health care scenario in a patient care setting
- Define the stakeholders in a selected health care scenario in a patient care setting
- Describe the process of problem solving in a selected health care scenario in a patient care setting
- Describe the considerations to be made in the problem solving process for a selected health care scenario in a patient care setting
- State the solution to the problem defined for a selected health care scenario in a patient care setting
- Describe the up-side and the down-side of the proposed solution to the problem defined for a selected health care scenario in a patient care setting
- Describe the impact of the suggested solution on the stakeholders in a selected health care scenario in a patient care setting
- Describe how the solution to a problem defined for a selected health care scenario can be evaluated in a patient care setting
- Persuasively present the suggested solution to other health care colleagues and to patients and patients' agents
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DISPENSING OF PHARMACEUTICALS
Competency definition: Pharmacists perform a unique "safeguard" role in health care by consistently assessing the appropriateness of doses so as to avoid both supertherapeutic and subtherapeutic doses. A pharmacist's mathematical abilities are combined with knowledge of pharmaceutical products and their delivery to create systems approaches to ensuring safe and appropriate doses. The calculation, preparation and assessment of parenteral and nonparenteral doses are central to the pharmaceutical care process in all practice settings.
The P4 student shall be able to:
- Perform patient-specific pharmacokinetic calculations in a patient care setting
- Assess compliance in a patient care setting
- Intervene in correcting an adverse drug event for a selected drug regimen in a patient care setting
- Validate a patient's understanding of the prescription instructions given in a patient care setting
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PROVIDING PATIENT-SPECIFIC AND POPULATION-BASED PHARMACEUTICAL CARE
5.1 - Providing Patient Care
Competency Definition: Pharmacists base their clinical decision making on an understanding of the most common disease entities. Therefore, students must learn the most common disease states encountered in each clerkship course (e.g. pathophysiology, diagnosis and diagnostic studies, clinical laboratory medicine, treatment regimens, and monitoring parameters) and apply this knowledge to direct patient care.
The P4 student shall be able to:
- Describe the responsibilities of the pharmacist in a patient care setting
- Assess the outcome of pharmacotherapy and non-drug treatment in a patient care setting
- Manage a medical problem in a patient care setting
- Manage symptoms in a patient care setting
- Prevent an undesired outcome in a patient care setting
- Manage an undesired outcome in a patient care setting
- Assess the impact of a medical problem on the quality of life of a selected patient in a patient care setting
- Assess the impact of pharmacotherapy and non-drug treatment on the quality of life of a selected patient in a patient care setting
- Plan a therapeutic approach in a patient care setting
- Empower the patient as an active partner in a patient care setting
- Function as a pharmacist in selected health care settings
- Assess the cost-effectiveness of a therapeutic approach to resolution of a selected medical problem in a patient care setting
- Perform a drug use evaluation in a patient care setting
- Document interventions in a patient care setting
- Assess the effectiveness of selected interventions in a patient care setting
- Assess the cost-benefit of a clinical service in a patient care setting
5.2 - Patient-Care Plans
Competency Definition: Central to provision of patient care is creation of a pharmacist's care plan. The major steps in care plan creation, implementation, and modification include: data gathering, patient assessment, care plan formulation/implementation, modification of care plan and implementation of a follow-up plan. Communication of the care plan to the patient and other health care professionals is fundamental to improving patient health care outcomes.
The P4 clerkship student shall be able to:
- Accurately and efficiently locate information in the medical chart or other records and apply this information to patient care.
- Demonstrate effective data gathering skills and be able to report this data in an organized and concise format.
- Identify both active and potential drug-related problems.
- Integrate both objective and subjective patient information in the development of the patient care plan.
- Assess, evaluate, and apply drug information/clinical data to promote optimal health care for an individual patient and for patient populations.
- Develop a pharmacotherapy plan complete with alternative solutions to treat, improve, and solve drug related problems.
- Implement a rational pharmacotherapy plan and follow-up for an individual patient.
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PROFESSIONALISM
Competency Definition: Pharmacists should conduct their professional and personal lives in accordance with a set of moral principles and values. These principles govern pharmacists' individual and collective group activities. Professionalism entails adherence to moral, ethical and technical codes of conduct as well as supporting the entire body of persons committed to the pharmacy profession.
The P4 clerkship student shall be able to:
- Demonstrate empathy in the care of patients in a patient care setting
- Acknowledge patient rights in a patient care setting
- Demonstrate sensitivity to individual patient values in a patient care setting
- Practice within legal guidelines in a patient care setting
- Practice in an ethical manner in a patient care setting
- Take into consideration personal ethics and values in health care decision-making in a patient care setting
- Defend a decision made in a selected situational dilemma in a patient care setting
- Demonstrate the ability to lead where indicated in a patient care setting
- Demonstrate an appropriate level of flexibility in a patient care setting
- Demonstrate the ability to define the concept of job satisfaction in a patient care setting
- Demonstrate the ability to define patient interest in a patient care setting
- Demonstrate the ability to define the general interest of the profession of pharmacy in a patient care setting
- Demonstrate the ability to promote good health and healthy lifestyles in a patient care setting
- Demonstrate sensitivity to the impact of external influences on the profession of pharmacy in a patient care setting
- Demonstrate the ability to perform as a role model in a patient care setting
- Demonstrate the ability to prioritize several tasks in a patient care setting
- Demonstrate the ability to influence colleagues in a patient care setting
- Demonstrate the ability to motivate patients in a patient care setting
- Demonstrate the ability to work within their professional limits in a patient care setting
- Demonstrate the ability to work within a team in a patient care setting
- Demonstrate the ability to persuasively influence an outcome in a patient care setting
- Demonstrate the ability to continuously learn in a patient care setting
- Demonstrate a commitment to continuous, lifelong learning
- Demonstrate the ability to work within their personal limits in a patient care setting
- Demonstrate the ability to follow when indicated in a patient care setting
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SOCIAL AND ADMINISTRATIVE SCIENCE
Competency Definition: All pharmacists require practice management skills regardless of their specific practice setting or orientation. Frontline practicing pharmacists must participate in planning, organizing, leading and controlling organizational resources in the pharmacy environment. They may be responsible for demonstrating the outcomes of their practice to supervisors, other health care providers and payers. Other pharmacists may assume a more direct management role of technicians, other pharmacists, and operations.
The P4 clerkship student shall:
- Demonstrate time management skills.
- Identify the cultural differences among patients and the impact these differences have on the delivery of pharmaceutical care
Additional Competencies
ACCOUNTABILITY
Competency Definition: Pharmacists fulfill multiple responsibilities simultaneously. Central to all pharmacists' responsibilities is self- accountability to ensure that responsibilities are fulfilled to the fullest extent, within the expected time frames, and appropriate follow-up mechanisms are created, implemented, and monitored.
The P4 clerkship student shall be able to:
- place the care of patients above all other responsibilities.
- perform patient care functions in a punctual and professional manner.
- ensure that all patient care functions are performed prior to leaving for the day.
- provide optimal care for patients so that practice accountability will be applied to patient care post graduation.
- understand a pharmacist's role in patient care and be accountable for the provision of pharmaceutical care to patients
- learn to prioritize and complete the multiple responsibilities of a health care provider.
TEAMWORK
Competency Definition: Teamwork is work done by several associates with each doing a part, but, all subordinating personal prominence to the efficiency of the whole. Pharmacists function as an integral component of a team whose ultimate goal is to provide the best patient care possible.
The P4 Clerkship student shall be able to:
- function effectively within the team to optimize patient outcomes.
- communicate effectively within the team.
- handle an appropriate level of responsibility within the team.
- interact appropriately with different members of the team (e.g. pharmacists, patients, caregivers, physicians, medical students, nurses, therapists);
- sacrifice personal gain for the good of the team and its patient.
LITERATURE EVALUATION AND APPLICATION
Competency Definition: Pharmacists should consistently exhibit leadership in providing drug information using multiple state-of-the-art resources for both patient-specific drug therapy and system-wide drug therapy issues (e.g. creation of clinical practice guidelines or formulary backgrounds).
The P4 clerkship student shall be able to:
- demonstrate the ability to make rational, patient-specific therapeutic decisions, based upon critical evaluation of the literature and clinical experience.
- locate and analyze literature to solve a therapeutic dilemma in a timely fashion.
- make a recommendation to health care colleagues or a team.
- display the ability to find and accurately disseminate medical information through formal and informal presentations, discussions, and written communications.
- develop a personal method of staying current with the medical and pharmacy literature, including development of a filing system and/or a "peripheral brain."
INTERPRETATION AND APPLICATION OF PHYSICAL ASSESSMENT DATA
-- This competency may not apply to all advanced community sites and will be considered a site specific competency.
Competency Definition: Interpretation of physical assessment data and its application to creating and modifying drug therapy regimens is fundamental to pharmacy practice. Students shall incorporate physical assessment data into the provision of patient care and initiation, modification, and monitoring of drug therapy regimens.
The P4 student shall be able to:
- demonstrate skill in identifying and interpreting results of general and targeted physical exams (performed by any health care practitioner). apply physical exam data to the initiation and modification, and monitoring of drug therapy regimens.
Teaching Methods: This experiential course will be delivered in practice settings where students will provide clinical services under the supervision of pharmacy practice faculty / preceptors.
Assessment Methods: Grading will be based on overall performance, professional performance and assignments.
Grading:
| Professional Performance | 60% |
| Final Exam (written and verbal) | 20% |
| Educational in-service | 10% |
| TSBP Intern-Clerkship Evaluation Form | 10% |
| Total | 100% |
Intellectual Integrity: Standard
Attendance: Standard
Class Timeliness/Tardiness: Standard
48 Hour Turnaround Policy: Standard
Second Chance Policy: There is NO second chance policy regarding this clerkship. If a student fails this course, they must retake it at the next opportunity when it can be rescheduled.
Etiquette: Standard
Clerkship Confidentiality: Standard
Name Tags and Professional Attire: Standard
Candidate Disability: Standard
Ethical Standards: Standard
Facilities: Standard
Candidate Inquiries: Standard
Communication: Standard
Autobiographical Data Form: Standard
Immunizations and CPR Certification: Standard
Removal >From Practice Site: Standard
Maternity Notification: Standard
Exposure Reporting: Standard
Candidate Professional Leave Policy: Standard