Residency
Neuroscience Acute Care Rotation
Preceptors:
Benson Sederholm, PharmD, BCPS
Gary Davis, PharmD
Chad Condie, PharmD
Site Description:
The Neuro Acute Care (NAC) unit located on the third floor of University of Utah Hospital is a 34-bed unit including neurology, neurosurgery, and medicine patients.
Rotation Description:
The pharmacist functions as part of a multidisciplinary team comprised of a neurology attending physician, neurology residents, medical students, stroke nurses, and neuroscience nurses. Pharmacists on the Neurology service are expected to round daily on all patients, respond as a member of the Brain Attack / Stroke team, provide drug information, counsel patients, and facilitate medication delivery. Didactic and experiential training includes a focus in the following areas: stroke, multiple sclerosis, epilepsy, headache, meningitis, myasthenia gravis, Parkinson's disease, Guillain-Barre syndrome, anticoagulation management, and other medical and neurological disorders. Hypertension, hyperlipidemia, atrial fibrillation, diabetes, pain-related disorders, and other issues are reviewed.
RLS Goals:
R1.4 - Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system.
R2.3 - As appropriate, establish collaborative professional relationships with members of the health care team.
R2.4 - Collect and analyze patient information.
R2.6 - Design evidence-based therapeutic regimens.
R2.7 - Design Evidence-based monitoring plans
R2.9 - Implement regimens and monitoring plans.
R5.1 - Provide effective medication and practice-related education, training, or counseling to patients, caregivers, health care professionals, and the public.
E7.2 - Communicate Effectively
Activities Evaluated:
| Rotation Activity | RLS Goal | Teaching Method |
| Participate in interdisciplinary Neurology team rounds daily in order to establish professional collaborative relationships with the medical students, neurology and medicine residents, nurses and attending physicians. | R1.4, R2.3, E7.2 | M |
| Follow and evaluate patient information in medical chart, including PowerChart and PharmNet, as well as information from patient and family interviews. This should be for all assigned patients with the goal of taking all neurology service patients by the end of the rotation. | R2.4, R2.7 | I |
| Independently design and follow-up on an appropriate pharmacotherapy plan for each patient on service given a specific disease state such as newly diagnosed diabetes, hypertension, hyperlipidemia, arrhythmias, stroke, MS, headache, etc. | R2.7, R2.9 | C |
| Perform medication histories and reconcile medications at hospital admission and transfer; documenting in the medical record, as well as communicating to the Neurology team. | R5.1, E7.2 | F |
| Educate patients, nursing staff, medical residents, and pharmacists on medication related topics relevant to patient care and document this education appropriately in the medical record when needed. (e.g. anticoagulant patient education.) | R5.1 | F |
| Develop skills in searching and evaluating the medical literature to enable an evidence-based approach to patient care using current literature. These plans are reviewed with the preceptor and recommendations made to the team daily. | R2.9 | I |
Teaching Methods include: I=direct instruction, C=coaching, M=modeling, and F=facilitation
Readings and Preparatory Work:
Readings will include relevant clinical studies which impact patient care as well as available clinical guidelines for stroke, epilepsy, headache management, meningitis, and other conditions. Other readings include: disease state reviews found within the medical and neurology literature, chapters from Pharmacotherapy, as well as PSAP modules of interest.
Project/Presentation Description:
The trainee will present patient cases daily, provide an in-service topic discussion to members of the neurology team, and conduct one journal club in which an article relevant to clinical practice is discussed and reviewed.
Typical Daily/Weekly/Monthly Activities:
Include following patients admitted to the neurology service, participating in daily patient care rounds, outlining a pharmacotherapy care plan for a given disease states, patient medication education, and drug monitoring. The trainee will discuss patient cases daily and present one in-service and one journal club article.
Evaluation:
The preceptors will give daily feedback regarding the resident's skills and knowledge. The resident and preceptor will complete a snapshot of the resident's ability to collect and organize data at the midpoint. A summative evaluation of strengths and weaknesses at the midpoint and a full summative evaluation of the selected goals and objectives will occur on the last day.
