Learning Experiences

The required six-week Antimicrobial Stewardship learning experience includes hospital-wide surveillance of antibiotic use to promote the rational, safe and cost-effective use of antimicrobial agents.

During the learning experience, the resident will:

• Review and assess hospital-wide culture and susceptibility reports to ensure appropriate antimicrobial coverage, dose and duration of therapy
• Identify opportunities for de-escalation and resolve any therapeutic duplications, unintended drug interactions or adverse events
• Optimize the outcome of individuals with an infectious disease by providing evidence-based, patient-centered medication therapy as an integral member of an interdisciplinary team
• Participate in and document patient-centered care such as pharmacokinetic and renal dosing of antimicrobial agents
• Serve as a resource on the optimal use of antimicrobial agents
• Conduct medication use evaluations and formulary reviews as needed, and report results to the Antimicrobial Stewardship Committee
• Precept pharmacy students

The required Cardiac Intensive Care Unit learning experience is six weeks long. There are 14 beds on the Cardiac Intensive Care Unit.

During the learning experience, the resident will:

• Monitor all patients in the CICU daily and assist clinicians with optimizing medication regimens
• Participate in CICU multidisciplinary rounds every week on Mondays, Wednesdays and Fridays
• Complete admission medication histories
• Prepare and complete clinical and operational projects
• Attend monthly Pharmacy and Therapeutics Cardiovascular Subcommittee meetings, Critical Care Practice Council meetings and other multidisciplinary process improvement meetings; assist with related initiatives, as needed
• Precept pharmacy students

The required Cardiovascular Intensive Care Unit (CVICU) learning experience is six weeks long. There are 12 beds in the CVICU. 

During the learning experience, the resident will:

• Evaluate each CVICU patient and identify opportunities for pharmacotherapy optimization
• Facilitate medication delivery to CVICU and cardiovascular operating room patients
• Participate in medical emergencies such as code blues and code strokes
• Participate in multidisciplinary rounds on Tuesdays and Thursdays
• Precept pharmacy students
• Prepare clinical project materials based on the initiatives of cardiothoracic surgery and/or pharmacy department 
   

The required Neuro/Trauma Intensive Care Unit learning experience is six weeks long. There are 14 beds in the Neuro/Trauma ICU.

During the learning experience, the resident will:

• Participate in emergency medical and stroke codes
• Participate in multidisciplinary rounds on Mondays, Wednesdays, and Fridays
• Monitor pharmacokinetic, anticoagulant and antimicrobial dosing
• Prepare intravenous drugs in an emergency situation
• Interview and counsel patients about previous medications, new medications and disease states
• Attend Intensive Care Unit Subcommittee and Critical Care Practice Council meetings
• Complete a journal club in the practice area and conduct in-service programs for medical staff when necessary

The required six-week adult internal medicine learning experience takes place on a 65-bed unit.

During the learning experience, the resident will:

• Review interventions and alerts from the Antimicrobial Stewardship Tool daily for assigned patients
• Ensure appropriate anticoagulation for all patients on the floor 
• Act as a resource to floor staff to answer any questions and educate patients regarding medications
• Provide recommendations to cardiothoracic surgery service about step-down cardiac surgery patients
• Screen new-start sotalol/dofetilide patients for appropriateness and follow these patients throughout their stay to verify medication safety and efficacy 
• Conduct monthly cardiac rehab education courses
• Precept pharmacy students

The required six-week Internal Medicine-Cardiology learning experience takes place on a 40-bed unit that serves primarily cardiac, neurology and trauma patients.

During the learning experience, the resident will:

• Monitor assigned patients daily and assist providers with optimizing medication regimens
• Round with multidisciplinary team daily and identify barriers to discharge
• Ensure appropriate anticoagulation, renal dosing and antimicrobial use for telemetry patients
• Act as a resource to healthcare team members
• Educate patients and/or nursing staff as needed
• Precept pharmacy students

The required Internal Medicine-Orthopedics rotation is a six-week learning experience on a 60-bed internal medicine unit. The patient population is primarily orthopedic patients, surgical site infections, and some internal medicine overflow. 
During the learning experience, the resident will:

• Monitor assigned patients daily, communicate with providers in person to optimize medication therapy
• Evaluate for appropriate perioperative antibiotic prophylaxis, postoperative DVT prophylaxis and postoperative pain management
• Review cultures, imaging, patient labs/vitals for appropriate antibiotic coverage and dosing for surgical site infections, utilize pharmacokinetic dosing for vancomycin
• Speak with patients to clarify home medications, medication allergies, and evaluate pain control
• Precept pharmacy students, as available

The required six-week learning experience takes place on a 36-bed unit. 

During the learning experience, the resident will:

• Review interventions and alerts from the electronic medical record daily for assigned patients
• Act as a resource to healthcare team members
• Round with multidisciplinary team daily and identify barriers to discharge
• Speak with patients to clarify home medications, medication allergies, and provide education as appropriate
• Monitor assigned patients daily and provide recommendations to optimize medication therapy
• Evaluate renal dosing of medications, and assess dosing/time for hemodialysis patients
• Precept pharmacy students, as available

The Ambulatory Clinic rotation is a required longitudinal learning experience that takes place at NKC Health ambulatory clinics located throughout the northland. Residents will participate in annual wellness visits, anticoagulation visits, and assist reviewing patient refills. This experience will start during orientation and average one clinic day every two weeks.

During the learning experience, the resident will:

• Participate in:
  • Pharmacist warfarin management medication therapy services protocol
  • Pharmacist led annual wellness visits
  • Refill request review and authorization
• Work closely with other team members
• Act as a medication resource for patients, family, clinic staff, and providers
• Precept pharmacy students, as available

The required Health Systems Administration longitudinal learning experience is scheduled throughout the residency program. Pharmacy management provides an overview of the leadership and management issues within the profession, hospital and Pharmacy Department. Pharmacy management will complete the evaluation process.

The required Learning and Education longitudinal learning experience focuses on professional presentations, communication and preceptorship.

During the learning experience, the resident will:

• Gain experience with effectively disseminating information to healthcare professionals, patients and students. Good communication and interpersonal skills are vital to success in this experience
• Devise efficient strategies for accomplishing the required activities in the allotted time
• Increase their knowledge base and therapeutic management of the renal disease state
• Complete the teaching certificate requirements
• Precept pharmacy students

The required Research longitudinal learning experience focuses on the design, conduct and collection of information related to the required medication use evaluation and residency research project. The learning experience discusses principals of research conduct. The experience is designed to allow full immersion into the project.

The medication use evaluation and residency research projects run concurrently for the full year. Residents get one research day with every learning experience and approximately five days in December. After completing the medication use evaluation, the resident will be able to recommend opportunities for improvement with the medication use process. The residency research project culminates in a presentation and manuscript suitable for publication.

The required Staffing longitudinal learning experience will be focused on pharmacy operations, July through June. Residents will rotate working every third weekend and one weekday evening per week (two shifts every three weeks).

During the learning experience the resident is expected to progress over the year as follows:

• 1st quarter:
  • Start as extra staff, partnered with a mentor pharmacist (direct observation/modeling/coaching)
• 2nd quarter:
  • Continue expansion into operations (take on more facilitation role)
  • During quarter, start taking clinical interventions
• 3rd & 4th quarter:
  • Handle vast majority of central pharmacy workflow (expand further into facilitation role)
  • Late 3rd quarter and 4th quarter will cover clinical weekend shifts

The required Orientation and Training learning experience is approximately six weeks long. During that time, residents become familiar with North Kansas City Hospital and the Pharmacy Department's processes and are exposed to hospital and department policies and procedures. Topics covered in orientation and training include, but are not limited to, pharmacy workflow, an overview of patient safety, computer systems training, medication management, technology, controlled substances procedures, compounding procedures and competency demonstrations/tests. Emphasis is placed on making independent judgments while using effective verbal and written communication. Residents prioritize tasks and collaborate with pharmacists, pharmacy technicians, prescribers, nurses and other members of the healthcare team.