Yuma Regional Medical Center
 
 

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Rotations and Electives

5-week rotations

Internal Medicine

The Internal Medication residency rotation is a 10-week (divided into two 5-week rotations) required learning experience at Yuma Regional Medical Center. This rotation allows the resident to be involved in the care of patients in the general medicine setting, which provides a wide variety of disease states. Emphasis is made to enhance the resident's knowledge of the pathophysiology, diagnosis, treatment, and prevention of disease states and complications encountered in general medicine patients. The resident's primary responsibility is evaluation of medication therapy for patients. This includes identifying and resolving drug therapy problems, communication of the recommendations to appropriate healthcare providers, implementation of the follow-up plan, and appropriate documentation in the patient chart and/or clinical pharmacy consult records. Residents will expand their pharmacotherapy knowledge through participation in topic discussions, literature searches, review of evidence-based guidelines, and review of patient cases. Residents may be assigned additional projects during the rotation that will supplement their knowledge and improve medication use in the hospital.

Critical Care

The Critical Care residency rotation is a 10 week (divided into two 5-week rotations) required learning experience at Yuma Regional Medical Center. This rotation allows the resident to be directly involved in the care of patients in the 32-bed Intensive Care Unit (ICU). The resident's primary responsibility is the evaluation of all medication therapies associated with the care of patients in the ICU. This includes identification and resolution of drug therapy problems, communication of recommendations to the health care team, implementation of the follow-up plan and appropriate documentation in the patient medical record and ICU clinical pharmacy monitoring profile and/or pharmacy consult form. Residents will expand their pharmacotherapy knowledge through participation in topic discussions, literature, review of evidence-based guidelines, and review of patient cases with the preceptor and ICU intensivist physician. Residents may be assigned additional projects/presentations during the rotation that will improve their knowledge base and improve care to critical care patients.

Infectious Disease

The Infectious Diseases residency rotation is a 5-week required learning experience at Yuma Regional Medical Center. This rotation allows the resident to be involved in care to patients in the hospital that are receiving antimicrobials. The resident's primary responsibility is evaluation of medication therapy for patients receiving antimicrobials. This includes identifying and resolving drug therapy problems, communication of the recommendations to appropriate healthcare providers, implementation of the follow-up plan, and appropriate documentation in the patient chart and/or clinical pharmacy consult records. Residents will also have opportunities to work directly with the infectious disease specialist, infection control and microbiology lab. Residents will expand their pharmacotherapy knowledge through hands on participation, participation in topic discussions, literature searches, review of evidence-based guidelines, and review of patient cases. Residents may be assigned additional projects during the rotation that will supplement their knowledge and improve antimicrobial use in the hospital including but not limited to patient case presentation, journal club presentation and drug MUE.

Outpatient

The Outpatient Pharmacy Services rotation is a required 5-week learning experience based in Yuma Regional Medical Center's Outpatient Pharmacy. The rotation is designed to provide residents with the opportunity to develop and practice the knowledge and skills necessary to provide excellent pharmaceutical care to patients in an ambulatory setting.
Responsibilities of residents during this rotation include prescription order evaluation, processing, verification and dispensing, patient and caregiver medication counseling, intervention and communication with prescribers, and formulary management.
A variety of practice related topics will be explored and discussed and the resident will spend time with offsite care providers to foster understanding of the pharmacist's role in an integrated healthcare team approach. Residents are expected to develop and deliver educational presentations and distributable materials for healthcare professionals and our ambulatory clients.

Preceptor Development/Teaching

The Teaching/Preceptor Development rotation is a 5-week required learning experience at Yuma Regional Medical Center. This rotation may be completed in one of the last four rotations of the YRMC PGY1 Pharmacy Residency program. The resident is responsible for precepting pharmacy students, providing educational presentations to healthcare professionals, and developing or improving a pharmacy student or resident rotation. Residents will gain knowledge of and demonstrate the four preceptor roles employed in practice-based teaching (direct instruction, modeling, coaching, and facilitation). The resident is also responsible for readings pertaining to teaching and preceptor development.

Pharmacy Practice Management

The Pharmacy Practice Management rotation is a 5-week required rotation at Yuma Regional Medical Center. Residents will learn management skills, including meeting and presentation styles, career development, formulary management, and work on interdisciplinary committees discussing pertinent current topics. The resident will be involved in administrative activities and projects throughout the course of the rotation. The resident will be expected to develop and use independent problem-solving skills related to assessing the impact of pharmacy services on the medication use process These skills will be utilized in developing and implementing recommendations for pharmacy processes improvement.

Longitudinal Rotations

Anticoagulation Clinic

The Anticoagulation Clinic longitudinal rotation is an ambulatory experience that will be completed during the course of the residency. The pharmacy resident will gain knowledge in anticoagulation management through this rotation. The resident will provide patients education on diet, medication interactions, and other important information regarding continued therapy on warfarin. During each visit, a fingerstick will be preformed, the INR interpreted, and the patient's dose of warfarin will be adjusted, if necessary, based on the results. Residents will understand the importance of continuity of care and develop relationships with patients and healthcare providers. Other anticoagulation medication therapies will also be reviewed.

Pain and Palliative Care

The Palliative Care/Pain Management longitudinal rotation is a 12-month experience in which the resident will appropriately integrate the timely assessment, treatment, and monitoring of patients with malignant and non-malignant pain, as well as gain an understanding of the complexity of end-of-life issues. The resident will learn to distinguish the important physiological, psychological and emotional differences associated with the three main areas of pain: palliative, acute, and chronic, and how this knowledge plays a critical role in the perception, assessment and treatment of pain in a community hospital setting. The resident will act as part of an integrated, collaborative healthcare team by making recommendations on patient-specific pain management plans and act as a source of education and information for other healthcare professionals including, but not limited to, nursing, physical therapy and case management.

Research

This is a longitudinal experience that will be completed during the course of the residency and will include the conduction of a medication use evaluation (MUE) and research project. Appropriate processes will be followed (ie, seeking IRB approval) when necessary. The MUE will be presented in poster format at the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting. The research project will be presented as a platform presentation at the Western States Residency Conference. Prior to completion of the residency, a manuscript suitable for publication will be written explaining the resident's research.

Staffing

The staffing residency rotation is a longitudinal required learning experience at Yuma Regional Medical Center. It is broken down into 4 quarterly evaluation periods. Each resident will be assigned to work (staff) weekends in the Inpatient Pharmacy on a rotating basis. The purpose of working as a staff pharmacist is to gain experience and improve skills in the medication use process. Understanding the process is part of leadership in the profession. Pharmacists must have a thorough understanding of the medication ordering/delivery system utilized by the individual institution to be fully successful. Residents will work with both the unit-dose and IV admixture systems.

Electives

Information Technology

The PGY1 pharmacy informatics rotation is a 5-week core experience that exposes residents to the evolution of organizations' medication-use systems by applying pharmacy informatics principles, standards, and best practices. Residents will gain basic understanding of the language and concepts of information technology (IT) thereby equipping the resident to function in the interdisciplinary environment of informatics project teams to advance the professional duties and responsibilities of a pharmacy informatics specialist.

Oncology

The PGY1 Oncology elective is a 5-week rotation experience located primarily at Yuma Regional Cancer Center clinic. It has a multidisciplinary team of attending medical oncologists, radiologists, nurse practitioners, nurses, pharmacist, chemo certified chemotherapy technician, social workers, dieticians, psychologists, and lab technicians all dedicated to the care of cancer patients. The pharmacy department at Yuma Regional Cancer Center consists of a chemo-certified pharmacy technician, a specialty practice oncology pharmacist. The role of the pharmacist within the infusion pharmacy involves double checking of lab values along with chemotherapy dosing/regimens to ensure proper dosing, and involvement in supportive care issues such as prevention of chemotherapy-induced nausea and vomiting, anemia management, and prevention of febrile neutropenia. The chemotherapy pharmacist works closely with the infusion nurses, nurse practitioners, and physicians to ensure both safe chemotherapy delivery and that appropriate supportive care measures are in place.

The oncology pharmacist in the clinic work in collaboration with the physicians, nurse practitioners, and research coordinators in dosing, therapy choices (especially as related to evaluation of off-label uses for chemotherapeutic agents), supportive care measures (especially in those patients who have failed traditional measures), and acting as an educator/liaison between infusion nursing, pharmacy, and the medical oncology team both on a patient case-by-case basis and when new standards of care for specific diseases or medications emerge.
The pharmacy resident, under the coaching and facilitation of the preceptor, will learn the operation of our pharmacy department and provide care for outpatient oncology patients.

Pediatrics/Neonatal

The Pediatrics / NICU residency rotation is a 5 week elective learning experience at Yuma Regional Medical Center. It is broken down into 4 quarterly evaluation periods. The resident's primary responsibility is the evaluation of medication therapy of patients being treated for medical conditions related to: pediatrics and neonatology. Emphasis is made to enhance the resident's knowledge of the pathophysiology, diagnosis, treatment, and prevention of disease states and complications encountered in pediatric and neonatal patients. Residents will have the opportunities to round with pediatricians on the pediatric floor as well as neonatologist in the NICU during their rotation. Residents will expand their pharmacotherapy knowledge through hands on participation, participation in topic discussions, literature searches, review of evidence-based guidelines, and review of patient cases. Residents may be assigned additional projects during the rotation that will supplement their knowledge and improve antimicrobial use in the hospital including but not limited to patient case presentation, journal club presentation and drug MUE.


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