810 Rotations

• Rotation Manual Main
• PhPr 810A – Internal Medicine Rotation
• PhPr 810B – Surgery Rotation
• PhPr 810C – Pediatrics Rotation
• PhPr 810D – Geriatrics /Gerontology Rotation
• PhPr 810E – Outpatient Practice Rotation
• PhPr 810H – Clinical Pharmacokinetics Rotation
• PhPr 810I - Psychopharmacy/Neurology Rotation
• PhPr 810J – Nutrition Support Rotation
• PhPr 810K - Specialty Institutional Rotation

PhPr 810B - Surgery Rotation

(Also refer to the general goals and objectives for PhPr 810)

Goals

• To become familiar with the provision of clinical pharmacy services to surgery patients.
• To be responsible for providing accurate and timely drug information to surgeons and other health care professionals related to a surgery service.
• To gain a general understanding of the medications involved with a surgery service with emphasis on antibiotic therapy, nutritional support, and pain management.

Objectives
At the completion of this rotation, the student should be able to:

1. Consistently obtain complete and accurate drug histories including previous adverse reactions to medications.
2. Present well-organized and accurate patient case histories including subsequent problem-plan management.
3. Effectively and appropriately communicate with both patients and other health care professionals.
4. Punctually and thoroughly complete and present the results of a literature search related to a disease, medication, or surgery performed on a surgery service.
5. Spend the necessary amount of time in the patient care area to complete all service responsibilities related to his/her patients.
6. Initiate interactions with other health care professionals.
7. Understand the pathophysiology and pharmacology of the medications used on a surgery service with special emphasis on antibiotics and pain management.
8. Understand the fundamental principles of acid-base balance, and fluid and electrolyte therapy.
9. Have a general understanding of the role of parenteral and enteral nutrition in the surgery patient.
10. Recognize and monitor adverse effects of medications and make a rational decision for their prevention and/or treatment.
11. Understand the controversies involved with deciding which is the most effective and least toxic drug in specific clinical situations.
12. Calculate a measured creatinine clearance given the appropriate data.
13. Discuss the effects of renal and/or liver disease on the appropriate dosing of medications.
14. Quickly and accurately calculate doses for medications used on the surgery service with emphasis on antibiotics and pain relievers.
15. Realize that medication-related questions from health care professionals should only be answered when all of the relevant facts are known and that accuracy is of highest priority.
16. Promptly and accurately search and answer questions from health care professionals when the answer is not initially known.
17. Realize the importance of patient confidentiality.
18. Know how to decide the order of priority for monitoring patient medications when on a busy surgery service.

Additional Information for a Successful Rotation
The responsibilities will include but are not limited to the following:

1. Punctual attendance at daily morning rounds with the assigned surgery team.
2. Punctual attendance at clinical pharmacy conferences.
3. Punctual attendance at morbidity and mortality rounds with the surgeons if applicable.
4. Completely, accurately, and promptly responding to questions from health care professionals.
5. Initiating interactions with other health care professionals.
6. Filling out drug reaction forms for any undesired or unintended effect of a medication.
7. Completing and presenting two literature searches relating to a surgery topic.
8. Monitoring and making decisions related to nutritional support especially with regards to total parenteral nutrition (TPN).
9. Being a professional when interacting with patients and other health care professionals.
10. Obtaining complete and accurate medication records for each patient.
11. Presenting patient-related information completely, succinctly, and accurately during rounds with preceptor as well as other health care professionals when queried.
12. Deciding which medications to use and how to use them with reference to pharmacokinetics and pharmacodynamics.
13. Completely and accurately evaluating the medications of all assigned patients on the surgery service.

Absence from Rotation

1. Sick days: more than two missed days must be made up, e.g., weekends.
2. Extended absences (those that cannot be made up on weekends): these will be evaluated on an individual basis with input from director of experiential programs.
3. Excused absences due to exceptional circumstances: these will be allowed with permission of preceptor. They will not be allowed for frivolous reasons, e.g., birthdays.