Cardiovascular Intensive Care APPE

The Cardiovascular Intensive Care Rotation is a four-week experiential rotation. This rotation involves the provision of care for the patients of CVICU and cardiology patients on H4S. The student should develop the ability to effectively review patient medication profiles, identify potential issues, and make appropriate recommendations.

The student should also learn to effectively initiate, monitor, and adjust various monitored therapies including antibiotics and parenteral nutrition. The student will work alongside the pharmacist to provide support to other members of the health care team (physicians, nurses, medical residents, etc.).

  • Participation in CVICU rounds
  • Reviewing and following patient medication profiles and hospital course
    • Ensure correct dosages, including IV drips
    • Identify and recommend dosage adjustments for renal or hepatic dysfunction
    • Ensure patient’s indications and medications match.
    • Identify and monitor adverse drug reactions and side effects
  • Providing drug information/drug use policies to providers
  • Assisting with patient education
  • Monitoring laboratory and microbiology test results
  • Completion of projects determined as determined at the beginning of the rotation

Core content covered through patient care experiences, discussions, readings, journal clubs, and case presentations will include:

  • Evaluation of the postoperative patient’s primary issues and pharmacological course
  • Identification and evaluation of appropriate medical therapy to improve outcomes after coronary artery bypass grafting (CABG) and other cardio-thoracic surgery procedures as well as general critical care issues.
  • Address postoperative complications and factors influencing intensive care duration:
    • Perioperative MI
    • Left ventricular dysfunction/low cardiac output
    • Hypotension/hypertension
    • Arrhythmias
    • Pericarditis and tamponade
    • Bleeding
    • Thromboembolism including heparin induced thrombocytopenia (HIT)
    • Neurologic complications
    • Acute renal failure
    • Infection
    • Nutrition
    • Sedation and pain control

Efforts will be made to individualize the rotation within reason to the student’s interests and learning style. The preceptors will serve as role models and learning resources as well as provide opportunities for independent learning and practice. The primary preceptor will not always be the staff pharmacist working with the student. The student should use this opportunity to explore and become familiar with different practice styles.

The overall goal of this rotation is to provide the student with the opportunities and support needed to develop the skills and knowledge base necessary to provide pharmaceutical care. Ultimately the student will be responsible for their own learning and development during this rotation.

Location

Preceptors

Betsy Thomas, RPh, BCPS
  • School of pharmacy: University of Kansas
  • Specialty interests: Cardiovascular and Thoracic surgery, Critical Care
  • Health system, hospital, pharmacy, and residency committee involvement: Cardiovascular Surgical Services Quality and Patient Care Committee; Pharmacy Representative, Comprehensive Cardiac Care
  • Professional involvement: Society of Critical Care Medicine (SCCM)
Tim Berry, PharmD, BCPS
  • School of pharmacy: University of Missouri-Kansas City
  • Residency training: PGY1—Saint Luke’s Hospital of Kansas City
  • Specialty interests: Extracorporeal Membrane Oxygenation, Infectious Diseases
  • Health system, hospital, pharmacy, and residency committee involvement: Saint Luke’s Hospital Infection Prevention Committee, Antimicrobial & Diagnostic Advisement Program Committee, Infectious Disease Evidenced-Based Practice Team
Julie Welge, PharmD, BCPS
  • School of pharmacy: University of Kansas
  • Residency training: PGY1—Saint Luke’s Hospital of Kansas City
  • Specialty interests: Cardiothoracic Surgery, Cardiovascular Intensive Care, Heart Failure and Cardiac Transplant, Mechanical Circulatory Support
  • Health system, hospital, pharmacy, and residency committee involvement: Saint Luke’s Health System Pharmacy Clinical User Group; Cardiac Transplant and Mechanical Circulatory Support
  • Professional involvement: Society of Critical Care Medicine (SCCM)