Advanced Pharmacy Practice Experiences (APPE)

Advanced pharmacy practice experiences (APPE) at Saint Luke's are scheduled in two or three month blocks. The block contains multiple rotations so that a student generally spends a month on one practice site before switching to a new practice site for the next month.

Orientation is required for APPE students before their rotational experience.

View APPE opportunities:


Abdominal Transplant Outpatient Clinic

Preceptors

  • Jennifer Guy, Pharm.D., BCPS
  • Lindsey Dezotell, Pharm.D., BCPS
  • Jill Robke, Pharm.D., BCPS, FASHP
  • Breanna Clark, Pharm.D

Location

  • Saint Luke’s Hospital
    Medical Plaza I, Suite 340

Rotation Description

The abdominal transplant clinic rotation involves the provision of pharmaceutical care for patients under the kidney and liver transplant teams. The area of practice is primarily in the transplant clinic in Medical Plaza I on the Saint Luke’s Plaza campus. Patients seen in this clinic include those in the pre-transplant evaluation and the post-transplant follow-up phases of care. This rotation allows students to experience working as a part of the multidisciplinary team including nurse coordinators, nephrologists, hepatologists, surgeons, and other members of the transplant team.

Potential Topics/Activities

Specific topics which the student will learn through readings, topic discussions, and patient care shall include:

  • Renal and liver transplantation and immunosuppressive therapy.
  • Pharmacotherapy of complications associated with renal and liver transplantation.
  • Management of chronic diseases in transplant recipients.
  • Antimicrobial management including post-transplant prophylaxis, screening and management of opportunistic infections, and review of culture data.
  • Assessing medication adherence/compliance.
  • Smoking cessation.

Daily activities include:

  • Monitoring and assessing drug therapy.  
  • Identification of drug related problems.
  • Screen for medication non-adherence and assist with belatacept compliance program
  • Collect and organize accurate and comprehensive patient information.
  • Assess patient appropriateness for transplant from a medications perspective.
  • Attend renal (Wednesdays at 1430) and liver (Tuesdays at 1530) transplant selection meetings.
  • Adverse drug reaction and medication error reporting.
  • Immunization screening and patient education.
  • Providing patient/care partner(s) education.
  • Clinical documentation as indicated.
  • Drug information searches and responses (including verbal, and in some instances, written responses).
  • Other activities as agreed upon by student and preceptor, possibly including topic discussions, journal clubs, and presentations.

Ambulatory Care

Preceptors

  • Kristin Repp, Pharm.D., BCPS, 816-317-8706      
  • Katie Wilson, Pharm.D., BCACP   
  • Theresa Lockwood, Pharm.D., BCACP
  • Joe Windscheffel, PharmD, BCACP

Rotation Description

The Ambulatory Care rotation involves the provision of pharmaceutical care for those patients in a primary care setting at Saint Luke's Health System. The rotation will allow students the experience of working as a part of the multidisciplinary team in multiple primary care clinics. The complete spectrum of pharmaceutical care is experienced during the rotation. The majority of time will be spent performing comprehensive medication management directly to patients with pharmacist oversight. 

The pharmacy team is part of Saint Luke’s Population Health team and as such will have the opportunity to interact with other members of the health care team including primary care physicians, nurses, medical assistants and care coordination nurses. The focus of our team is help patients achieve their health goals specifically in the area of diabetes management, hypertension and hyperlipidemia, polypharmacy and healthy lifestyle changes.

Potential Topics/Activities

  • Evaluation of patient risk and need for pharmaceutical care using scoring tools
  • Collect and organize accurate and comprehensive patient information
  • Monitoring and assessing drug therapy  
  • Identification of drug related problems
  • Engage in shared therapeutic decision making 
  • Development and documentation of patient care plan and therapy goals in SOAP note
  • Identification and reporting of adverse drug reactions and medication errors
  • Participate in transition of care visits for patients at high risk for readmission
  • Provide telephonic and video follow up with patients being longitudinally managed
  • Providing patient/family education
  • Effectively communicate evidence based therapy plans to collaborating providers and patients
  • Drug information searches and responses
  • Interacting with physicians, nurses, and other care team members 
  • Assignments and projects dependent on needs of the site and student

The student is encouraged to take initiative in assisting the direction of the learning experience during the rotation to optimize his or her personal development.


General Cardiology

Preceptors

Location

Rotation Description

The General Cardiology rotation involves the provision of pharmaceutical care for those patients in the Saint Luke's Mid America Heart Institute (MAHI) 6th floor (North and South) and 3rd floor South.  The MAHI 6th floor is composed of 38 beds that are monitored via centralized telemetry; and, provides patients with comprehensive multidisciplinary medical intermediate cardiac care.  The 3rd floor is comprised of pre- and post-procedure cardiac patients.

Potential Topics/Activities

These are potential topics which may be covered via actual patient care experiences, discussions of reading materials, and/or case presentations:

  • Acute myocardial infarction/Acute Coronary Syndrome/Angina pectoris
  • Anticoagulation/ Thromboembolic disorders
  • Aortic stenosis
  • Cardiac arrhythmias, see https://www.hrsonline.org/ (the Heart Rhythm Society); www.crediblemeds.org (create free account to see medications that prolong the QTc interval)
  • Cardiac diagnostic testing (Echo, EKG)
  • Cardiac procedures/surgeries (PCI (AKA Cath, Angiogram), PPM, CABG, TAVR, etc.)
  • Infective endocarditis (IE)
  • Hypertension/Hypertensive urgency/Hypertensive emergency
  • Heart failure, see guidelines.gov and search “heart” for more information
  • Hyperlipidemia
  • Valvular Heart disease, see www.cdc.gov/heartdisease/
  • Weekly attendance at staff meetings (Wednesdays at 1430 in the Main Pharmacy)
  • Attendance at Journal Club Presentations, Case/Topic Presentations, Therapeutic Controversies (Informal case presentations/journal clubs sometimes in CVOR Pharmacy office; formal case presentations will be in conference room area near the Main Pharmacy on B-Level)
  • Topic/Case presentations (usually a formal patient case presentation at mid-point, and a formal Topic presentation during final week of rotation)
  • Daily verbal discussion of patients and medications
  • Verbal informal patient presentation daily as time allows
  • New drug briefing (5-10 minutes in length) 1-2 times during rotation

The student is strongly encouraged to take the initiative in assisting the direction of the learning experience during the rotation to optimize his or her personal development.


Cardiac Critical Care 

Preceptors

Location

Rotation Description

The Cardiology Critical Care rotation involves the provision of pharmaceutical care for those patients in the Coronary Intensive Care Unit (CICU) as well as the Advanced Heart Failure/Heart Transplant Unit (H5 South). The CICU encompasses the hospitalization of patients for cardiac-related diagnoses. The complete spectrum of pharmaceutical care is experienced during the rotation, including:

  • Medication order review, clarification, and validation
  • Interaction with nurses regarding medication administration issues/questions
  • Monitoring and assessing drug therapy
  • Rounding with the healthcare team
  • Providing patient/family education (i.e., anticoagulant education, as well as dofetilide and sotalol education)

Interactions with other members of the health care team include staff physicians, residents and fellows, medical students, social workers, nurses and dietitians.

Potential Topics/Activities

Core content which will be covered via actual patient care experiences, discussions of reading materials, and/or case presentations includes a review of the following (Bolded items will be required):

  • Acute Coronary Syndromes
  • Advanced cardiac life support and therapeutic hypothermia
  • Cardiac arrhythmia pathology and treatment
  • Cardiac Devices (Pacemakers, ICD, VAD, IABP, etc)
  • Cardiac transplantation
  • Heart Failure (Acute Decompensated)
  • Heparin Induced Thrombocytopenia
  • Infective Endocarditis
  • Peripheral Arterial Disease
  • Pulmonary Arterial Hypertension
  • Thromboembolic disorders

Emphasis will be placed on designing, monitoring, and evaluating patient-specific pharmacotherapy.  The preceptor serves as a role model and a learning resource for the student, but also provides the opportunity for independent practice.  The student is encouraged to take initiative in assisting the direction of the learning experience during the rotation to optimize his or her personal development.


Cardiac Transplant/Heart Failure

Preceptors

Location

Program Description

The Heart Failure/Transplant (HF/TXP) rotation involves the provision of pharmaceutical care for those patients with advanced heart failure, including the provision of care for those advanced HF patients who have mechanical circulatory support (MCS) devices including, but not limited to ventricular assist devices (VADs), or those who have received a heart transplant. The complete spectrum of pharmaceutical care is experienced during the rotation, including:

  • Medication order review, clarification, and validation
  • Interaction with nurses regarding medication administration issues/questions
  • Monitoring and assessing drug therapy
  • Rounding with the healthcare team
  • Providing patient/family education including, but not limited to anticoagulant education, transplant medication education, dofetilide and sotalol education.

Interactions with other members of the health care team include staff physicians, residents and fellows, medical students, pharmacy residents, nurse practitioners, transplant coordinators, social workers, nurses and dietitians.

Potential Topics/Activities

Core content which will be covered via actual patient care experiences, discussions, reading materials, and/or case presentations includes a review of the following:

  • Cardiac Transplant
    • Overview of the Process
    • Induction Therapy
    • Immunosuppressive Therapy
    • Complications of Immunosuppressive Therapy
    • Associated Medical Problems
    • Drug-Drug Interactions
    • Rejection- monitoring and treatment
  • Heart Failure
    • Acute Decompensated
    • Chronic- including importance of physical exam
    • Ventricular Assist Devices

Emphasis will be placed on designing, monitoring, and evaluating patient-specific pharmacotherapy.  The preceptor serves as a role model and a learning resource for the student, but also provides the opportunity for independent practice as appropriate.  The student is encouraged to take initiative in assisting the direction of the learning experience during the rotation to optimize his or her personal development.


Cardiovascular Intensive Care 

Preceptors

Location

Rotation Description

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 his or her own learning and development during this rotation.


Emergency Medicine 

Preceptors

Location

Rotation Description

The emergency medicine rotation will provide students exposure and opportunity to participate in the essential roles of the pharmacist in the Emergency Department through the activities outlined below. Topic discussions, projects, and presentations will be required as directed by the preceptor. The goal of the rotation is for the student to become familiar with the role of the pharmacist in the Emergency Department, obtain experience in working with an interdisciplinary team, and to gain experience in optimizing pharmacotherapeutic regimens, patient care, and safety.

Potential Topics/Activities

The student should expect to participate in or observe the following activities during the rotation:

  • Direct patient care rounds
  • Medication order review
  • Medication therapy monitoring
  • Patient care involving high-risk medications and procedures
  • Resuscitation
  • Medication procurement and preparation
  • Distribution of medication information
  • Documentation of pharmacist related activities
  • Care of boarded patients
  • Medication histories and medication reconciliation
  • Promotion of patient safety through identifying, addressing, and reporting of real or potential errors or hazardous conditions with potential for harm
  • Quality-improvement initiatives
  • Leadership duties and professional service through attendance of select pharmacy and emergency department meetings
  • Emergency preparedness planning and implementation
  • Provision of education related to pharmacy topics to pharmacy students, PGY1 pharmacy residents, patients, patient representatives, and other healthcare professionals
  • Research and scholarly activity

Rotation activities adapted from the ASHP Guidelines on Emergency Medicine Pharmacist Services available at http://www.ashp.org/DocLibrary/BestPractices/SpecificGdlEmergMed.aspx


Evening Critical Care and Emergency Department (CC/ED) Rotation

Preceptors

Location

Description

The CC/ED rotation is a rotation at Saint Luke's Hospital of Kansas City. The rotation involves covering all of the adult intensive care units (CICU, CVICU, MSTICU, NSICU) and the emergency department in the evening. Students will have the option between working five eight-hour days per week (4 pm – 12 am) or four ten-hour days per week (2 pm – 12 am). Students are to contact their primary preceptor prior to starting the rotation to discuss which schedule they prefer and to find out what day/time to meet for the first day of rotation. There will be some flexibility in being able to work with student preferences for which days of the week students are scheduled as preceptors for this rotation site work seven days a week. A full schedule will be made when the student and primary preceptor meet at the beginning of the rotation.

This rotation will give the student the opportunity to participate and help care for critically ill patients with a wide range of critical illnesses and attend emergency situations. The student will work on developing the ability to effectively review patient medication profiles, identify potential issues, and make appropriate recommendations. Additionally, the student will be involved with responding to various bedside emergencies during rotation hours including codes, traumas, strokes, intubations, STEMIs, etc. The student will have the opportunity to work with a multidisciplinary team during emergency situations. Topic discussions, projects, and presentations will be required as directed by the preceptor.

Potential Topics/Activities

Core content, which will be covered via actual patient care experiences, discussions of reading materials, and/or case presentations, includes a review of the following:

  • Basic Life Support (BLS)/Advanced Cardiac Life Support (ACLS)/Pediatric Advanced Life Support (PALS)
  • RSI/post-intubation management
  • Targeted temperature management post cardiac arrest
  • Advanced Trauma Life Support (ATLS)
  • Obstetric emergencies
  • Anticoagulation reversal
  • Traumatic brain injury
  • Acute ischemic stroke
  • Status epilepticus
  • Subarachnoid hemorrhage and cerebral vasospasm
  • Mechanical circulatory/ventilation support
  • Cardiac Devices (pacemakers, ICD, VAD, IABP, etc)
  • Sepsis and septic shock
  • Cardiogenic shock
  • Acute coronary syndromes
  • Diabetic ketoacidosis and non-ketotic hyperglycemia
  • Sedation, analgesia, delirium, and neuromuscular blocking agents for mechanically ventilated patients

Assessment

You will have two preceptors who will provide frequent informal feedback on your performance throughout the rotation. Your primary preceptor will complete formal evaluations with input from both preceptors. Assessment of performance will be done using the respective school of pharmacy evaluation form. The student and primary preceptor will meet at the beginning of the rotation to identify any additional goals/objectives/projects to be accomplished during the course of the rotation, and discuss appropriate timeliness. A formal verbal assessment will be done at the midpoint of the rotation using the evaluation form as a platform. The primary preceptor will provide a formal written and verbal evaluation within one week of the rotation’s completion.


Saint Luke’s North Hospital - General Hospital/Acute Care Rotation (APPE)

Preceptors

Della Bahmandar, PharmD, MBA, BCPS (Operations Manager), Jonathan Kountz, PharmD, Blake Miller, PharmD, BCPS, Cassie Jo Mitchell, PharmD, BCPS, Brett Nelson, PharmD, BCPP, Felicia Seiler, PharmD, BCPS, Lisa Williams, PharmD, BCPS, Curtiss Lane, PharmD

Location

Rotation Description

Saint Luke’s North Hospital is a two-campus hospital serving Kansas City’s Northland region. Between our Barry Road and Smithville campuses, Saint Luke’s North offers 160 patient beds and more than 20 specialized services.  The inpatient pharmacy is decentralized for best coordination of care. This rotation experience emphasizes patient care involvement, to include: patient data collection, organization, and assessment; development of plans that respond to desired therapeutic objectives; patient monitoring to include physical and laboratory assessment; communication with patients and care givers to acquire patient data, assess treatment outcomes, and drug therapy management. Under the supervision of a preceptor provide education to patients; communicate with and make recommendations to prescribers, and engage other health care providers in delivery of patient care.

Potential Topics/Activities

  • Critical care rounds with the multi-disciplinary team (daily in the ICU)
  • Attend and participate in Rehabilitation rounds on a long term rehab unit
  • Interact with hospitalists, cardiology, pulmonary, infectious disease, and other specialists on a daily basis
  • Selected lectures and topic discussions
  • Targeted drug therapy monitoring including vancomycin, aminoglycosides and TPN
  • Antibiotic surveillance including review of culture and sensitivity data daily
  • Medication profile review and identification of drug-related problems
  • Obtaining a patient’s medication history
  • Adverse drug reaction and medication error reporting
  • Patient education and targeted medication teaching (i.e. enoxaparin, oral anticoagulants)
  • Drug information searches and responses (verbal and/or written)
  • Present required presentations (one or two per preceptor discretion) to pharmacy staff
  • Other activities as agreed upon by student and preceptor

Saint Luke's South Hospital - General Hospital/Acute Care Rotation (APPE)

Preceptors

Location

Rotation Description

Saint Luke's South Hospital is a 115 bed acute care hospital in Overland Park, Kansas and is part of the Saint Lukes Health System serving the metropolitan and surrounding Kansas City area. Saint Luke's South Hospital provides a variety of care practices including cardiac, oncology and onsite chemotherapy infusion center and has earned Center of Excellence designations for Orthopedic/Joint surgery, Bariatric surgery and Stroke/AMI.

Potential Topics/Activities

The inpatient pharmacy is decentralized with a pharmacist assigned to each floor.  Pharmacy students will participate in:

  • Critical care rounding
  • Daily patient clinical monitoring
  • Dosing and monitoring of  Warfarin, Vancomycin and aminoglycosides
  • Utilize various CDTM agreements for standardization of care
  • Introduction to IV preparation and sterility testing
  • Management and processes involving medication inventory
  • Hospital management and committee meetings
  • Various shadowing opportunities
  • Minimum of 2 presentations to staff and/or public
  • Provide anticoagulation education to patients
  • Act as a drug information resource for the health care team
  • Adverse Drug Reaction (ADR) reporting
  • Various daily learning activities and projects as they arise.

Saint Luke’s East Hospital - General Hospital/Acute Care Rotation (APPE)

Preceptors

Lauren Aversman PharmD., Rachel Doering PharmD. BCPS, Annie Hayes, PharmD. Tom Johnson PharmD. BCPS, Theresa Lockwood, PharmD., Kunal Patel, PharmD.,BCPS, Alex Pope RPh., Joe Truong PharmD.

Location

Rotation Description

The Saint Luke’s East General Hospital / Acute Care Rotation is designed to provide the student with a well-rounded overall experience in acute care medicine and general hospital pharmacy.  Students will participate in various facets of the daily drug distribution process, and have opportunities to apply their clinical knowledge and skills through our professional integrated pharmacy services.  Throughout the rotation, students will spend time on different units and provide pharmaceutical care to varying patient populations –including telemetry patients, surgery patients, intermediate care patients, and ICU patients.

Potential Topics/Activities

  • Patient Teachings (including but not limited to anticoagulation and antiarrhythmics)
  • Infectious Disease – including but not limited to CAP, Sepsis, UTIs
  • ACS / Heart Failure / Hypertension
  • Diabetes / Renal Dysfunction
  • Drug therapy monitoring / Dosing consults for antibiotics and warfarin
  • Clinical documentation and notes for treatment team and pharmacy staff
  • Medication profile review / Monitoring and assessment of laboratory data, microbiology, and test results.
  • Drug info queries from medical and pharmacy staff
  • Response to Code Blues
  • Adverse drug reaction reporting
  • Journal Club or Inservice –  usually presented at midpoint of rotation(can be replaced with a school required presentation if necessary)
  • Disease state / Patient case presentation –  presented during final week of rotation

Hedrick Medical Center - General Hospital/Acute Care Rotation (APPE)

Preceptors

  • Katie O’Dell, Pharm.D., BCPS, kodell@saint-lukes.org
  • Cassandra Peters, Pharm.D., BCPS
  • Andrew Bottorff, Pharm.D.

Location

Rotation Description

Hedrick Medical Center is a 25-bed acute care critical access hospital located in Chillicothe, Missouri, and is part of the Saint Luke’s Health System. Hedrick Medical center provides comprehensive care, including 24-hour emergency services, a spacious maternity unit, Intensive Care Unit featuring eICU, a specialty clinic, an onsite chemotherapy infusion center, and inpatient and outpatient surgery. Students will participate in the daily drug distribution process, clinically monitor patients, and experience the unique challenges a critical access hospital encompasses. Students will apply their acquired knowledge and skills to a wide range of professional services and activities that the pharmacy department provides.

Potential Topics/Activities

  • Medication dispensing/distribution under pharmacist supervision
  • Communicate with nurses and physicians to optimize medication use
  • Selected topic discussions
  • Respond to drug information requests (verbally and/or through documentation in chart)
  • Targeted drug therapy monitoring including vancomycin, aminoglycosides, and others
  • Antibiotic surveillance including review of microbial culture and sensitivity data
  • Medication profile review and identification of drug-related problems
  • Adverse drug reaction and medication error reporting
  • Medication counseling on discharging patients
  • Documentation of clinical activities in the medical record
  • Various shadowing opportunities
  • Introduction to IV preparation and sterility testing

Goals/Objectives

  • Introduce students to the medication use process and patient care activities that occur in the critical access hospital pharmacy setting  
  • Provide a learning environment for students to apply classroom knowledge and skills to patient care
  • Foster students’ ability to effectively communicate with other members of the healthcare team
  • Improve students’ proficiency in using available resources to ensure the safe and effective use of medications

Hematology/Oncology 

Preceptors

Phillip Lorhan, Pharm.D., BCPS; Jennifer Collier, Pharm.D., BCPS, BCOP; Rachel Vaught, Pharm.D., BCOP; Lindsey Douglass, Pharm.D., BCPS, BCOP; Beth Gustafson, Pharm.D., BCOP; Lai Kheng Chan, Pharm.D., BCPS, BCOP, Anne Kaminski, Pharm.D., BCPS, CK Kim Pharm.D.

Location

Rotation Description

The Hematology/Oncology rotation is a four week experiential rotation for pharmacy students. The area of practice is primarily in the oncology infusion centers across the health system. Time will also be spent on the Neuro 4 nursing unit which houses both inpatient oncology and neuro step-down patients. This rotation places emphasis on the workings within the outpatient infusion centers including but not limited to daily operations, patient education, and patient therapy monitoring. This rotation also exposes the student to supportive care for patients with leukemia, lymphoma, solid tumors, and hematologic disorders including anemia, sickle cell disease, and idiopathic thrombocytopenic purpura (ITP) in the inpatient setting.

Potential Topics/Activities

Specific topics which the student will learn through readings, lectures, patient care rounds and patient discussions shall include:

  • Anti-emetic practice guidelines and strategies
  • Prevention and treatment of cancer-related infections
  • Use of growth factors (ESAs, G-CSF, etc)
  • Supportive care including management of tumor lysis syndrome, GI toxicities of chemotherapy, and management of extravasations
  • Hypercoagulability of malignancy
  • General review of antineoplastic agents’ mechanism of action, dose-limiting and hallmark toxicities
  • Other issues pertaining to oncology brought forth by the student

Students will be required to participate in the following activities while in the outpatient setting:

  • Daily review of patient’s current chemotherapy in regards to current course of therapy as well as history of disease and progression of care.
  • Ensure  safety and efficacy information for patient chemotherapy regimen, including correct dose, form, rate of administration, diluents and other special considerations as warranted by each individual chemotherapy agent
  • Be able to interpret and understand necessary lab parameters to ensure safe administration of chemotherapy
  • Understand and anticipate hallmark toxicities of specific chemotherapy
  • Use and follow safe handling of cytotoxic medications principles as well as understanding the principles of preparation of chemotherapy
  • Understand some basic purchasing and distribution issues surrounding the 340b program
  • Interview  new patients and be able to obtain pertinent patient information as well as counsel them on use of breakthrough anti-emetic medications
  • Understand the role of research and use of clinical trials as it relates treatment of cancer patients and the necessary steps required to ensure study medications are appropriately managed

Students will be required to participate in the following activities while in the inpatient setting:

  • Supervised participation in rounds with Saint Luke’s Cancer Institute Specialist in Cancer Care (hem/onc team)
  • Targeted drug therapy and TPN monitoring
  • Medication profile review and drug interaction screening
  • Adverse drug reaction and medication error reporting
  • Nursing education and participation in teaching opportunities with nursing staff
  • Drug information searches and responses
  • Required readings as requested by preceptor
  • Patient/family education including warfarin, enoxaparin, and immunizations

Home Infusion and Specialty Pharmacy

Preceptor

Bryan L. Schuessler PharmD, MS
Director of Home Infusion and Specialty Pharmacy
Saint Luke’s Advanced Care Pharmacy
10920 Elm Avenue
Kansas City, MO 64134
bschuessler@saint-lukes.org

Rotation Description

This Specialty and Home Infusion Administration rotation will provide students exposure and opportunity to participate in the essential roles of a director of pharmacy, as well as other pharmacists and staff within the department, through the activities outlined below. Topic discussions, projects, and presentations will be required as directed by the preceptor. The goal of the rotation is for the student to become familiar with the specialty pharmacy industry, obtain experience in working in a management position, and gain valuable specialty and home infusion drug information knowledge.

Schedule

Rotation site hours are variable, usually falling around 0830-1630 Monday through Friday. The first day of rotation the student should report to the pharmacy at 0900 to meet the preceptor, discuss the schedule, and projects. The student may be required to attend meetings or shadow staff at other Saint Luke’s locations in the metro area. Absences, other than those required for the rotation should be discussed with the preceptor in advance.

Attire

Students are expected to dress professionally in business casual attire in accordance with school and hospital policy. A name tag should be worn to allow access into the pharmacy.

Rotation Goals

  1. Be able to clearly define specialty and home infusion pharmacy and key operations related to such
  2. Be able to receive, process, compound, and “dispense” a home infusion/specialty medication
  3. Present 1 to 2 drug information presentations to the appropriate staff
  4. Complete 2 to 3 topic discussions on articles read
  5. Initiate and complete projects as assigned
  6. Act, communicate, and remain professional at all times

Rotation Activities

The student should expect to participate in or observe the following activities during the rotation:

  1. Shadow specialty and home infusion areas as needed to become familiar with workflows
  2. Meet members of the team and understand their roles
  3. Attend all weekly department meetings
  4. Required and suggested readings will be assigned as time permits
  5. Several major projects, to be completed by the end of the month (will be assigned at the beginning of the rotation, subject to change based on needs of the department)
  6. Distribution of medication information through drug info presentations
  7. Leadership duties and professional service through attendance of select department and administration meetings

Evaluation

Assessment of the student’s performance will be done utilizing the evaluation form provided by the student’s school of pharmacy. The student and preceptor will meet at the beginning of the rotation to identify any additional goals/objectives/projects to be accomplished during the course of the rotation and identify appropriate timelines.  Development of a rotation calendar is strongly encouraged.  The preceptor will provide a formal verbal assessment of student’s performance at the midpoint of the rotation and a formal written assessment will be performed upon completion of the rotation.


Leadership and Management

Preceptors

  • Jeff Little PharmD, MPH, BCPS, FACHE
  • Mark Woods PharmD, FASHP, BCPS
  • Scott Aldridge PharmD, BCPS
  • Brian Kempin PharmD, MS

Location

Rotation Description

The Saint Luke’s Hospital Pharmacy Leadership and Management Rotation is designed to allow the Doctor of Pharmacy Student to acquire the first-hand experience in pharmacy practice's managerial and administrative aspects. Throughout the rotation, the student will gain exposure to and an understanding of the responsibilities of pharmacy administration within a complex integrated health care system, including financial management, personnel management, performance improvement and quality assurance, pharmacy operations, planning and project management, clinical pharmacy services and program development, and interdisciplinary collaboration, communication, and teamwork. The student will work with the various members of the Pharmacy Leadership Team. Their scopes and roles vary from department-specific leadership and personnel management (Inpatient Pharmacy Operations Manager, Residency Program Director) to system pharmacy leadership (Director of Pharmacy, Clinical Coordinator).

Potential Topics/Activities

  • Attend and participate in departmental and enterprise-wide meetings
  • Work with multidisciplinary teams on patient care initiatives
  • Participate in quality improvement and medication safety activities
  • Participate in the therapeutic review process, adverse drug reaction reporting, and drug utilization evaluation process
  • Develop mechanisms for predicting and measuring the costs and benefits associated with both new and existing services
  • Establish, develop, and/or refine an efficient system of drug distribution
  • Supervise and evaluate job performance of personnel
  • Develop strategies to increase teamwork and empower employees

Medical/Surgical/Trauma Critical Care 

Preceptors

  • Ashley K. Holmes, PharmD, BCCCP
  • Shelby Shemanski, PharmD, BCCCP

Location

Rotation Description

The Medical Critical Care rotation is a month long clinical rotation.  The rotation is designed to expand on basic clinical knowledge and abilities gained on previous rotations, and to enhance the student’s critical thinking skills. This rotation places emphasis on the care of the critically ill patient, including those requiring mechanical ventilation, sedation, vasopressor support, and other life-saving therapies.

The Medical/Surgical/Trauma Intensive Care Unit (MSTICU) is a 20 bed closed unit. Each patient is admitted to either the Pulmonary Critical Care or Surgical Critical Care service, after which other specialty services may be consulted. Students will be assigned specific patients to follow and will provide pharmaceutical care by rounding with one or both of these teams. Patient care discussions are held daily and numerous critical care topic discussions are performed throughout the rotation. Students will interact with all members of the medical team, including nurses, respiratory therapists, dieticians, medical and surgical residents, advanced practice providers, and attending physicians.

Potential Topics/Activities

Specific topics which the student will learn through readings, lectures, patient care rounds, and patient discussions shall include:

  • Treatment of sepsis and septic shock (e.g., vasopressors, fluids, steroids, antibiotics and supportive care)
  • Sedation and analgesia for mechanically ventilated patients
  • Acute respiratory distress syndrome (ARDS) management and utilization of neuromuscular blocking agents
  • Advanced Cardiac Life Support (ACLS)
  • Acute and chronic renal failure and renal replacement therapy
  • Treatment of acute and chronic liver failure and its complications, including drug dosing adjustment
  • GI bleeding (upper, lower, variceal bleeding)
  • Diabetic ketoacidosis and non-ketotic hyperglycemia
  • Acid-base disorders
  • Management of the trauma patient
  • Infectious Diseases –pneumonia, line sepsis, Clostridium difficile infections, viral & fungal infections, etc.
  • Respiratory failure (primary and secondary) and mechanical ventilation
  • Anemia of critical illness
  • Complications in patients with prior organ transplants
  • Correction of electrolyte abnormalities
  • Pharmacokinetics including dosing in critical illness, organ dysfunction and varying body habitus
  • Post-operative surgical patients – acute complications, nausea/vomiting, and pain management
  • Nutrition support in critical illness
  • Venous thromboembolism prevention and treatment
  • Stress ulcer prophylaxis
  • End of life issues

Neonatology/Obstetrics 

Preceptors

Location

Rotation Description

The Neonatology/Obstetrics rotation involves provision of pharmaceutical care for patients in the Level 3b Neonatal Intensive Care Unit (NICU), Labor and Delivery Unit/Complicated Obstetrics, and Mother/Baby postpartum. These units encompass the hospitalization of neonates and women before (prenatal), during (perinatal), and after (post partum) birth.

Potential Topics/Activities

Specific topics which the student will learn through readings, discussions and patient care rounds include:

  • Antepartum and intrapartum medication use
  • Neonatal drug dosages
  • Neonatal infections
  • Neonatal parenteral nutrition
  • Bronchopulmonary dysplasia
  • Apnea of prematurity
  • Intraventricular l hemorrhage
  • Necrotizing enterocolitis
  • Patent ductus arteriosis
  • Gastroesophageal reflux
  • Vaccinations
  • Pregnancy and Infection
  • Medication use in pregnancy and lactation
  • Neonatal resuscitation
  • Preeclampsia
  • Gestational Diabetes
  • RSV prophylaxis
  • Post-Partum medication use and lactation
  • Management of drug shortages

Goals/Objectives

Throughout the rotation, the student will be expected to demonstrate the following:

  • Participation in patient-centered care.
  • Efficiently collect and interpret patient data.
  • Develop evidence based drug therapy recommendations.
  • Communicate professionally with members of the healthcare team.
  • Communicate and document patient information and therapeutic plans.
  • Communicate with patients and family members when appropriate.
  • Demonstrate knowledge of pharmacotherapy of disease states seen in the neonatal and obstetric population.

Neuroscience Intensive Care

Preceptors

Location

Rotation Description

The neurosurgical intensive care unit rotation (NSICU) is a four-week experiential rotation for pharmacy students at Saint Luke's Hospital. The pharmacist's role in this practice area is to encourage the best medication-related patient outcomes possible through taking part in multidisciplinary rounds, assisting with medication delivery to the unit, establishing and enforcing safe medication policies and formulary, and education of other staff, residents and students. Pharmacists are often responsible for antibiotic and anticoagulant ordering per CDTMs.

During the NSICU rotation the pharmacy students will be responsible for monitoring the pharmacotherapy for the 18 ICU beds in the NSICU and the patients on a neuro-ward floor (Neuro-2). The pharmacy students will be expected to work with other healthcare disciplines to identify and resolve medication-related problems for these patients. Other disciplines the resident will be expected to interact with include but are not limited to; attending physicians, medical and surgical residents, advance practice nurses, respiratory therapists, registered nurses and dietitians.

Potential Topics/Activities

These are potential topics which may be covered via actual patient care experiences, discussions of reading materials, and/or case presentations: 

  • Aneurysmal subarachnoid hemorrhage and cerebral vasospasm
  • Traumatic brain injury
  • Refractory elevated ICP
  • Acute Ischemic stroke
  • Status epilepticus
  • Spinal cord injury
  • Acute non-traumatic weakness
  • Intracerebral hemorrhage
  • Meningitis and encephalitis
  • Pain, anxiety, delirium, NMB
  • Hypo and hypernatremia
  • Anticoagulant reversal
  • Other topics of interest
  • Weekly attendance at staff meetings (Wednesdays at 1430 in the Main Pharmacy)
  • Attendance at Journal Club Presentations, Case/Topic Presentations, Therapeutic Controversies (Informal case presentations/journal clubs sometimes in CVOR Pharmacy office; formal case presentations will be in conference room area near the Main Pharmacy on B-Level)
  • Topic/Case presentations (usually a formal patient case presentation at mid-point, and a formal Topic presentation during final week of rotation)
  • Daily verbal discussion of patients and medications
  • Verbal informal patient presentation daily as time allows
  • New drug briefing (5-10 minutes in length) 1-2 times during rotation

The student is strongly encouraged to take the initiative in assisting the direction of the learning experience during the rotation to optimize his or her personal development.


Overnight Rotation

Preceptors

Location

Rotation Description

Saint Luke’s Hospital is a 400+ bed not-for-profit tertiary teaching hospital located in the historic Country Club Plaza. The overnight rotation is a 7-on/7-off four week rotation that provides students with the opportunity to explore the roles of pharmacists in an overnight hospital setting. Students will be exposed to various operational and clinical activities that overnight clinical pharmacists engage in on a nightly basis. Students will apply their acquired knowledge and skills to a wide range of professional services and activities that the inpatient pharmacy department provides. The goal of this rotation is to allow the student to develop the ability to assess patient profiles to identify drug-related issues and effectively initiate, adjusted, and monitor patients on various therapies under protocol.

Potential Topics/Activities

  • Medication verification and dispensing/distribution under pharmacist supervision
  • Communicate with nurses and physicians to optimize medication use
  • Selected topic discussions
  • Respond to drug information requests (verbally and/or through documentation in chart)
  • Targeted drug therapy monitoring including vancomycin, aminoglycosides, and others
  • Antibiotic surveillance including review of microbial culture and sensitivity data
  • Medication profile review and identification of drug-related problems
  • Medication reconciliation
  • Adverse drug reaction and medication error reporting
  • Targeted medication teachings as necessary (e.g. antiarrhythmics or anticoagulants)
  • Documentation of clinical activities in the medical record

Goals/Objectives

  • Introduce students to the medication use process and patient care activities that occur in the overnight inpatient pharmacy setting
  • Provide a learning environment for students to apply classroom knowledge and skills to patient care
  • Foster students’ ability to effectively communicate with other members of the healthcare team
  • Improve students’ proficiency in using available resources to ensure the safe and effective use of medications

Pulmonary

Preceptors

Location

Rotation Description

The Neuro A/B pulmonary rotation is a 4-week clinical rotation.  The rotation is designed to expand on basic clinical knowledge and abilities gained on previous rotations, and to enhance the student’s critical thinking skills. This rotation places emphasis on the care of the hospitalized patient with focus in pulmonary diseases, infectious disease, neurological diseases, and general internal medicine.

Both the Neuro A (epilepsy / neurology) and Neuro B (pulmonary / internal medicine) units are 24-bed units. Patients are typically admitted under hospitalist care with consulting services for pulmonology, neurosurgery, neurology, epilepsy, and infectious disease. Students will be assigned specific patients to follow and provide pharmaceutical care, as well as round with Pulmonary Consult service. Patient care discussions are held daily, and numerous topic discussions are performed throughout the rotation.

Potential Topics/Activities

Specific topics which the student will learn through readings, lectures, patient care rounds, and patient discussions shall include:

  • Infectious Diseases – endocarditis, meningitis, pneumonia, line sepsis, viral & fungal infections, etc.
  • COPD and Asthma
  • Diabetes Mellitus
  • Hypertension / atrial fibrillation
  • Epilespy
  • Respiratory failure (primary and secondary) and mechanical ventilation
  • Acute management of stroke
  • Acute and chronic renal failure and renal replacement therapy
  • Treatment of liver failure and its complications, including drug dosing adjustment
  • GI bleeding (upper, lower, variceal bleeding)
  • Anemia
  • Correction of electrolyte abnormalities
  • Acid-base disorders
  • Nutrition support
  • Venous thromboembolism: prevention and treatment
  • Stress ulcer prophylaxis
  • End of life issues
  • Journal Club (UMKC)
  • Treatment Guideline Review (UMKC)
  • Interprofessional Education Reflection (UMKC)
  • Formal Case Presentation (SOAP Note)
  • Noon meetings (student presentations, resident presentations, etc.)
  • Weekly Wednesday staff meetings at 2:30pm

Retail/Community Pharmacy

Participating Sites

Saint Luke’s Hospital Outpatient Pharmacy
4320 Wornall Rd Suite #128
Kansas City, MO 64111
Paige Ulrich Pharm.D., preceptor

Saint Luke’s North Outpatient Pharmacy
5844 NW Barry Rd Suite #20
Kansas City, MO 64154
Suzie Smith Pharm.D., preceptor

Saint Luke’s South Retail Pharmacy
12300 Metcalf Ave
Overland Park, KS 66213
Susan Steiner RPh., preceptor

Saint Luke’s East Outpatient Pharmacy
100 NE Saint Luke’s Blvd        
Lee’s Summit, MO 64086
Mandy Young, Pharm.D., preceptor

Saint Luke’s South Mission Farms Pharmacy
4061 Indian Creek Parkway Suite #120
Overland Park, KS 66207
913-323-4777
Jeff Gerstner RPh., preceptor

For inquiries – Suzie Smith, ssmith@saint-lukes.org

Rotation Objective

Students will provide patient-centered care in a community pharmacy setting under the supervision of the site pharmacy preceptor.  The rotation is designed to provide students with the opportunity to gain understanding of the daily functions and responsibilities of a retail pharmacist and further develop applicable knowledge regarding use of medications.  Students will experience the operations and management of a community pharmacy and be involved in all aspects of the medication delivery system. 

Students will be expected to participate in patient education and counseling on OTC products, dietary supplements, medical devices, and prescription medications.  Our sites provide opportunities for students to interact directly with patients by providing pharmacy services such as Medication Therapy Management and Discharge counseling for our Meds to Beds program.  Students will gain confidence in their ability to communicate information to patients that have various educational background levels as well as other medical professionals.  Students should strive to be independent learners.  As much as possible, students should find answers to questions individually and then discuss with preceptor in order to determine the best course of action.

Students are required to comply with all federal and state rules and regulations as it applies to pharmacy practice while coordinating the safe, accurate, and time-sensitive distribution of medication.