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.

View APPE opportunities:


    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 / Content

    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 www.hrspatients.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.


    Cardiology 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, transplant medication 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 / Content

    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
    • Students will be required to present a midpoint case presentation.
    • Students will be required to present a power point presentation (approximately 30 minutes long) at the end of the rotation on a topic to be determined by the student and preceptor.

    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 (HF)/transplant rotation is a 4 week rotation for APPE students at Saint Luke's Hospital. The 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 devices including, but not limited to ventricular assist devices (VADs), or those who have received a heart transplant. Pharmaceutical care will be provided for this patient population and usually includes patients on the heart transplant and HF floor (HS5) as well as patients in the cardiac intensive care unit (CICU) or cardiovascular intensive care unit (CVICU) in the Mid America Heart Institute (MAHI). The rotation will also include the provision of care of patients in the HF/transplant clinics. Students will follow all patients on the HF/transplant service and interact/round with the HF/transplant team which includes a fellow, nurse practitioner and attending. Other members of the patient care team may include some or all of the following: medical residents, clinical pharmacist, pharmacy residents, nurses, respiratory therapists, dieticians, and social workers. Patients are often cared for by other medical disciplines alone or in conjunction with the HF/transplant service, such as: cardiovascular (CV) surgery, CV critical care, pulmonology/critical care, infectious disease, and nephrology services.  Pharmacy students are expected to interact and round with these other disciplines when caring for the HF/transplant patients. 

     Potential Topics / Activities / Content

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

    • Disease states in which the resident will be expected to gain proficiency through literature review, topic discussion, and/or direct patient care experience include, but are not limited to:
      • 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
        • Systolic/Diastolic
        • Mechanical Circulatory Support and Resynchronization Therapy
    • Weekly attendance at staff meetings 
    • 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.


    Cardiovascular Intensive Care 

    Preceptors

    Location

    Rotation Description

    The Cardiovascular Intensive Care Rotation is a 4-week experiential rotation.  This rotation involves the provision of care for the patients of CVICU and cardiology patients on  H5N and H6N.  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

    Potential Topics / Activities / Content

    • 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. 

    Be prepared each day with the tools (calculator, etc) and resources (drug information, etc) you will need for rounds and daily activities.


    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 / Content

    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


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

    Preceptors

    Kristin Repp, PharmD, BCPS (Operations Manager), Carolyn Huninghake, PharmD, BCPS, Jonathan Kountz, PharmD, Blake Miller, PharmD, BCPS, Cassie Jo Mitchell, PharmD, BCPS, Brett Nelson, PharmD, BCPP, Lauren Titterington, PharmD, BCPS, Lisa Williams, PharmD, BCPS

    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 159 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 / Content

    • 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 / Content

    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 / Content

    • 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

    Hematology/Oncology 

    Preceptors

    Phillip Lorhan, Pharm.D., BCPS; Jennifer Collier, Pharm.D., BCPS, BCOP; Rachel Reiner, Pharm.D., BCOP; Angie Wood, Pharm.D., BCPS, BCOP; Lindsey Douglass, Pharm.D., BCPS, BCOP; Beth Gustafson, Pharm.D., BCOP; Lai Kheng Chan, Pharm.D., BCPS, BCOP, Anne Kaminski, Pharm.D., BCPS

    Location

    Rotation Description

    The Hematology/Oncology rotation is a 4 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 / Content

    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
    • 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
    • Other issues pertaining to oncology brought forth by the student

    Students will be required to complete a combination of the following projects:

    • Provide a 5 minute clinical pearl, new medication overview, or medication update to the nursing staff
    • Provide a 15 minute new medication overview or medication update to pharmacy staff and may coincide with nursing in-service
    • Complete one or two rotation projects that will focus on improving patient care, drug utilization, or improving the competency and/or training of medical staff
    • Weekly or more frequent topic discussion pertaining to care of oncology patients (see core content above).  Topic will be selected by student and presented to the pharmacist for discussion.
    • An open-book, take home test will be distributed at the beginning of the rotation.  This will be due approximately the last week of the rotation.  It will be graded and will factor into the student’s overall rotation grade.

    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.


    Medical/Surgical/Trauma Critical Care 

    Preceptors

    Location

    Rotation Description

    The Medical Critical Care 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 critically ill patient, including those requiring mechanical ventilation, sedation, pressure support, and other life-saving therapies.

    The Medical/Surgical/Trauma Intensive Care Unit (MSTICU) is a 14 bed open unit. Patients are typically admitted to the MSTICU through the ED, after deterioration on a medical floor, or as a transfer from an outside hospital. 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 these teams. Patient care discussions are held daily and numerous critical care topic discussions are performed throughout the rotation.

    Potential Topics / Activities / Content

    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., pressors, fluids, steroids, antibiotics and supportive care)
    • Sedation, analgesia and neuromuscular blocking agents for mechanically ventilated patients
    • Advanced Cardiac Life Support (ACLS)
    • Infectious Diseases – endocarditis, meningitis, pneumonia, line sepsis, viral & fungal infections, etc.
    • COPD flare and status asthmaticus
    • 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)
    • Diabetic ketoacidosis and non-ketotic hyperglycemia
    • Anemia of critical illness
    • Complications in patients with prior organ transplants
    • Correction of electrolyte abnormalities
    • Acid-base disorders
    • Manifestations of end stage AIDS
    • Pharmacokinetics including dosing in critical illness, organ dysfunction and varying body habitus
    • Post-operative surgical patients – acute complications, nausea/vomiting, and pain management
    • Management of the trauma patient
    • Nutrition support in critical illness
    • Venous thromboembolism prevention and treatment
    • Stress ulcer prophylaxis
    • End of life issues
    • Noon meetings (student presentations, resident presentations, etc.)
    • Weekly Wednesday staff meetings at 2:30 pm

    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.  Other areas of practice the preceptors are responsible for covering in their daily responsibilities include EA8 (Rehabilitation) and E1S (Admissions Unit). 

    Potential Topics / Activities / Content

    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
    • 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.

    Nephrology/Kidney Transplant

    Preceptors

    Location

    Rotation Description

    The nephrology/kidney transplant rotation is a 4-week clinical rotation.  The area of practice is primarily on the H5N nursing unit located in the Mid-America Heart Institute, which currently has 20 patient beds, including an area designated for renal transplant recipients.  Incenter Dialysis (ICD) is also located on this floor which includes 8 beds designated to provide hemodialysis for hospitalized patients.  This adult medicine rotation places emphasis on the care of the patient with kidney disease, including those receiving chronic renal replacement therapies (e.g. hemodialysis or peritoneal dialysis), and renal transplantation.

    Potential Topics / Activities / Content

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

    • Assessment of renal function.
    • Medical management of acute renal failure
    • Management of chronic and end-stage renal disease, with emphasis on pharmacotherapy.
    • Drug-induced renal disease.
    • Drug dosing in patients with kidney disease.
    • Renal replacement therapies, including complications of hemodialysis and peritoneal dialysis and medication-related issues.
    • Renal transplantation and immunosuppressive therapy.
    • Pharmacotherapy of complications associated with renal transplantation.
    • Patient care rounds with the Nephrology service on H5N (and in the MSTICU/Neuro ICU as time allows).
    • Selected Nephrology lectures with the medical residents at 1100.
    • Targeted drug therapy monitoring, including vancomycin, aminoglycosides, anticoagulation and TPN.
    • Antibiotic surveillance including review of culture and sensitivity data.
    • Medication profile review and identification of drug-related problems.
    • Adverse drug reaction and medication error reporting.
    • Immunization screening and patient education.
    • Target medication teaching.
    • Nursing education and participation in teaching opportunities with nursing staff.
    • Drug information searches and responses (including verbal, and in some instances, written responses).
    • Clinical documentation, including progress notes and pharmacy documentation (iVents, acuity monitoring) as indicated.
    • Mid-point patient case presentation.
    • Formal topic presentation to pharmacy staff during last week of rotation.
    • Inservice education for nurses and other members of health care team.
    • Other activities as agreed upon by student and preceptor.

    Neuroscience Intensive Care

    Preceptors

    Location

    Rotation Description

    The neuroscience 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 / Content

    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 / Content

    • 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 / Content

    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

    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.