Advanced Pharmacy Practice Experiences at UH Parma Medical Center

Clinical Rotations

Emergency Medicine

Preceptor: Catherine Wilson, PharmD, BCEMP

This rotation will be located at the emergency department at UH Parma Medical Center, a Level 3 Trauma Center. Hours are variable, between 11 a.m. to 11 p.m., for a minimum of eight hours, Monday through Friday, unless otherwise specified (subject to change depending on preceptor availability). This rotation will include participation in trauma response, stroke response, STEMI response, rapid sequence intubation, advanced cardiac life support, and emergent compounding. Activities include drug information questions, patient chart review, topic discussions, development of nursing educational materials, and a journal club or patient case presentation.

Internal Medicine

Preceptor: Erin Laraway, PharmD, BCPS

The Internal Medicine APPE rotation is an inpatient, mixed unit based and interdisciplinary team rotation in which the student will be able to care for adult patients admitted on general medical floors and the ICU stepdown unit in this community hospital. Daily responsibilities will include clinical monitoring (renal dosing, antimicrobial stewardship, IV to PO conversions, etc), pharmacokinetic dosing, chart review, and bedside rounding daily. Additionally, the student will participate in topic discussions and make recommendations for optimal medication therapy to the interdisciplinary team, which includes medical residents. There are also opportunities for the student to present topic discussions to the medical residents, as well opportunities for practice with medication reconciliation. Finally, students are able to spend time in the ICU stepdown unit with their preceptor, who is unit based. A case presentation and/or journal club presentation will also be given to other preceptors and participants from the pharmacy department. 

Infectious Disease

Preceptor: Kimberly Brandt, PharmD, BCCCP

The Infectious Disease APPE rotation is an inpatient rotation where students will have the opportunity to care for patients on the Infectious Disease consult service. Responsibilities include daily chart review, interdisciplinary team rounds, providing medication recommendations and education to the healthcare team, clinical monitoring with a focus on antimicrobials, pharmacokinetic dosing, and antimicrobial stewardship interventions. Students will also have the opportunity to participate in topic discussions, complete a project (medication use evaluation or newsletter article), and present a journal club or case presentation to the pharmacy department.

Critical Care

Preceptor: Daniel Weiland, PharmD, BCCCP

The Critical Care rotation at Parma Medical Center covers both the Medical Intensive Care Unit (MICU) and the Cardiovascular Intensive Care Unit (CVICU) and focuses on the overall pharmacological care of critically ill patients with a typical census of 10-15 patients. During this rotation the pharmacy student will be responsible for providing direct patient care alongside the intensivists, residents and nurses; evaluating patient's drug therapy regimens to improve patient care; engaging actively during code situations as appropriate and serving as a direct pharmacotherapy source for the ICU team. The student will be asked to delve deeper into some unique ICU topics such as sepsis, ARDS, DKA/HHS, mechanical ventilation, alcohol withdrawal, etc. During this rotation the student will attend daily rounds and discuss ICU related topics as assigned.

Anticoagulation

Preceptor: Elizabeth Mokri, PharmD

The Ambulatory Care rotation at Parma Medical Center includes management of warfarin in the chronic care clinic.  The student will be introduced to the ambulatory setting and become acquainted with seeing and talking with patients one on one. A point of care (POC) INR test will be done on each patient to check their INR. The student will interpret the INR value based on the patient’s INR range while considering each patient’s dietary, social and routine habits and medical histories. Students will learn how to dose warfarin, when to make appropriate dosing changes, and how to ask open-ended questions to find out why an INR may be out of range. Lovenox bridging and administration will also be introduced. The student will learn when and how to use Lovenox as a bridge with warfarin for procedures that require holding warfarin. INR monitoring and warfarin dosing will be emphasized, along with guidelines and patient response based on dietary and medical factors. Vitamin K administration is also introduced using guidelines with respect to understanding the patient’s medical history, personal, and routine behaviors.

Hospital

Preceptor: Elaina Grandinetti, PharmD

The Institutional Rotation at University Hospitals Parma Medical Center will involve gaining experience in hospital pharmacy operations. The student will gain knowledge in the storage of medications and be involved in the preparation and dispensing of medications.  This will involve experience with ordering and verifying medications in the EMR, preparing unit dose medications and intravenous admixture medications, inventory control, medication reconciliation, disposal of medications, and Omnicell functionality.  The student will be exposed to various policies, procedures, and protocols that are put in place for safe medication use.  They will evaluate and investigate operational issues to improve pharmacy workflow and help implement new policies and procedures within pharmacy operations (if applicable).