The Prisma Health-Upstate Antimicrobial Stewardship Program (ASP) is a coordinated system level program that promotes appropriate use of antimicrobial therapy, reduces microbial resistance, decreases the spread of infections caused by multidrug-resistant organisms, and improves patient outcomes. The multidisciplinary program is led by an ID trained pharmacist and an ID physician.
Residents on this rotation will complete targeted antimicrobial stewardship reviews and make patient specific recommendations to the primary teams, provide education to various services regarding antimicrobial stewardship topics, and complete antimicrobial stewardship related quality improvement projects for the system.
Topics focused on during this rotation include:
The Cardiology Teaching Service (CTS) experience is an elective rotation. CTS directly admits patients and accepts consults from various services to manage a broad scope of cardiovascular conditions. This rotation is designed to provide a basic overview of the acute and chronic management of commonly encountered adult cardiovascular diseases. CTS provides medical; as well as, interventional management as treatment approaches.
The resident will be assigned to a team consisting of an attending physician, medical resident(s), intern(s) and student(s). Disease states encompass STEMI, NSTEMI/US, CHF exacerbations, arrhythmias, anticoagulation, hypertensive crises, interventional cardiology and others.
The Cardiovascular Critical Care Attending Service is a non-teaching, multi-disciplinary service comprised of a pulmonary/critical care board certified attending physician, respiratory therapist, nurse practitioner, and a clinical pharmacy specialist. This team provides management for post-operative cardiovascular or thoracic surgery patients in a 25-bed CVICU. Disease states managed include post-operative care of coronary artery bypass grafts and valve repair/replacement, sepsis resulting from a multitude of causes, pain management as well as many other disease states.
The goal of the Emergency Department Experience is to provide the resident opportunities to build upon knowledge and skills acquired during their critical care year and apply them in direct patient care activities in the Emergency Department setting. This experience will expose the resident to the essential roles of the pharmacist in the Emergency Trauma Center that may include optimization of medication use through interaction with the Emergency Medicine team, order review, drug therapy monitoring, monitoring the use of high-risk medications, medication preparation and dispensing, providing of drug information, and obtaining medication histories.
The Infectious Diseases Consult Service is utilized by all of the various services in at the Prisma Health – Upstate Greenville Memorial Medical Campus to participate in the care of patients with difficult to manage infectious diseases. The service is a multi-disciplinary team consisting of an infectious disease attending physician, internal medicine residents, medical students, and a pharmacist. Disease states commonly encountered include pneumonia (community and hospital acquired), urinary tract infections, bacteremia/sepsis, hepatitis/cirrhosis, human immunodeficiency virus, osteomyelitis, endocarditis, sexually transmitted diseases, opportunistic infections, meningitis, and various fungal infections.
The goal of the Medicine Critical Care Rotation is to provide the resident opportunities to build upon knowledge and skills acquired during their PGY1/PGY2 years and apply them in direct patient care activities in the ICU setting. This is a multidisciplinary team consisting of a pulmonary/critical care board certified attending physician, emergency department residents, and a pharmacist. This experience will expose the resident to the essential roles of the pharmacist in the ICU that may include optimization of medication use through interaction with the team, order review, drug therapy monitoring, monitoring the use of high-risk medications, medication preparation and dispensing, providing of drug information, and obtaining medication histories.
The Neonatal Intensive Care Unit (NICU) rotation is designed to teach the resident how to provide pharmaceutical care services for neonatal patients by applying population-based pharmacodynamic/pharmacokinetic principles and critical thinking skills. The rotation will focus on the neonatal disease states commonly seen at our institution and specific issues related to neonatal drug therapy and therapeutic monitoring. The resident will round with neonatologists, medical pediatric residents, neonatal nurse practitioners, and several other multidisciplinary services. The resident will
The average daily census in the NICU is around 70 patients. The resident will be expected to round on an average of 20-30 patients daily. This rotation is one of the choices for the required pediatric rotation selection. By the end of the rotation, the resident is expected to have mastered how to provide clinical pharmacy services in a less familiar patient population with unique challenges.
The Neurocritical Care service at Greenville Memorial Medical Campus is a multi-disciplinary teaching service consisting of neurointensivists, nurse practitioners, a clinical pharmacy specialist, and medical students/interns/residents. This clinical rotation will provide exposure to various neurological disease states including acute ischemic stroke, intracerebral hemorrhage, status epilepticus, meningitis, intracranial hypertension, toxic encephalopathy, cerebral venous sinus thrombosis, and neuromuscular emergencies. Students will be responsible for designing and monitoring drug regimens for these critically ill patients. Other services provided by the student may include researching drug information for the team as requested, pharmacokinetic evaluation / dosing, and patient education as needed.
This rotation will provide the resident with exposure to care of the general pediatric inpatient. This one-month experience is designed to develop the resident’s knowledge and skills in the pharmaceutical care of pediatric patients, with specific focus on the application of supportive care principles to this population. Participation in the multidisciplinary team approach to the care of the pediatric patient will offer the resident experience in: designing and recommending therapeutic regimens, application of pharmacokinetic principles, healthcare team interaction, patient and family education, and provision of drug information to other members of the health care team.
The preceptorship experience gives pharmacy residents an opportunity to participate as the direct preceptor / mentor for a pharmacy student’s clinical rotation while at Prisma Health – Upstate. It is designed to develop the resident’s clinical preceptorship and mentorship skills through direct precepting of pharmacy students, designing an individualized student curriculum, conducting pharmacotherapy discussions, and providing feedback/evaluations to students.
This service is a multi-disciplinary teaching service consisting of a pulmonary/critical care board certified attending physician, internal medicine residents, medical students, a clinical pharmacy, and a respiratory therapist. The average daily patient census for the PCCTS team is 15-20 patients, with most patients receiving mechanical ventilation. Disease states range from COPD exacerbations, community and hospital acquired pneumonias, drug overdoses, acute neurological events to sepsis resulting from various infections, pulmonary embolus, adult respiratory distress syndrome, as well as many other disease states
Throughout the rotation, the resident will have the opportunity to provide pharmaceutical care to critically ill patients on the Surgery Critical Care Teaching Service (SCCTS) at Greenville Memorial Hospital, an American College of Surgeons Verified Level 1 Trauma Center. The SCCTS is a multi-disciplinary team consisting of a general surgery/critical care dual board certified attending physician, a critical care fellow, general surgery residents, emergency medicine residents, orthopedic surgery residents, medical students, and a clinical pharmacist. The SCCTS is often consulted to manage neurosurgical, general surgery, trauma, and vascular patients who require mechanical ventilation.
The average daily census for the SCCTS ranges from 15-20 patients depending on consultations. Disease states managed included traumatic brain injuries, acute spinal cord injuries, sepsis resulting from a multitude of causes, adult respiratory distress syndrome, acute alcohol withdrawal, blunt trauma, aortic aneurysms, necrotizing fasciitis, and many other surgical disease states. In addition to these surgical disease states, a variety of other medical disease states will be encountered while on the rotation.