Rotations & Clinical Experience

Pharmacy Residency in Delaware Valley

The rotations, clinics and electives that have been designed into the program were all included to help you become an experienced, well-rounded and professional pharmacy practitioner.

They vary in length, from four- and six-week rotations to longitudinal experiences.

Rotations

From Orientation to Pediatric Intensive Care, these rotations will give you a solid grounding in the profession.

 
Orientation

The Nemours/Alfred I. duPont Hospital for Children is a full-service pediatric hospital with 190 beds, of which 100 beds are medical/surgical. The hospital offers all of the specialties of pediatric medicine, surgery, and dentistry. General pediatric and specialty clinics are also located on campus.

The inpatient pharmacy is a 24-hour, 7-day-a-week operation that processes an average of 600 orders a day. Also, there is an associated outpatient pharmacy that provides full prescription services to patients and employees.

This learning experience is designed to develop your skills in order to adequately process a wide variety of provider orders. At the end of the rotation, you’ll have training to process pediatric medication orders safely and efficiently. You’ll also improve your ability to communicate to nursing and the medical teams, and to supervise technical staff.

 
Drug Information/Investigational Drug Service

This is a longitudinal rotation experience, designed to develop your skills in providing drug information to health care professionals and to demonstrate proficiency in preparing investigational drug study monographs. You’ll develop and refine the knowledge and skills to meet healthcare professionals' needs for drug information in the health-system.

You’ll evaluate requests to add medications to the health system's formulary, and apply the principles of quality improvement to the medication-use process. You’ll also improve your ability to communicate drug information/investigational study information to the medical/pharmacy team.

Within this experience, you’ll be expected to answer at least 15 detailed drug information questions, complete one P&T monograph, complete one drug class review, and complete one investigational drug study monograph. Either the drug class review or the investigational drug study monograph will be presented to the pharmacy/medicine staff.

 
General Pediatrics

The General Pediatrics rotation will expose you to direct patient care for a variety of pediatric disease states, working with patients on the 3E and 3F units of the hospital (3E and 3F are general pediatric areas, with 3E’s emphasis on respiratory patients and 3F focusing on gastroenterology patients). You’ll work with medical residents, nurses, aides, attending physicians, and the precepting pharmacist to implement pharmacy care plans and to prevent and solve medication therapy issues.

You’ll alternate rounds daily on each side with the designated preceptor at the beginning. Based on performance, you may later round on one unit while the preceptor rounds on the other side. In addition to the General Pediatrics teams, you must also work with the pulmonary and gastroenterology (GI) teams who are covering patients on the two units.

The rotation helps you develop a variety of skills, including decision-making, teaching, and communication skills. You’ll also learn to develop treatment plans and work closely with the medical teams. These skills and the general disease states followed will help you on further rotations.

 
Infectious Diseases

The goals of this residency are to optimize patient outcomes, reduce the emergence of antimicrobial resistance, and reduce costs associated with antimicrobial use. The Antimicrobial Stewardship team consists of Infectious Diseases attending physicians and an Infectious Disease clinical pharmacist. The team works in conjunction with Infection Control, Microbiology, and the Pharmacy Department.

This learning experience is designed to develop your skills to adequately provide pharmaceutical care in the area of infectious diseases (ID) to pediatric patients and to function as an independent clinician on the Antimicrobial Stewardship team. You’ll have the opportunity to learn about various aspects of pediatric ID as well as the operation and mission of the Antimicrobial Stewardship Program (ASP).

You’ll spend time rounding with the ID consult team and the ASP team. The experience will involve the development of sound practice methods in order to provide competent, confident and compassionate pharmaceutical care to patients.

 
Informatics

This is a core experience of your residency and will expose you to the evolution of organization-wide medication-use systems by applying pharmacy informatics principles, standards, and best practices. You’ll gain a basic understanding of the language and concepts of information technology (IT), equipping you to function in the interdisciplinary environment of informatics project teams to advance the professional duties and responsibilities of a pharmacy informatics specialist.

The informatics department at Nemours plays a critical role in providing clinical informatics expertise to support the Nemours strategy. Activities include participating in scholarly clinical informatics knowledge exchange, supporting clinical research and quality improvement, advancing clinical best practices guided by domain experts, and developing user competencies of clinical applications. An important component of the department’s function is to partner with IS to ensure an environment that enables clinical applications to perform optimally.

Pharmacists have unique, comprehensive knowledge about safe and effective use of medications. More importantly, pharmacists understand core pharmacy operations and have developed expertise in end-to-end medication-use management, including communication with other information systems. Pharmacists provide expertise to effectively translate and seamlessly communicate the language of medication use across the continuum of care. They can interpret and implement requirements to ensure safe and comprehensive medication order communication.

An experienced pharmacist is skilled in the use of electronic medication-order entry systems and has knowledge of human factor issues (e.g., interpretation of ambiguous clinical data) and development of interfaces to disparate applications and systems.

 
Longitudinal Project Management

You’ll meet with the rotation preceptor for one hour every other week. This learning experience is designed to develop your skills in research techniques so you’ll be able to design, develop, implement, and assess a residency research project by the end of the residency. This project will be presented at the Eastern States Residency Conference, usually held in May of each year.

 
Longitudinal Practice Management

Meet with the rotation preceptor for one hour every month, and develop skills in leadership and pharmacy management. You’ll be involved in pharmacy and therapeutics meetings, management projects, budgeting, and will prepare a management project for presentation.

 
Pediatric Intensive Care

This learning experience is designed to develop your skills to adequately provide pharmaceutical care for up to 22 patients. You’ll review the pathophysiology and therapeutic treatment recommendations of disease states encountered, with emphasis on pharmaceutical management in accordance with national guidelines. You’ll improve your ability to design and implement treatment and monitoring plans and your ability to communicate recommendations to the medical team.

This rotation will also strive to prepare and motivate you to commit to lifelong learning in the rapidly changing health care environment. The rotation requires extensive readings and will assume an adequate knowledge base on the topics reviewed in these required readings. Time management and prioritizing tasks are essential for a successful and rewarding experience, as you’ll be expected to cover and be familiar with all the patients currently in the intensive care unit.

Clinics

For specialized clinical experience, we offer training in the HIV and Hematology/Oncology clinics.

HIV Clinic

The HIV Clinic provides specialized management of HIV infection to pediatric patients up to the age of 21. The clinic services about 40 patients. The interdisciplinary team consists of an Infectious Disease Physician, nurse practitioner, social worker, and pharmacist.

The main role of the pharmacist is to provide medication adherence counseling to the patients and their caregivers. Other clinical activities include, but are not limited to, monitoring patient’s antiretroviral therapy, perform dosage checks and adjusting doses based on weight change, ensuring that the immunization record is up to date, and providing drug information to the healthcare team.

This is a six-month, ½ day/week, longitudinal experience. This learning experience is designed to develop your skills to adequately provide pharmaceutical care to pediatric HIV patients, and review the pathophysiology and therapeutic treatment recommendations of disease states in accordance with national guidelines. The rotation will also help you improve your ability to design and implement treatment and monitoring plans, as well as to communicate recommendations to the medical team.


Outpatient Hematology/Oncology Clinic

The Hematology/Oncology Clinic provides comprehensive outpatient services to children with hematological and oncological diagnoses from birth through age 18. Services in the outpatient clinic and day therapy area include diagnostic workups, physical exams, medication administration, chemotherapy administration, blood product administration, pre-, post- and intra-sedation monitoring, and the initiation of the admission process to the hospital.

Caregivers in the Hematology/Oncology Clinic assess, plan and initiate care for a variety of patients, while collaborating with the interdisciplinary team. Disease-specific and supportive care education is provided to patients and families on an ongoing basis.

Electives

From Cardiac Intensive Care to Management, our electives give you the chance to personalize your educational experience.

 
Cardiac Intensive Care Unit

The Nemours Cardiac Center consists of a 10-bed cardiac intensive care unit, a 16-bed step-down unit, a state-of-the-art digital cardiac catheterization and electrophysiology suite, and an operating room, all used only for the care of infants and children with heart disease. In addition to first-class open-heart surgery, this care includes modern approaches to closing cardiac anomalies in the heart and opening restrictive blood vessels and valves in the catheterization lab. These treatment capabilities, offered in a mere handful of centers in the United States, are available at the Nemours Cardiac Center.

This rotation is designed to develop your skills to adequately provide pharmaceutical care to cardiac patients and review the pathophysiology and therapeutic treatment recommendations of disease states encountered — with emphasis on cardiac surgery — in accordance with national guidelines. The rotation will also help you improve your ability to design and implement treatment and monitoring plans and communicate recommendations to the medical team.

 
Inpatient Hematology/Oncology (Heme/Onc)

The Hematology/Oncology (Heme/Onc) rotation includes patients admitted to the 3CN and 3A units of the hospital. Between both units there are approximately 31 beds in total, 21 of which are located on 3CN and 10 on 3A. 3CN patients are usually Heme/Onc patients and the 3A patients typically are blood and bone marrow transplant patients (BBMT). The average daily census of oncology patients (there are also endocrinology, rheumatology, and neurology patients on 3CN) is about 15 patients, with 70 percent being Heme/Onc and 30 percent BBMT. Case-mix can vary significantly.

The initial goal is to have you cover at least five patients. This may increase based on case variability. This rotation is designed to further develop the skills necessary to adequately provide pharmaceutical care to these patients and review the pathophysiology and therapeutics of their disease states in accordance with national guidelines. The experience involves the provision of direct patient care for Heme/Onc inpatients. You’ll participate in daily patient care rounds and be responsible for working with the residents, the attending physician, and the nurses to prevent, identify and/or solve medication therapy issues.

 
Management

This learning experience is focuses on management activities, and you’ll develop your skills in leadership and pharmacy management. You’ll be involved in pharmacy and therapeutics meetings, management projects, budgeting, and will prepare a management project for presentation.

 
Neonatal Intensive Care Unit/Special Care Nursery (NICU/SCN)

The NICU/SCN rotation will give you the opportunity to learn various aspects of critical care medicine in the neonatal setting. Through participation in patient care rounds and other activities, you’ll be given the opportunity to implement pharmaceutical interventions and provide drug information to the medical staff.

The SCN/NICU rotation is a six-week rotation experience. The first three weeks of the rotation will be spent at Christiana Hospital’s Special Care Nursery (SCN), where you’ll develop a foundation for neonatal intensive care. This unit contains a Level III NICU with a bed capacity of 60 and an average daily census of 40 beds. You’ll review the pathophysiology and therapeutic treatment recommendations of disease states encountered in the SCN, such as respiratory distress syndrome, patent ductus arteriosus, and hyperbilirubinemia.

The second three weeks of the rotation will be spent at the Nemours/Alfred I. duPont Hospital for Children’s Neonatal Intensive
Care Unit (NICU). This 14 to 18 bed Level III NICU, with a daily
census ranging from 12 to 15 patients, encompasses surgical neonatal patients transferred from other area hospitals. Here you’ll learn the surgical aspect of neonatal intensive care and continue to learn pertinent neonatal disease states. Overall, the rotation will help you improve their ability to design and implement treatment and monitoring plans, as well as communicate recommendations to the medical team.

 
Solid Organ Transplant

The solid organ transplant rotation is an elective rotation experience focused on liver and kidney transplants. This learning experience is designed to develop the resident’s skills in order to adequately provide specialized pharmaceutical care, review the pathophysiology and therapeutic treatment recommendations of disease states encountered with emphasis on pharmaceutic management in accordance with national guidelines. The resident will also document progress notes and transplant pre-assessments in the medical record. Opportunities exist for the resident to participate in discharge counseling for patients as well. The rotation will help the resident improve their ability to design and implement treatment and monitoring plans and their ability to communicate recommendations to the medical team. This rotation will strive to prepare and motivate the resident to commit to life-long learning in the rapidly changing health care environment.

This rotation will require extensive readings and will assume an adequate knowledge base on the topics reviewed in these required readings. Time management and prioritizing tasks is essential for a successful and rewarding experience as it will be expected that the resident will be familiar with all the patients currently on the transplant service.

Contact Us

Elora Hilmas, PharmD, BCPS

Program Coordinator
(302) 651-5791
elora.hilmas@nemours.org

Apply for Our Program

Application Requirements
Deadline: Jan. 12, 2015
  • PharmD degree
  • eligibility for Delaware licensure (must be obtained by September 15)
  • academic transcript
  • curriculum vitae
  • three letters of recommendation
  • letter of intent

Ways to Apply