Lacey Ioppolo, PharmD, BCCCP
PGY-1 Pharmacy Residency Program Director
Our PGY-1 residency provides excellent clinical, academic, and practice opportunities. The program is accredited by the American Society of Health-System Pharmacists and features the following core, elective, and longitudinal rotations:
PGY-1 program
The purpose of the MHUMC PGY1 Residency Program is to build on Doctor of Pharmacy education and outcomes to contribute to the development of clinical pharmacists responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and eligible for PGY2 pharmacy residency training.
Core rotations
Orientation/institutional practice
This rotation is designed to orient the resident to the general functioning of the central pharmacy and acclimate him or her to the hospital environment. The resident is trained to enter orders, initiate and adjust Total Parenteral Nutrition (TPN) formulas, and compound I.V. admixtures and chemotherapy. Meetings with the residency director and residency advisory board are held on a regular basis to discuss expectations, requirements, and personal goals for the program. During this rotation, the resident is expected to complete IRB proposals for a research project and a medication utilization evaluation.
Critical care - medicine
The resident rounds daily in the ICU as part of the medicine critical care team. Common diagnoses include acute respiratory failure, sepsis/septic shock, hypovolemia/cardiogenic shock, acute decompensated heart failure, arrhythmias, acute intoxication, and acute renal failure. Common disease states/therapeutic issues encountered on this service include nutrition management, hemodynamics and physiologic monitoring, acid/base management, principles of mechanical ventilation, stress ulcer prophylaxis, prophylaxis and management of DVT/PE, basic ECG analysis and arrhythmia management (ACLS guidelines), fluid and electrolyte management, shock syndromes, acute respiratory failure/ARDS, MODS, acute renal failure, sepsis, management of select infectious diseases, antimicrobial pharmacokinetics and pharmacodynamics, alcohol withdrawal management, and other disease states consistent with this patient population.
Infectious disease
The primary goal of this rotation is to gain an understanding of appropriate empiric and definitive antibiotic utilization in adult inpatients using the principals of antimicrobial stewardship. Daily activities include supporting Memorial Health University Medical Center's Antimicrobial Management Program (AMP) through prospective audit and feedback, engaging in active dialogue with ID attending, and initiating AMP interventions with medical staff. The resident will also be involved with antimicrobial and microbial surveillance, patient counseling, allergy assessments with penicillin skin testing, pharmacokinetic monitoring, HIV medication management, and providing timely drug information for healthcare professionals and patients. This rotation also allows the resident to participate in daily rounds with an infectious disease consult team.
Internal medicine
The resident participates in patient rounds as an integral part of the internal medicine multidisciplinary team which consists of an internal medicine attending physician, medical residents, PA students, medical students, and an internal medicine clinical pharmacist. The resident provides pharmaceutical care by providing pharmacokinetic consultations and drug information, monitoring for the appropriateness and cost-effectiveness of drug therapy, reporting adverse drug reactions, and assessing drug-drug, drug-disease state interactions. The resident has the opportunity to attend morning report, noon conference, and weekly grand rounds, providing for intense involvement and exposure to a variety of internal medicine topics and discussions. The resident also has direct patient contact and plays an important role in patient education and patient counseling.
Pediatrics
The pediatric rotation places emphasis on pathophysiology and treatment of disease states in the pediatric population within the Memorial Health Dwaine & Cynthia Willett Children's Hospital of Savannah. Dosing medications specific to pediatric patients, alternatives to drug therapy, pharmacokinetics, and selection of antimicrobial regimens are important aspects of this rotation. The pharmacy resident is responsible for rounding with the multidisciplinary pediatric hospitalist team, making medication selection and dosing recommendations, educating medical residents and students about medications specific to the patient's disease state, and drug monitoring. The pharmacy resident will be responsible for topic discussions related to pediatric disease states, as well as daily review of patient medication regimens. The resident is also responsible for a formal case presentation to pharmacy staff and administration, as well as attendance to any medical resident conferences pertinent to their rotation.
Practice management
The resident meets with the pharmacy clinical manager to discuss theories on pharmaceutical administration, budget issues, technology advancements, and other global issues relating to the department and the profession. The resident attends all meetings required by the pharmacy clinical manager. The resident is assigned necessary projects throughout the rotation arising from discussions and meetings. A medication utilization evaluation will be assigned during this rotation to be completed on the rotation with an action plan presented to the P&T Committee if applicable.
Elective rotations
Any core rotation
Core rotations can also be repeated as electives.
Cardiology
The resident will attend daily multidisciplinary team rounds on cardiac patients admitted to the intermediate care unit and may have opportunities to observe interventional cardiology procedures. Instruction includes identifying patients at greatest risk for medication therapy problems, drug information, patient education, discussing medication-related issues with the appropriate physician, providing in-service education to the team, code participation, and contributing to the analysis of adverse drug reactions and/or medication errors. The resident is expected to gain advanced knowledge through literature review, topic discussion, and direct patient care.
Critical Care – Cardiology
The CVICU is a 10-bed ICU. The most common diagnoses seen on service include acute coronary syndrome, arrhythmias, acute decompensated heart failure, and cardiac valvular disease.
The management of the cardiovascular patient can range from a cardiologist, cardiovascular surgeon or pulmonary critical care attending physician, clinical pharmacist, respiratory therapist, nurses, and a clinical nutritionist. The pharmacy resident is responsible for participating as a member of the CVICU team by providing input for treatment planning, identifying and resolving medication therapy problems and monitoring patient care outcomes (efficacy, safety, financial) of all cardiovascular patients in the CVICU. The resident is responsible for ensuring safe and effective medication use, including active participation in work and attending rounds daily; collaboration with other pharmacists to assure timely medication availability; education of patients and their family members, education of physicians and nurses, and education of pharmacy trainees.
Critical Care - Neuro
The neuroscience ICU elective rotation is a specialized rotation focused on illnesses and injuries to the head and spinal cord. There is no single team that manages the neurologically injured patient and can range from an attending pulmonary critical care physician, trauma/surgical critical care service, neurologist or neurosurgeon. To maintain continuity of care with the interdisciplinary team, the resident will round with the pulmonary critical care team that manages the majority of the neurovascular ICU. The resident will also follow all of the neurovascular ICU patients not on their primary rounding team to make recommendations to the patient’s respective team as well as follow consults for all neurovascular ICU patients. The purpose of this rotation is to allow the resident to become an expert in the pharmacotherapeutic management of critically ill neurologically injured patients, including expertise in antiepileptic monitoring and stroke management.
Critical Care – Pediatrics
The pediatric critical care rotation places emphasis on pathophysiology and treatment of disease states in the pediatric ICU population within the Memorial Health Dwaine & Cynthia Willett Children's Hospital of Savannah. Common diagnosis include septic shock, post-op neurosurgical management, acute respiratory failure, acute renal failure, drug overdose management, as well as a variety of other pediatric critical disease states. The pharmacy resident is responsible for rounding with the multidisciplinary pediatric ICU team, making medication selection and dosing recommendations with preceptor guidance, educating medical residents and students about medications specific to the patient's disease state, and drug monitoring. The pharmacy resident will be responsible for topic discussions related to pediatric disease states, as well as daily review of patient medication regimens. The resident is also responsible for a formal case presentation to pharmacy staff and administration.
Critical care - Trauma
As a member of the trauma surgery team, the resident follows trauma patients in the medical, cardiovascular, trauma, and neuro intensive care units. Responsibilities include participating in daily rounds, providing pharmacokinetic consultation, recognizing drug-drug and drug-disease state interactions, reporting and preventing adverse drug reactions, and general monitoring of drug therapy. Care for critically ill patients is a highly specialized area and an increased emphasis will be placed on the monitoring of hemodynamic states, the utilization of appropriate antibiotics, and management of TPNs.
Emergency medicine
This rotation is for PGY1 pharmacy residents. The resident, along with the E.D. pharmacist, will cover all areas of the E.D., including trauma, cardiac treatment, exams, express, observation, pediatrics, admission unit, and the clinical decision unit. This rotation allows the resident to apply the clinical, communication, and teaching skills necessary to interact in a multidisciplinary emergency medicine environment. The practice environment requires daily interaction with physicians, residents, nurses, pharmacy staff, and other healthcare professionals to optimize pharmacotherapy for patients.
Medication safety
The resident will be responsible for reviewing medication adverse event reports, collaborating with department and hospital leadership to resolve medication use system issues, and communicating action plans to the department. Additionally, the resident will conduct a medication use evaluation with a focus on process safety improvement. The resident is involved with the management of investigational drug products according to established protocols, policies, and procedures.
Neonatal
The NICU is a 92- bed Level III unit where the resident will encounter a wide range of disease states and pharmaceutical care needs. The resident will be expected to work closely with the medical staff that will include neonatologists, nurse practitioners, medical residents, medical students, nurses, respiratory therapists, and dieticians to optimize pharmacotherapeutic management and improve patient care and safety. The pharmacy resident is responsible for identifying and resolving medication therapy issues for patients and will assume care of all patients on the service throughout the learning experience. The resident will follow and provide recommendations for neonatal patients receiving drugs requiring monitoring. The resident is responsible for optimization of medication use through interaction with the neonatal ICU Teams, order review, drug therapy monitoring, participation in high‐risk procedures including resuscitation and other time dependent emergencies, monitoring use of high‐risk medications, medication procurement and preparation, and provision of drug information. Emphasis is placed on designing evidence-based therapeutic regimens and monitoring plans, as well as communication with other healthcare providers and improving time- and task-management skills.
Oncology
This rotation exposes the resident to a variety of issues involved in the management of adult inpatient oncology/hematology patients at Memorial Health. Daily responsibilities include providing patient counseling for all chemotherapy patients, providing recommendations for the management of chemotherapy-induced side effects, and answering oncology-related drug information requests. During the rotation, the resident has topic discussions, journal club, and a case presentation focused on patients seen during the rotation. In addition, if needed, the resident presents a brief in-service for the oncology nursing staff. Other experiences during the rotation include attendance at weekly multi-disciplinary tumor board meetings.
Psychiatric
The Psychiatry I rotation will provide the resident with experience in an inpatient behavioral medicine unit at an academic medical center. The resident will be exposed to numerous psychiatric diseases states. The resident will participate in daily patient review and round with the attending psychiatrist (patients admitted to the behavioral health unit), participate in daily multidisciplinary treatment team rounds, and round on patients admitted to the main medical floors that the psychiatry team has been consulted on.
Additional elective rotations
- Critical Care - Medicine II
- Emergency Medicine II
- Infectious Disease II
- Internal Medicine II
- Pediatrics II
- Psychiatric II
Longitudinal experiences
Code Blue
The Code Blue Participation experience is a required longitudinal 12 month learning experience at MHUMC. The purpose of the rotation is to develop the necessary skills to become a leader and expert in the management of medical emergencies in code blue responses.
In a code blue response, the pharmacy resident is responsible for preparing medications for administration, calculating dosages and drug infusions, and keeping medication administration time intervals per ACLS guidelines. The pharmacy resident is expected to respond to all code blue responses during assigned rotation hours and during any staffing.
Research Project and MUE
Residents will present a year-long research project at the Southeastern Residency Conference in the spring. Residents will work with the research coordinator starting at the onset of the year and will meet regularly to discuss issues and progress. Residents will also be active in coordinating sponsored research throughout the health system. In addition to the research project, each resident is responsible for one Medication Use Evaluations that are coordinated by the program director and presented to the P&T Committee.
Staffing
Staffing is a required longitudinal 12-month rotation at MHUMC and serves as an opportunity for the resident to develop foundational practice skills in pharmacy practice. The resident will gain proficiency in distribution and clinical skills, personnel management and leadership skills, and insight into process improvement opportunities for acute care facilities.
Teaching certificate
Residents participate in a program administered by Mercer University that encompasses teaching strategies, both didactic and experiential. After completion of the requirements of the program through submission of a teaching portfolio, the resident is eligible to receive a teaching certificate.
Additional information
Other areas of interest addressed by residents will be evaluated by the program director and will be coordinated if appropriate with the guidelines set forth by the ASHP Standards of Pharmacy Practice Residencies.
Regular meetings are held with the pharmacy director and manager to discuss the practice of pharmacy and other issues pertinent to the profession. Journal Club is held regularly for article discussion as well as case presentation. Residents also present a 60-minute CE presentation and precept pharmacy students as well as provide education for the pharmacy, nursing, and medical staff.