ADS Nutrition

Three great take aways for me from this session include:

Complications with enteral feeds include:

  • Aspiration due to wrong tube placement
  • Aspiration due to vomiting
  • Diarrhea (due to malabsorption) (Diarrhea does not occur due to tube feeding it occurs due to malabsorption)

Indications for PN:

Contraindications to PN include:

  • Functional GI tract
  • Required < 5 days
  • Inability to obtain venous access
  • Risk outweighs benefits

ADS: ECGs

ECGs are a crucial part of the patient care journey as they help us understand cardiac diseases the patient may be experiencing. A step-wise approach to ECG interpretation is a very useful way of going about your interpretation. A great resource to reteach yourself or to teach yourself can be found here: http://peterloewen.com/ecg-interpretation/

Leadership Rotation:

Management Vs Leader:

Management: 

  • Follow processes and procedures 
  • Compliments leadership by organizing staffing 
  • Organize
  • Controlling a group to accomplish a goal 
  • Maintain 

Leadership: 

  • Set the direction 
  • Develop a vision for the future with strategies to make the changes 
  • Motivate, influence 
  • Strategic thinking 
  • Challenges

Management is more task oriented 

Leadership is the visionary, get everyone board, ability the influence 

Leadership project:

My leadership project was to conduct a literature review on remote medication order hubs, and write an SBAR on the implementation of these hubs into medium sized hospitals in Fraser Health. Based on my literature review I drafted an SBAR which highlighted the benefits of the medication order hub along with how to implement the hub and certain data which should be collected to help validate the hub.

Commitment to the profession:

To me commitment to the profession means adhering to the current scope of practise and maximizing pharmacist role in patient care. We must adhere to our current scope of practise so we can showcase the benefit which pharmacists bring to the team. We also must constantly showcase the benefit of the pharmacist to the patient team as it allows other HCPs to understand our role and our impact. Moreover, by adhering to our scope and maximizing our role we can slowly expand our scope of practise. Commitment to the profession also means to be as involved as possible with regards to different committees and initiatives, especially when medications are involved. By doing this we can showcase what our scope is and the role the pharmacist plays in patient care to other HCPs.

ADS- Stroke

Stroke AKA CVA (cerebral vascular accident), Defined as a sudden loss of brain function with evidence on imaging

Ischemic stroke risk doubles every year >55 y/o

Statins may increase the risk of hemorrhagic stroke in those with a previous stroke. Not seen in pts without previous stroke. Statins are used post subarachnoid haemorrhage with mortality benefit

For subarachnoid haemorrhage we use Pravastatin as it reduces vasospasm

Liver Cirrhosis

The stages of Liver cirrhosis are identified in the image below:

In Liver Cirrhosis the following lab abnormalities can be seen. However, it should be noted that AST and ALT are not always elevated b/c damage can be so severe

Primary Prophylaxis for Variceal bleeds includes: Non selective-Beta-blockers and Carvedilol

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