Pediatric Pharmacy Inpatient Care Programs

1 The Pediatric Pharmacy Inpatient Programs are managed by our Pediatric Clinical Pharmacy Specialists (CPSs), Point-of-Care Pharmacists (PCPs), Night Shift Pharmacists, and Pharmacy Coordinators. Together, all Pediatric Pharmacists work collaboratively, in order to fulfill the duties outlined within each of the Programs listed. With adequate collaboration and communication, the Pediatric Pharmacy Inpatients Programs : Optimize safe and effective use of medications Enhance patient care and outcomes Advance the clinical knowledge and expertise of our Pediatric Pharmacy staff Enhance collaboration among Pediatric Pharmacists and the medical teams The Pediatric Pharmacy has developed and maintains multiple Inpatient care Programs which include: 1.

2 Clinical Pharmacy Specialist On-Call Program 2. Pediatric Pharmacy Rapid Response Team and Emergency Program 3. Inpatient Clinical Pharmacokinetics Competency Program for Vancomycin and Aminoglycoside Therapeutic Drug Monitoring Program 4. Inpatient anticoagulation Program 5. Transplant and Immunosuppressant Therapeutic Drug Monitoring Program Outline of Clinical Inpatient Care Program Coverage Responsibility Daytime Hours: Mon Fri, 0800 1600 Evening Hours: Mon Fri, 1601 0759 Weekends Department Holidays PK Primary: Team CPS/PCP Back-Up 1: PCP for the unit Back-Up 2: CPS On-Call Back-Up 3: Back-Up CPS On-Call Primary: PCP Back-Up 1: CPS On-Call Back-Up 2: Back-Up CPS On-Call AC Primary: CPS for Service Back-Up 1: CPS On-Call Back-Up 2: Back-Up CPS On-Call Primary: CPS On-Call Back-Up 1.

3 Back-Up CPS On-Call SOT TDM Primary: Team SOT CPS Back-Up 1: PCP for the unit Back-Up 2: CPS On-Call Back-Up 3: Back-Up CPS On-Call Primary: PCP Back-Up 1: CPS On-Call Back-Up 2: Back-Up CPS On-Call BMT TDM Primary: Nicole Arwood/PCP Back-Up 1: PCP for the unit Back-Up 2: CPS On-Call Back-Up 3: Back-Up CPS On-Call Primary: PCP Back-Up 1: CPS On-Call Back-Up 2: Back-Up CPS On-Call AC: anticoagulation ; BMT: Bone Marrow Transplant; PK: Pharmacokinetics; SOT: Solid Organ Transplant; TDM: Therapeutic Drug Monitoring Pediatric Pharmacy Inpatient Care Programs Clinical Pharmacy Specialist On-Call Program All Pediatric Clinical Pharmacy Specialists (CPSs) are required to serve as CPS On-Call, and Back-Up CPS On-Call on a rotating, weekly schedule.

4 The CPS On-Call is responsible for review of therapeutic drug monitoring (TDM) inquiries, assisting with additional clinical inquires when contacted, and managing warfarin for patients at Kennedy Krieger Institute (KKI) and services not covered by another CPS. When unavailable, the Back-Up CPS On-Call shall fulfill these duties. The CPS On-Call Schedule is outlined on the Outlook Calendar accessible to all Pediatric Pharmacists Procedure for Contacting CPS On-Call during Evening Hours, Weekends, and Department Holidays NOTE: All inquiries shall be vetted through the CPS On-Call, who can at their discretion involve other CPSs as needed 1.

5 First contact the CPS On-Call via preferred method of contact listed below. If no response within 15 minutes, contact via same method again. 2. If no response within 15 minutes after 2nd attempt, contact the CPS On-Call via 2nd (or 3rd) preferred method of contact 3. If no response after 15 minutes after 3rd attempt, contact Back-Up CPS On-Call via preferred method listed below Clinical Pharmacy Specialist (CPS) Service(s) Contact Numbers Preferred Methods of Contact: Evening Hours (Mon Fri, 1601 0759) Weekends Department Holidays Alice Hsu Pediatric Infectious Disease Cell: (908) 463 1148 1.

6 CORUS 2. Call Cell Alice Pan Pediatric Pulmonology & Outpatient Cystic Fibrosis Cell: (270) 791 6355 1. CORUS 2. Call Cell Bethany Sharpless Neonatal Intensive Care Cell: (607) 592 1186 1. Call Cell 2. CORUS Carlton Lee General Pediatrics (Neil & Zinkham) Cell: (443) 622 8509 1. CORUS 2. Call Cell David Procaccini Pediatric Intensive Care (PICU) Green, PICU Red (Odd Months), & cardiology /Heart Transplant Cell: (609) 937 6202 1. Call Cell 2. CORUS Elizabeth Goswami Pediatric Nephrology and Kidney Transplant Cell: (605) 949 1410 1. CORUS 2. Call Cell Kim Conner Pediatric Surgery, Gastroenterology, Nutrition, & Liver Transplant Cell: (443) 838 9698 Home: (443) 327 6546 1.

7 Call Cell 2. CORUS 3. Call Home LeAnn McNamara PICU Blue Team & PICU Red (Even Months) Cell: (443) 876 5520 Home: (410) 497 5882 1. CORUS 2. Call Cell 3. Call Home Lisa Hutchins Pediatric Emergency Medicine Cell: (443) 206 6702 1. CORUS 2. Call Cell Nicole Arwood Pediatric Oncology & Bone Marrow Transplant Cell: (708) 606 7017 1. CORUS 2. Call Cell Pediatric Pharmacy Rapid Response Team and Emergency Program All Pediatric pharmacists shall actively respond to medical emergencies in The Children s Center as outlined below The Pediatric Clinical Pharmacy Specialists (CPSs) shall carry the Rapid Response Team (RRT) pager on a rotating, weekly schedule, outlined on the department Outlook Calendar accessible to all Pediatric Pharmacists Emergency Response Page Central Pediatric Pharmacist Response Location Who Responds and Hours ROC: Resident On Call Peds RX.

8 Pediatric Point of Care Pharmacist or Coordinator CPS: Pediatric Clinical Pharmacy Specialist PPR: Peds Pharmacy Resident, IPR Resident Pediatric Rapid Response Team (RRT) Yes Children s Center, Common Areas, Historic Campus, Wilmer M-F 0800 1600: CPS/PPR + Peds RX M-F 1600 2300: ROC + Peds RX M-F 2300 0700: Peds Night Shift Pharmacist M-F 0700 0800: Peds RX Sat/Sun: 0700 1100: Peds RX Sat/Sun: 1100 2300: ROC + Peds RX Sat/Sun: 2300 0700: Peds Night Shift Pharmacist Pediatric Brain Attack Team (BAT) No Children s Center No Pediatric Pharmacist response unless page in conjunction with a Pediatric RRT Page is primarily an alert to look for STAT alteplase EPIC orders Pediatric Difficult Airway Team (DART) Yes Children s Center Respond to all Pediatric pages (ICU, Non-ICU, and PED Patients) 24 hours a day Pediatric Pharmacists will respond to Pediatric patients based on location M-F 0800 1600: CPS/PPR + Peds RX M-F 1600 2300: ROC + Peds RX M-F 2300 0700.

9 Peds Night Shift Pharmacist M-F 0700 0800: Peds RX Sat/Sun: 0700 1100: Peds RX Sat/Sun: 1100 2300: ROC + Peds RX Sat/Sun: 2300 0700: Peds Night Shift Pharmacist Alpha Trauma No Peds ED M-F 0700 1530 PM: Peds ED CPS (also attends Bravo Traumas) M-F 1300 2100: Peds ED PCP (when scheduled and also attends Bravo Traumas) M-F 1600 2300: ROC (+/- adult ED CPS Sat/Sun: 1100 2300: ROC May receive phone requests to assist outside of Peds ED CPS/Peds ED PCP hours. Please assist if staffing allows. Pediatric Expedited Transfer (PET) to PICU No Peds ED M-F 0700 1530: Peds ED CPS M-F 1300 2100: Peds ED PCP (when scheduled) M-F 1600 2300: ROC Sat/Sun: 1100 2300 ROC ECMO/ECPR No PICU/NICU No Centralized Pediatric Pharmacist response unless page is in conjunction with a Pediatric RRT Page is primarily an alert to expect STAT ECMO orders in EPIC or paper orders from the FAX machine M-F 0700 2200.)

10 PICU/NICU PCP (+/- PICU/NICU CPS) JHOC, KKI, Rubenstein Clinic No JHOC, KKI, Rubenstein Clinic Pediatric Pharmacists are not required to respond to JHOC, KKI, or Rubenstein JHOC has their own emergency response team KKI has their own emergency response team, however if the KKI PCP is located in KKI at the time of the emergency they should respond Rubenstein calls 911 Clinical Pharmacokinetics Competency Program for Vancomycin and Aminoglycoside Therapeutic Drug Monitoring Overview and Pharmacist Responsibilities The Pediatric Pharmacy Division provides a comprehensive clinical pharmacokinetics (PK) service for the therapeutic drug monitoring (TDM) of vancomycin and aminoglycosides.