Nutrition Support Rotation

Nutrition Support Rotation

Rotation Goal

The goal of the nutrition support rotation is to allow the PGY1/PGY2 resident the opportunity to enhance his/her knowledge base and develop clinical skills in providing nutrition support therapy.  In collaboration with other healthcare professionals, the resident will gain direct patient care experience and become familiar with providing nutrition support for adult and pediatric patients. The pharmacy resident will be expected to function as a Nutrition Support Pharmacist and manage consults by the end of the rotation. 

Rotation Description

The nutrition support rotation will provide the resident the opportunity to become independent in providing appropriate parenteral nutrition orders for hospitalized patients including adult and pediatric populations.  The resident will provide pharmaceutical care as described below:

  • Assess patients nutritional goals based on patient-specific parameters
  • Collecting and organizing patient-specific information
  • Determining the presence of medication-therapy problems related to administration of medication and nutrition support therapy and/or medication/nutrient interactions. 
  • Work as part of an inter-disciplinary team to assess the nutritional goals and design patient specific plans.
  • Design and re-design the parenteral nutritional prescription orders using appropriate knowledge base and monitoring parameters.
  • Using the Nutrition Support Core Curriculum (Adult and Pediatric) to follow patients with conditions needing specialized nutrition support therapy and discuss weekly readings with preceptor. 

Rotation Activities 

  • Evaluate appropriateness of nutrition support therapy
  • Develop a parenteral nutrition formula with respect to age, disease state, and specialized needs and access sites.
  • Monitor patient-specific therapeutic regimens daily, focusing on appropriate lipid, carbohydrate, protein, vitamin and mineral requirements, and electrolyte needs.
  • Be familiar with parenteral nutrition preparation techniques and components, and  considerations for stability and compatibility
  • Evaluate patient's fluid requirements and review patient's daily intake and output record as appropriate
  • Monitor patients daily to redesign nutrition support therapy while on parenteral nutrition and/or transitioning to enteral/oral feeding
  • Describe the different formulary enteral formulas with respect to differences in concentration and composition for specific disease states
  • Round with nutrition support dietitian
  • Review common enteral nutrition - drug interactions
  • Review enteral access tubing and feeding methods
  • Evaluate medication regimens for drug/nutrient interactions, drug duplication, and preventing incompatibilities
  • Demonstrate influence in helping ensure adherence to medication use policies, such as non-formulary conversions and criteria for use of specific therapies
  • Transition to home care
    • Develop cyclic parenteral nutrition regimen for transition to home or long-term care.
    • Communicate with home care as needed to safely transition patients to outpatient care, or from outpatient to inpatient care 

Rotation Requirements

  • Required hours 7:30 am to 4 pm. The times may vary based on patient care and team needs. Absences must be approved in advance.
  • Required weekly readings as decided upon by the preceptor
  • Document therapeutic interventions in the clinical decision support software, Theradoc®
  • Participate in adverse drug reaction reporting
  • Provide drug information to patients or caregivers as requested
  • Assist in precepting pharmacy students and attend student presentations and topic discussions
  • Effectively communicate with physicians, nurses and other members of the health care team when discussing nutrition therapy
  • Utilize Baxa automated compounder and ABACUS accompanying software

Julianne Harcombe RPh, BCNSP
(813) 870-4870