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Internships

Purpose

The purpose of the inpatient internship program is to provide knowledge and practical experience necessary for functioning competently and effectively upon licensure in a health-system pharmacy. This internship seeks to prepare students for residency training or careers in a hospital beyond graduation.

Program Details

The program is now a year-round internship with a 12-week summer component (after P1 coursework) and a weekend commitment at least every six weekends throughout the academic year. The 12-week rotational experience includes rotations such as central pharmacy, sterile and non-sterile compounding, drug information, pediatric satellite, chemotherapy satellite, medication reconciliation, and clinical drug monitoring with an operational focus for first year interns. Requirements of the program include a summer project, two presentations, attendance at pharmacy intern meetings and clinical pharmacy conferences. The internship start and end dates are flexible depending on department and student final exam schedules. It is ideal if all students can start and end on the same dates. The summer portion of the internship runs May-August.

Eligibility

The candidate must have completed three years of college coursework including the first professional year in pharmacy school (completed the P3 year of a P6 program or P1 year of a P4 program). It is ideal if students can apply during their P1 year to be considered for two consecutive summers. Applicants must possess an Ohio internship license and be able to work weekends throughout the academic year. Entry into this internship program is competitive and students will be evaluated on various parameters including career goals, prior rotation experience (IPPE’s), communication skills, and ability to work in a dynamic team atmosphere. Candidates should plan for virtual online interviews in late February or early March.

Applications

Please submit a complete application including a letter of intent, CV and three letters of recommendation by February 15, 2014 at the following link: http://form.jotform.us/form/33077640078153

Recommendation letters should be in PDF format and must be signed by the author. Recommendation letters may also be submitted separately by the author via the link above. Mailed or incomplete applications will not be accepted.

Contact

Garrett Eggers, PharmD, MS

Manager – Inpatient Pharmacy
Cleveland Clinic Foundation
Department of Pharmacy/Hb105
9500 Euclid Avenue
Cleveland, OH 44195
Phone: 216.444.1751
Email: eggersg@ccf.org

Purpose

The purpose of the community pharmacy summer internship program is to develop knowledge and skills in community pharmacy to assist with patient transition from hospital to ambulatory pharmacy care.

Program Details

Community Pharmacy interns will rotate through a variety of outpatient pharmacy settings within the Cleveland Clinic enterprise including main campus, family health centers, and outpatient pharmacies within community hospitals. Experiences will include: patient consultation, technical functions, medication therapy management, specialty medication services, technology development, and quality assurance. Requirements of the program include a summer project, two presentations, attendance at pharmacy intern meetings and clinical pharmacy conferences. The internship program is currently designed for a 12-week rotation experience during the summer months only; start dates are flexible depending on department and student final exam schedules. The summer internship usually runs May-August each year.

Eligibility

Same as above for inpatient year-round internship program with the exception of weekend requirements during academic year. It is ideal if students can apply during their P1 (of P4 program) year to be considered for two consecutive summers, although P2 candidates will be considered. Ohio internship license is required.

Applications

Please submit a complete application including a letter of intent, CV and three letters of recommendation by February 15, 2014 at the following link: http://form.jotform.us/form/33077640078153

Recommendation letters should be in PDF format and must be signed by the author. Recommendation letters may also be submitted separately by the author via the link above. Mailed or incomplete applications will not be accepted.

Contact

Angie Ortenzi, RPh

Assistant Director of Operations
Ambulatory Pharmacy Services
Cleveland Clinic
Department of Pharmacy
9500 Euclid Avenue/JJN-10
Cleveland, OH 44195
Phone: 216.444.3401
Email: ortenzi@ccf.org

Examples of Student Longitudinal Projects

  • Evaluation of inpatient administration of medications that should be given in HOP setting only (e.g., infliximab, select chemo, etc.)
  • Develop and implement a patient satisfaction survey for the anticoagulation clinics.
  • Develop weekly communication regarding formulary changes, drug shortages and alternatives, and drug recalls, or any other pertinent information from the FDA, etc.
  • IVIG drug usage evaluation in BMT population

Example of Completed Intern Project Abstract

Moxifloxacin Drug Use Evaluation

Purpose 
Moxifloxacin was added to the Cleveland Clinic Formulary in July 2008. It is restricted to penicillin-allergic patients with community-acquired pneumonia (CAP). Ceftriaxone plus azithromycin is the preferred treatment for CAP. Limiting fluoroquinolone use may assist with preventing the emergence of quinolone-resistant isolates. In addition quinolone use, especially moxifloxacin, has been reported with increased C. difficile rates. Therefore, determining if moxifloxacin is prescribed appropriately is important to reduce the possibility of resistance and C. difficile infections.

Methods
A concurrent, non-interventional chart review of patients prescribed moxifloxacin from January 2010-June 2010 was performed. The Cleveland Clinic electronic medical records system (EPIC) was utilized to review and analyze a sample of these patients. Any patient 18 years of age and older who received moxifloxacin was included in the study. Patients treated in the Emergency Department or for tuberculosis (TB) or non-mycobacterial TB were excluded. Data collected included: age, gender, nursing unit, penicillin allergy, type of allergic reaction if applicable, indication for moxifloxacin use, initial formulation of medication, duration of therapy, Infectious Disease consult, and other antimicrobial agents.

Results
165 patients were prescribed moxifloxacin during the time period. 70 patients were reviewed. 18 patients were excluded: four did not receive the medication, 13 were treated in the emergency department, and one was treated for Mycobacteria tuberculosis. A total of 52 patients were analyzed. The average age of the patients was 61 years (± 14 years). The median length of stay (LOS) was nine days (2-36 days). 28 patients were allergic to penicillin with the most common reactions of: rash/itching (nine), hives (five), and anaphylaxis (four). 16 patients were correctly prescribed moxifloxacin (30.7%) according to the restriction. 36 patients did not meet the restriction criteria; the most common indications were: CAP/presumed CAP with no penicillin allergy (13), HAP/HCAP (eight), sinusitis (five), COPD exacerbation (three), and bronchitis (two). In the non-adherence group, the median duration of therapy was three days (1-16 days). Seven non-adherence patients only received one dose and 29 patients were discharged on moxifloxacin. Infectious Disease was consulted for 19 of the non-adherence patients (53%).

Conclusion 
Overall adherence to the restriction appears poor (30.7%). However, a significant portion of use was for patients with penicillin allergies and upper respiratory tract infections. Consideration should be given to expanding the restriction criteria to include other URTIs (e.g., sinusitis, bronchitis) in penicillin allergic patients. Another significant use in the non-adherence group was for the treatment of HAP/HCAP. Ciprofloxacin is the quinolone of choice in this infection due to improved Pseudomonal activity. Finally, the type of penicillin allergy needs to be taken into consideration. Ceftriaxone and azithromycin may be used for non-severe reaction (e.g., rash). Moxifloxacin should not be used when the listed allergy is adverse reaction (e.g. nausea). Education should be provided to the health care team on these matters.