Implementation of a pharmacy residency resiliency program for PGY1 and PGY2 residents: Program structure and resident perceptions.

PURPOSE: To describe the implementation of a pharmacy residency resiliency program (PRRP) for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residents, including program structure, strengths and weaknesses/limitations, resident perceptions as captured by a postprogram survey, generalizability to other institutions, and opportunities for future directions. SUMMARY: Pharmacy residents face significant pressure, workload, and stressors that put them at risk for burnout and depression. While resiliency has been a major area of focus to help combat these risks for healthcare professionals, little has been published regarding formal, structured resiliency training in pharmacy, especially in pharmacy residency programs. American Society of Health-System Pharmacists (ASHP) residency standards recommend that programs consider education related to burnout prevention and that mitigation strategies be provided to residents and other pharmacy personnel, but no formal pharmacy-specific programs or strategies have been established. We implemented a 12-month PRRP for PGY1 and PGY2 pharmacy residents and conducted a postprogram survey to assess resident perceptions and to identify areas for growth. CONCLUSION: Implementation of a PRRP was feasible and could be replicated at other institutions. Residents in our program reported a high level of satisfaction, skills gained, and positive attributes of the addition of the PRRP. Some notable factors contributing to success included the program's longitudinal nature, use of a nonpharmacy facilitator, and impactful content from an established resiliency skills curriculum.

Weaning Analgosedation in Patients Requiring Prolonged Mechanical Ventilation.

Although research supports the minimization of sedation in mechanically ventilated patients, many patients with severe acute respiratory distress syndrome (ARDS) receive prolonged opioid and sedative infusions. ICU teams face the challenge of weaning these medications, balancing the risks of sedation with the potential to precipitate withdrawal symptoms. In this article, we use a clinical case to discuss our approach to weaning analgosedation in patients recovering from long-term mechanical ventilation. We believe that a protocolized, multimodal weaning strategy implemented by a multidisciplinary care team is required to reduce potential harm from both under- and over-sedation. At present, there is no strong randomized clinical trial evidence to support a particular weaning strategy in adult ICU patients, but appraisal of the existing literature in adults and children can guide decision-making to enhance the recovery of these patients.