Clinical Pharmacist

Pharmacy Technician

The pharmacist provides appropriate selection of drug therapy based upon the pharmaceutical principles of pharmacokinetics and pharmacodynamics; monitoring for efficacy, side effects and clinical outcome; and advises prescribers as appropriate.

Provides patient-specific therapeutic drug monitoring and communicates relevant findings and/or recommendations to other health care providers in charge of the patient both orally and in writing via notes in the electronic health record. Monitoring will include prospective review and intervention in:

• Therapeutic appropriateness of a patient's drug regimen
• Therapeutic duplication in the patient's drug regimen
• Appropriateness of the route and method of administration
• Degree of patient compliance with the prescribed drug regimen
• Drug-drug, drug-food, drug-laboratory, or drug disease interactions
• Clinical and pharmacokinetic laboratory data to evaluate the efficacy of drug therapy and to anticipate side effects, toxicity, or adverse effects

• Physical signs and clinical symptoms relevant to the patient's drug therapy
• Performs continuous evaluation of prescribed medications to assure optimal drug therapy
• Provides medication counseling to patients
• Completes medication histories including patient interviews
• Serves as a drug information resource by providing up-to-date drug information to prescribers, other health care professionals, patients and caregivers
• Participates in patient care rounds, review charts, evaluates pertinent laboratory data, drug-drug and drug-nutrient interactions, monitors for adverse drug effects, and screens for allergies
• Performs medication reconciliation at all transitions of care, including updating the medication profile to reflect an accurate, active list of VA and non-VA medications. This may include adding non-VA medications or discontinuing duplicate medications or those the patient is not taking
• Reports adverse drug events (ADE), close calls, and medication errors in alignment with VA ADERS reporting program and the hospital Joint Patient Safety Reporting (JPSR) program respectively
• Participates in the medical center medication utilization evaluation (MUE) program
• Participates in medical emergencies including code teams and emergency preparedness activities
• Provides pharmacokinetic consultation, including dosing vancomycin aminoglycosides and anticoagulants, in accordance with local policy.
• Implements P&T Committee policies including therapeutic interchanges and automatic substitutions to include appropriate patient and provider education
• Manages recalls and medication shortage situations by substituting alternate dosage strengths and instructions of the same medication to equal the prescribed dose and schedule
• Enters supply orders appropriate for patient care per facility policy

Reviews all medication orders for appropriateness, drug selection, dosage, route of administration and the amount, prior to dispensing

Ensures all medication orders are entered into the electronic patient medical record

Fills all orders in a timely fashion; a systematic review of the patient's allergy history, drug-drug, drug-nutrient, drug-laboratory and drug-disease state interactions and assessment of the clinical relevance should be performed and dealt with appropriately

Reviews medication profiles and monitors for compliance or potential abuse; problems encountered shall be resolved

Selects, compounds, dispenses and fills a range of drugs including extemporaneous preparations, special formulations, ophthalmics, narcotics, investigational drugs, oncolytic agents, etc., in both outpatient and inpatient areas. Adequate quality assurance procedures shall be followed as applicable

Maintains adequate drug stock, inspects drug storage areas, supervises prepacking and the operation of automated dispensing equipment

Supervises the activities of support personnel

Ensures drugs dispensed are completely and correctly labeled and packaged in full compliance with Federal rules and regulations

Work Schedule: 3:00 - 11:30pm, Mon - Fri, rotating weekends and holidays

Telework: Not Available

Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized

Permanent Change of Station (PCS): Not Authorized