Clinical Pharmacist
Current• Verifies electronic medication orders through Meditech while ensuring appropriate timing of medication administration and screening for drug therapy problems• Doses, monitors, and optimizes a wide range of antimicrobials, including but not limited to: antibiotics, including vancomycin and aminoglycosides, antifungals and antivirals• Doses, monitors, and adjusts anticoagulants (warfarin, DOACs, enoxaparin and heparin)• Identifies patients who may benefit from IV to PO medication conversion for PPIs and H2RAs, and converts these patients per hospital protocol• Provides medication education and counseling upon discharge as well as during length of stay• Works up inpatients and provides specific drug therapy recommendations directly to physicians and/or nurses• Reconciles patient medication history to obtain an accurate and thorough medication and allergy list• Dispenses IV and PO medications in accordance with aseptic technique and USP standards• Verifies dispensed medications for accuracy and quality• Serves as drug information resource to physician, nurses, and other medical staff• Responds to code emergencies (stroke, STEMI, cardiac arrest, and trauma) and doses and prepares emergent IV medications• Assist fellow pharmacy preceptors in educating and training pharmacy students on IPPE/APPE• Monitors and reports adverse drug reactions (ADRs)• Provides diabetes monitoring and education, including lifestyle modifications, blood glucose monitoring, and medication adherence• Reviews patient charts for drug therapy problems and communicates specific recommendations• Engages in antibiotic stewardship by ensuring appropriate selection of antibiotics based on patient characteristics, clinical status and microbiology
