ESSENTIAL FUNCTIONS
Serves in a professional capacity on unit-based decentralized teams when applicable. Monitors patients to assure optimal therapeutic outcomes. Monitors drug therapy regimens for contraindications, drug-drug interactions, drug-food interactions, adverse drug reactions, and appropriateness of drug and dose. Identifies and intervenes when problems involving drug therapy arise (i.e. allergies, drug interactions, therapeutic duplication, and adverse drug reactions).
Functions as a therapeutic consultant and works collaboratively with providers to provide guidance on appropriate use of medications, clinical pharmacology, pharmacokinetics, disease state management, and nutrition. Recommends evidence-based medication therapy regimens and monitoring plans. Suggests appropriate, cost-effective therapeutic alternatives to medical staff as needed.
Reads, extracts, and interprets information in patient charts accurately
Documents clinical activity/interventions as performed.
Provides pharmacokinetic consultation services as directed per protocol.
Follows and adjust medications based on patient specific factors (renal function, weight, etc.) as directed per hospital protocol.
Reviews/interpret culture and susceptibility data for antibiotic appropriateness and recommend changes as needed.
Reviews medication orders for appropriate IV to PO interchanges as directed per hospital protocol.
Evaluates need for all non-formulary medication requests and initiates approved therapeutic medications substitutions. Sustains formulary by minimizing non-formulary procurements, utilizing therapeutic ¬substitution protocols, and promoting rational drug therapy selection
Assesses total parenteral nutrition (TPN) monitoring and documentation per pharmacy guidelines and communicates therapeutic recommendations.
Acts as a consultant to healthcare professionals and patients regarding utilization of pharmaceutical therapies.
Promptly respond to inquiries with evidence-based and cost-effective therapy recommendations.
Provides direct patient interaction via bedside encounters, medication reconciliation, discharge counseling or as otherwise directed.
Promptly performs patient assessments and participate in the multidisciplinary clinical rounds on the patient care unit as directed.