The Clinical Pharmacist provides distributive and clinical Pharmacy support service to primary care, medicine, surgery and specialty clinics within the VAWNYHS. The scope of practice of the CP covers direct and indirect patient care, drug therapy monitoring, quality assurance/improvement, staff/patient education and consultation. The Clinical Pharmacist serves a multi-functional role and is specially prepared by education and experience to have an advanced knowledge of pharmacology, pharmacokinetics, pharmacodynamics, and pharmacotherapeutics. The Clinical Pharmacist spend a significant amount of time in the distributive and clinical areas of practice within the facility. These areas include, but are not limited to: medication processing and distribution, informational technologies, drug information and medication reconciliation. Distributive: Fills medication orders by selecting the correct drug and dosage form, reducing the drug from bulk to the quantity prescribed, compounding when necessary, then packaging and labeling the drug in an appropriate manner. Responsible for the dispensing of drugs, especially controlled substances, investigational and cytotoxic drugs, to assure that legal and agency regulations and instructions are followed, that proper and complete recordkeeping is maintained, and that the drug storage areas are stocked, safe, and secure. Reviews the patient medication profile prior to dispensing drugs and medications to ensure safe and appropriate medication use. Responsible for special formulations, and for extemporaneous compounding of routine and special medications requiring complex compounding procedures. Initiates medication orders for patients per approved protocol, established guidelines or provider consultation. Responsible for providing care in inpatient or other areas as required to meet patient care needs and to maintain competence in those areas of pharmacy practice. Clinical Duties: Identifies drug-induced problems that may be affecting the patient, takes appropriate steps to manage these problems and/or communicates these findings to his/her primary provider (includes drug side effects, allergic reactions, toxicities, dosage regimens, and non-compliance concerns). Reviews and recommends therapeutic care plans utilizing the most effective, least toxic, and most economical medication treatments, recognizing the special drug considerations of the age and stage of life for the patient, and communicates this plan to the patient's primary provider. Monitors patient profiles and ensures information is correct and up-to-date. This may include addition of or correction of documented allergies/ADRs, addition of or discontinuation of non-VA medications and discontinuation of orders per current scope of practice. Applies pharmacokinetics, using rate order equations as appropriate to assess serum levels using volumes of distribution and/or renal and hepatic clearances and to make recommendations when necessary. Analyzes laboratory, imaging and clinical data so as to make recommendations for modifying drug dosing when necessary in an effective manner and to rule out drug interferences or interactions. Makes suggestions to aid in the selection of alternate medications in cases where the initially selected plan fails to achieve the desired therapeutic result, are not available or when a more cost-effective approach appears appropriate. Applies the VISN2 auto-substitution protocols where indicated. Communicates this information to the patient's primary provider. Conducts drug usage evaluations, and monthly reviews of drug regimens for long term care patients/residents in accordance with medical center/pharmacy policy and JCAHO standards. Education: Assists in the orientation and training of new pharmacy employees, pharmacy residents, pharmacy students, medical residents, medical students, attending providers and pharmacy volunteers. Functions as a consultant to the medical staff on pharmacotherapeutics, pharmacokinetics, and toxicology via effective written and oral communication. Facilitates clinical portions of preceptorship programs for pharmacy interns and externs. Performs in-service training to pharmacy, medicine, nursing, and other disciplines as scheduled. Quality Assurance and Improvement: Participates in the DUE/MUE process by assisting in; determination of problem areas, criteria development, analysis and follow-up as deemed appropriate; e.g., education, review, etc. Documents all patient-centered workload according to current VISN2 Pharmacy guidelines. Research: Dispenses investigational and research drugs to inpatients and outpatients as required in accordance with VA policy. Participates in pharmacy research to optimize operational efficiency; e.g., in the testing of new VISTA/CPRS or other software, use of pharmacy technicians in functions formerly provided by pharmacists, etc. Work Schedule: Rotating tours including some nights and weekends Telework: Available Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.