Clinical Pharmacist (Ambulatory)

Department of Veterans Affairs

The Clinical Pharmacist provides distributive and clinical Pharmacy support service to primary care, medicine, surgery and specialty clinics within the VAWNYHS. The duties of the CP cover direct and indirect patient care, drug therapy monitoring, quality assurance/improvement, staff/patient education and consultation.

• Duties include, but are not limited to: 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 as required to meet patient care needs and to maintain competence in your areas of pharmacy practice. Dispenses investigational and research drugs to patients as required in accordance with VA policy. 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. Counsels patients and family members concerning directions for use, side effects, precautions, and the need to strictly follow the regimen. 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. Provides consultation to physicians, nurses, and other health professionals on medication management issues. This may include formal rounds, informal rounds, formal consults and informal consults and may be verbal, telephone or written consultations. 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. Education: Accurately completes all assignments in a timely manner with independence and minimal guidance, personally setting the deadlines for work completion as defined by immediate supervisor or other member of the Pharmacy Management Team. He or she assumes responsibility in work assignments in accordance with regulations and independently and resolves most conflicts by using considerable judgment and interpretation. Work is reviewed to ensure that overall objectives of the position are met. 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. 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 (education, review, etc.). Documents all patient-centered workload according to current VAWNYHS, VISN and VACO Pharmacy guidelines. Participates in pharmacy efforts to optimize efficiency (testing of new software, supporting new technology, proposing changes in operations, realigning workload, etc.) Administrative: Checks, guides, and advises lower-grade co-workers and trainees on the receipt, interpretation, compounding, and filling of medication orders. Effectively manages and supervises Pharmacy Technicians in their areas of responsibility. Verifies and/or corrects medication orders entered in the computer by Providers with the correct "Nature of Order" and any corresponding documentation as outlined in policy. Coordinates and resolves problems associated with medication distribution. Analyzes data and completes reports, including clinic/ward inspections and chart reviews, according to established policy. Work Schedule: Every other week: Saturday 7:45am-4:15pm Sunday 7:45am-4:15pm Monday 8:00am-4:30pm Subject to change based on needs of the service. Functional Statement #: 21N04-A

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