Pharmacist​/Clinical Pharmacist

• Department: Department of Veterans Affairs

The clinical pharmacist is a licensed professional with knowledge and proficiency in pharmacy practice including pharmaceutics, pharmacokinetics, pharmacodynamics and pharmacotherapeutics. The incumbent is responsible for analyzing real and potential drug-related medical problems and implementing corrective action to ensure that patients receive optimal drug therapy.

The clinical pharmacist is a licensed professional with knowledge and proficiency in pharmacy practice including pharmaceutics, pharmacokinetics, pharmacodynamics and pharmacotherapeutics. The incumbent is responsible for analyzing real and potential drug-related medical problems and implementing corrective action to ensure that patients receive optimal drug therapy.

The clinical pharmacist also applies standards relating to all aspects of distribution and control of scheduled and non-scheduled drugs.

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 Performs continuous evaluation of prescribed medications to assure optimal drug therapy Provides medication counseling to patients for all new prescriptions 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 Review patient profile, 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 Assesses drug safety and efficacy, including evaluation of physical symptoms Reports adverse drug events (ADE), near misses, and medication errors in alignment with VA ADERS reporting program Participates in the facility medication utilization evaluation (MUE) program Recommends formulary alternatives and completes non-formulary consults as assigned Participates in emergency preparedness activities including annual Drug Cache activation exercise Implements P&T Committee policies including therapeutic/ generic substitutions and perform automatic conversions as appropriate Manages recalls and medication shortage situations by substituting alternate dosage strengths and instructions of the same medication to equal the prescribed dose and schedule Manages various actions, as appropriate, for medication orders to include flagging prescriptions, managing view alerts, using the "hold medication" function, and generating unsigned discontinued orders using Service Reject Extends refills until next scheduled appointment under the provider's name as per facility policy Serves as a role model and preceptor to pharmacy students and residents Assumes an active role in staff development of peers and provides educational in-services to nursing, medical staff or to other ancillary services 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;

review of the patient's allergy history, drug- drug, drug-nutrient, drug-laboratory and drug-disease state interactions and assessment for 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, ophthalmic (subconjunctival and intravitreal injections), narcotics, etc.,

in outpatient 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…