Clinical Pharmacist

Job Description

• Advise health care providers on matters pertaining to drug selection while assessing for optimal drug therapy, dosage regimen, effective administration and drug therapy monitoring. Works independently responsible to exercise due care in the dispensing of pharmaceuticals.
• Conduct medication reconciliation: Identify the most complete and accurate list of medications a patient is taking and using this list to provide correct medications for the patient anywhere within the organization upon admission or transition of care.
• Participate in the multidisciplinary ward rounds/meeting.
• Assess current medication therapy; patient’s medical record should be reviewed in conjunction with the medication administration record and medication history obtained. Recent consultations, pathology results and investigations, treatment plan and daily progress should be taken into account when determining the appropriateness of current medication therapy and when planning patient care.
• Prevent, detect, and resolve medication-related problems, make appropriate evidence-based, patient-centered medication therapy recommendations as part of the interdisciplinary team.
• Recommend appropriate therapy for individual patients where evidence is not available, controversial evidence exists or other professionals may challenge advice.
• Provide advice on the pharmaceutical and pharmacodynamics properties of drugs including alterations of these parameters in ‘special groups’ of patients.
• Contribute to the organizations wider antimicrobial surveillance program, implement local programs ensuring appropriate antimicrobial prescribing within general practice.
• Attend Consultant/GP white board/MDT meetings to actively facilitate and provide advice on the treatment of patients.
• Undertake medication reviews with patients to support optimum therapy and adherence.
• Perform on shift and is expected to be on call for emergencies as required.
• Direct and guide Assistant Pharmacists, and related staff.
• Evaluate response to drug therapy using patient’s existing parameters.
• Therapeutic Drug Monitoring (TDM): interpretation, monitoring, and communication of measured drug concentrations in body fluids to optimize medication efficacy and minimize toxicity.
• Interpret each prescription before filling to ascertain if strength and dosage prescribed are within patient tolerance.
• Review patient profile to check for: Drug vs Drug Interaction; Drug vs Patient Allergies; and Drug vs Patient Diet Restriction and dosage suitability.
• Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients and health care providers.
• Provide medication counseling throughout patient’s journey.
• Resolve discrepancy within the shift and makes report, of not resolved refers the problem to the Supervisor.
• Management of medication errors and adverse drug reactions.