Pharmacists - what are you doing?

[spacecowgirl]

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I don't care if you're "clinical" or staff, residency trained or not, retail, hospital, other - what progressive things are you doing in your practice setting?

I'm sick to death of these baseless posts about how worthless and replaceable pharmacy is...so PRACTICING PHARMACISTS, what are you doing? I'd like to dispel some of the dumb around here with some informed posts.

 

[Its Z]

I have developed clinical quality (Core Measure) initiatives to expand pharmacists' role by incorporating Core Measure element monitoring to daily clinical activities.

Why you ask?

 

[Its Z]

oh... don't let the debbie downers down you. The truth is you practice pharmacy like it was meant to. You went through the proper training and now you practice in an environment where your practice is a vital component to the multidiscplinary patient care.

I will eventually find a setting similar to yours when I get tired of the road.

Regardless the practice setting, be it retail or hospital, some will find the positives while some will dwell on the negatives.

 

[spacecowgirl]

Thanks, Z 🙂 I'm not down on pharmacy, just down on SDN right now.

I want this thread to inspire students and pre-pharmers that there are people practicing the pharmacy we were taught in school (minus some of the puppies and rainbows of course).

 

[SpirivaSunrise]

Just spent the week traveling out of state to one of our pharmacies to help lead a Kaizen Event. We bring a team of their staff together to look at a specific process that is not working very efficiently...and provide them with the tools to improve.

This isn't even my day job! But I love having the opportunity to do it nonetheless...

 

[Its Z]

Just spent the week traveling out of state to one of our pharmacies to help lead a Kaizen Event. We bring a team of their staff together to look at a specific process that is not working very efficiently...and provide them with the tools to improve.

This isn't even my day job! But I love having the opportunity to do it nonetheless...

Y'all have karate tournaments? Like Dwight and Michael??

 

[VCU07]

Y'all have karate tournaments? Like Dwight and Michael??

Not many posts thus far...

 

[Thoughtfulsinner]

Not many posts thus far...

Count pills, answer dumb patient phone calls and questions, ring peoples tampons and food up, get voicemail, call public aid, and check expiratiin dates on drugs. Easy peasy and it pays well.

 

[spacecowgirl]

Count pills, answer dumb patient phone calls and questions, ring peoples tampons and food up, get voicemail, call public aid, and check expiratiin dates on drugs. Easy peasy and it pays well.

F*** off. Seriously. Go away.

 

[spacecowgirl]

I do some stuff that is directly pharmacy related - started a pharmaceutical care practice (more like disease state managment than just MTM). Received a couple of grants to expand pharmacy services. Right now I'm working on some systems-change processes that isn't directly pharmacy related (although MTM is part of it) but because of the grants and my background, I am taking this project on. Hoping to reduce rehospitalizations and high-cost care use (ER, UC). Been doing some work with CV risk patients. I have more projects than I have time.

 

[Thoughtfulsinner]

F*** off. Seriously. Go away.

Mad? That's seriously what I do. I can't wait to get out of retail.

 

[KARM12]

So this week I...
Worked on a new orderset for our SCIP guidelines, responded to a code blue where I am in charge of the med cart, daily patient/topic discussions with my resident/student, worked with the nurse manager in the ICU for a practice patient tracer for JACHO visit this year, presented a CE for the department, worked with the micro lab for implementing a protocol for PNA-FISH testing for blood cultures, presented my MUE on daptomycin use for antibiotic subcommittee, worked on a case report that I hope to publish with my ID docs.

Didn't see one pill the whole time...

 

[spacecowgirl]

Mad? That's seriously what I do. I can't wait to get out of retail.

Not mad. Really annoyed, yes.

 

[spacecowgirl]

So this week I...
Worked on a new orderset for our SCIP guidelines, responded to a code blue where I am in charge of the med cart, daily patient/topic discussions with my resident/student, worked with the nurse manager in the ICU for a practice patient tracer for JACHO visit this year, presented a CE for the department, worked with the micro lab for implementing a protocol for PNA-FISH testing for blood cultures, presented my MUE on daptomycin use for antibiotic subcommittee, worked on a case report that I hope to publish with my ID docs.

Didn't see one pill the whole time...

Are you using much daptomycin? We don't use any but I'm starting to think we should for our repeat diabetic foot people with already crappy kidney function.

 

[KARM12]

Are you using much daptomycin? We don't use any but I'm starting to think we should for our repeat diabetic foot people with already crappy kidney function.

We had a 120% increase in expense over the prior year and were trying to figure out why. We don't generally use very much (<30 pts for the year), as we have low rates of VRE and low MRSA/vanco MICs. Most were appropriate and switched off quickly. We had 1 pt on a prolonged course. Those that were not appropriate, we can provide feedback to the prescribers.

I'm not the biggest dapto fan. We've had a few cases of dapto failure recently with MRSA.

 

[Its Z]

Bah PNA FISH.....old news. PCR is where its at.

 

[KARM12]

Bah PNA FISH.....old news. PCR is where its at.

Agree...but this is a lab with little to no automation so it is a big deal for them.


We just implemented the C. Diff PCR...magical!

 

[aboveliquidice]

This week I...

• Presented my proposed research project - It was rough but productive
• Completed Internal medicine rotation #2, saving patients one renally dosed abx at a time
• Presented patient case - asymptomatic bateriuria
• Sat in on a cardiac bubble study... which was awesome

 

[aboveliquidice]

Bah PNA FISH.....old news. PCR is where its at.

Our lab just moved from the assay to PCR for C.diff... 90% sensitivity, ya heard.

 

[spacecowgirl]

What kind of vanc MICs are you seeing? I feel like the ones that don't seem to be responding to vanc don't have very high MICs.

What are you using for cSSI besides vanc? We have a few patients that seem to be on long vanc treatments then we don't see them for several months, a year, and then they are back again.

 

[PharmDstudent]

Getting change orders for Elidel < 2 yo, thinking about taking a first aid class (since I don't feel like I know enough about it to be able to counsel like I need to), and learning Spanish so that I can effectively counsel or answer questions to Spanish speaking people.

 

[GamecockPharmD]

I just finished tweaking my resume/CV and I'm about to apply for a hospital position because I am tired of the hell that is Rite Aid. Also studying for the NC MPJE so I can legally practice in said hospital. Already got my authorization to test.

 

[Its Z]

What kind of vanc MICs are you seeing? I feel like the ones that don't seem to be responding to vanc don't have very high MICs.

What are you using for cSSI besides vanc? We have a few patients that seem to be on long vanc treatments then we don't see them for several months, a year, and then they are back again.

Typical MRSA MIC of 1 and some 2s.. but I question the accuracy.

Throw in some Clinda.. remember, most of cSSI studies against Vanc are non-inferior... Dapto study is questionable.

I do think Ceftaroline could provide an interesting alternative for Dapto or Linezolid..

 

[aboveliquidice]

Typical MRSA MIC of 1 and some 2s.. but I question the accuracy.

Throw in some Clinda.. remember, most of cSSI studies against Vanc are non-inferior... Dapto study is questionable.

I do think Ceftaroline could provide an interesting alternative for Dapto or Linezolid..

Teflaro looks promising... the two major studies were cSSSI and CAP. Haven't seen anything for scary infections (osteo, endocarditis) yet. Also, I think they avoided diabetic foot ulcers in the cSSSI trials, which would have been interesting I think.

 

[joetrisman]

Our lab just moved from the assay to PCR for C.diff... 90% sensitivity, ya heard.

[YOUTUBE]http://www.youtube.com/watch?v=oCRJ4r0RDC4[/YOUTUBE]

 

[Its Z]

👍

I like the video!

 

[Shnurek]

I like this video: http://www.youtube.com/watch?v=j2WurhYEQyY&feature=related

Psychedelic scientists (Kary Mullis too!) lol