I am skilled in clinical pharmacy services working with multidisciplinary teams in ambulatory care settings. I have extensive experience working in collaboration with primary care providers, specialty physicians, nurses, and mental health providers to ensure appropriate use and monitoring of medications. I have worked closely with social services to assist patients access affordable medical care and access community services while addressing barriers to medication adherence. As a clinical pharmacist, I have served as the drug information expert providing verbal and written drug information consults to physicians, nurses and other medical staff as well as providing mentorship to pharmacy students and residents. I am highly motivated, self-directed and maintain strong communication skills. I am passionate about improving health outcomes in vulnerable patient populations while providing compassionate, evidence-based care.
Review medication profiles for drug-drug and drug-disease state interactions in patients with chronic kidney disease, dialysis and post-kidney transplant patients.
Work in collaboration with physicians, nurses, and dieticians to assure appropriate medication therapy for patients on dialysis.
Manage medication distribution process and ensure timely delivery of medications. Extensive patient education and medication counseling.
Managed anticoagulation therapy including warfarin, low molecular weight heparin, and direct oral anticoagulants perioperatively and during initiation and maintenance phases.
Ordered labs and made dose adjustments for anticoagulants per protocol. Worked in a multidisciplinary team consisting of primary care providers, specialist physicians, hospice/palliative care nurses, and care facility staff to optimize antithrombotic therapy and ensure appropriate drug monitoring.
Completed medication reviews during transitions of care, identified drug therapy problems and made appropriate recommendations to physicians. Participated in operational and clinical improvement committees; updated protocols based on clinical guidelines, quality measures and evidence based research.
Served as a mentor for pharmacy students and residents via direct preceptorship.
Under Collaborative Drug Therapy Management (CDTM) Agreement with primary care providers, managed and optimized drug therapies for patients with chronic disease states including Type II Diabetes, hypertension, and dyslipidemia based on current guidelines via routine office visits.
Completed extensive discharge counseling and medication reconciliation for high-risk patients to help reduce hospital readmissions and emergency room visits.
Worked closely with physicians, behavioral health providers, and social services to optimize medication adherence and improve health outcomes of vulnerable patients.
Updated medication formulary and clinic protocols. Provided staff education on management of anticoagulation and management and treatment of chronic pain.
Completed medication reviews and written reports for prescribers and caregivers on the best use of medications in older adults. Worked closely with nursing staff to minimize use of potentially inappropriate medications for patients in post-acute care, assisted living and skilled nursing facilities.
Organized and prioritized educations needed to ensure facility staff’s compliance with State and Federal Regulations with an emphasis on dosage limits for geriatric patients, fall reductions, and assessment of appropriate use of antipsychotics and sedative/hypnotics.
Participated in multidisciplinary team meetings to review use of antimicrobials, medication related problems and discuss formulary management and quality assurance measures.
Created written consults on cross tapering antidepressants, assessing lower effective doses of psychotropic drugs, and appropriate adjustment of diabetes medications with consideration of patients' individual goals of care and pharmacokinetic changes.