When you envision a pharmacist, what image comes to mind? For most people, it's the white-coated professional standing behind the counter at the local pharmacy. They're the healthcare professional who fills your prescriptions, deals with your health insurance company, answers questions about your meds, checks your blood pressure, and administers your Covid-19 and flu shots.
However, there are other pharmacy roles in this field apart from retail or community pharmacists. Some pharmacists work as part of medical teams in hospitals and other healthcare settings. Others teach or work in drug research, regulatory affairs, and marketing for drug manufacturers, or are employed by the Food and Drug Administration (FDA).
This article focuses on hospital pharmacists, who occupy the medical front lines providing pharmaceutical care. It's an important role that's sometimes overlooked.
So, if you're wondering what does a hospital pharmacist do, read on for the details. We also cover:
Scot H Simpson (BSP, PharmD, MSc), a faculty member in Pharmacy and Pharmaceutical Sciences at the University of Alberta, describes the primary role of the hospital pharmacist as the medication expert within the healthcare system. Hospital pharmacists help provide effective patient care by facilitating the safe use of appropriate medication therapies to ensure optimal patient outcomes. The hospital pharmacist is an integral component of the medical team, providing accurate and reliable healthcare service and advice to physicians and their patients.
Hospital pharmacists, also referred to as clinical pharmacists, possess specialized knowledge of drug information, drug protocols, clinical trials, and new medications. They are highly trained in pharmaceutical efficacy and care, including how specific drugs interact and what side effects can be expected from a specific medication therapy.
So, what are the discreet responsibilities of the hospital pharmacist and how are these tasks important to patients, physicians, and hospitals? Let's take a deeper look into the critical tasks performed by the hospital pharmacist.
Hospital pharmacists are responsible for:
The hospital pharmacist advises the medical team regarding specific medications and dosages for patients. Working in conjunction with doctors and the healthcare team, they help determine the best medication to prescribe for individual patients, taking into consideration drug efficacies, interactions, long and short-term benefits, and potential side effects.
Medication error is a significant problem in the healthcare industry. The Agency for Healthcare Research and Quality reports that the Food and Drug Administration (FDA) receives more than 100,000 incidents of suspected medication error each year. Common mistakes include the patient receiving the incorrect prescription (the wrong medication or the correct medication at the wrong dose), failure to avoid drug-to-drug interactions, and errors in drug preparation and delivery.
Accordingly, medication and patient safety is a chief concern in community pharmacies, hospitals, nursing homes, and other healthcare facilities. Hospital pharmacists are crucial in mitigating these errors by providing accurate, careful advice—and implementing and overseeing safety and compliance procedures in filling prescriptions and dispensing medications. To this end, they are responsible for managing the hospital pharmacy operation and supervising the <a href="https://www.ashp.org/pharmacy-technician/about-pharmacy-technicians/pharmacy-technician-career-overview" target="_blank">pharmacy technicians to ensure they carefully administer drugs to both inpatient and discharged patients.
In instances when ready-made drugs are unavailable or in short supply, circumstances may require hospital pharmacists to compound and manufacture medications as a suitable substitute. These alternatives are called compound medications, as they combine two or more medications to produce the same or similar effect of an existing medication. Since compound medications are not FDA-approved, doctors rely on hospital pharmacists to manufacture compound medications accurately and safely.
The hospital pharmacist plays a vital role in communicating correct dosages, possible drug interactions, and risk of side effects before medications are administered. They sometimes also monitor the effects of dispensed medications to ensure they are effective and safe.
Drug chart monitoring is critical to patient treatment and outcomes. Hospital pharmacists must keep up-to-date with the patient's medication chart and ensure that the correct medications are being given to the right patient and that proper protocols are followed. This includes checking on proper doses and how often tablets, inhalers, injections, infusions, ointments, and creams are administered.
Upon a patient's discharge from an inpatient setting, the hospital pharmacist reviews the discharge summary and inspects the patient's drug chart for accuracy. This task includes filling and dispensing any outpatient medications with proper instructions for dosage and administration as well as information regarding potential side effects.
It is the job of the hospital pharmacist to stay up-to-date regarding the latest relevant pharmaceutical information. This requires the hospital pharmacist to read medical journals and research papers, keep up with promising clinical trials, and utilize electronic databases to stay informed about drug information.
It is critical that hospital and community pharmacists remain current on the latest pharmaceutical developments so they can direct physicians to the most effective medication therapies available. Doctors rely heavily on pharmacists to maintain competency in the latest drug trials, trends, and treatments.
Hospital pharmacists are responsible for monitoring the supply of medicines in their hospital, medical facility, or nursing home. They procure and dispense medications, ensure that the drug supply matches demand, quality-test medications, and monitor drug expiration dates.
To become a hospital pharmacist, you first need to earn a Doctor of Pharmacy (PharmD). Most PharmD students hold an undergraduate degree in chemistry, organic chemistry, biology, biochemistry, health sciences, or pre-med. It's also possible to pursue a six-year BS to Doctor of Pharmacy (PharmD) program while you are still an undergrad. There are also pharmacy tracks you can apply to right out of high school, where you attend a pre-pharmacy program for two to three years and then earn your PharmD in four years.
Schools like Butler University offer online Doctor of Pharmacy programs with a pharmacy practices component. Butler's coursework incorporates fundamentals of community pharmacy practice and institutional pharmacy practice into its curriculum. Required on-site rotations in community pharmacy and hospital settings introduce students to interprofessional practices involving shared patient care and decision-making.
After earning a PharmD, pharmacist candidates must then pass the North American Pharmacist Licensure Examination (NAPLEX) as well as the Multistate Pharmacy Jurisprudence Examination (MPJE). The NAPLEX exam evaluates competency to practice pharmacy, while the MPJE exam assesses one's knowledge of federal and state laws and regulations relating to the practice of pharmacy in the state in which one is seeking licensure.
Most hospitals require clinical pharmacists to complete a one- or two-year residency. The PGY-1 (Post-Graduate Year 1) residency includes training in all areas of healthcare pharmacology, while the PGY-2 (Post-Graduate Year 2) residency enables students to specialize in specific medical areas including ambulatory care, cardiology, critical care, emergency medicine, geriatrics, infectious diseases, informatics, internal medicine, oncology, pediatrics, and pharmacotherapy.
Patients, physicians, and other medical professionals rely on the expertise and accuracy of pharmacists. Whether in the corner drugstore or hospital setting, these trained specialists bear a great deal of responsibility for patient care and safety. Their impact is felt in the day-to-day interactions between physicians and patients in healthcare facilities as well as in the broader world of public health.
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