-: My name is Breck Cascus and I'm in a microbial
stewardship clinical pharmacist. And my job is to help
manage antibiotics for patients admitted to the hospital.
A clinical pharmacist we're, have really cool role because
we get out from, when people think about hospital pharmacy
they just think about pharmacists sitting in a basement
and filling medications and checking IVs and that's
really not anything what clinical pharmacy is.
I'm up on the floors, I'm evaluating patients,
I'm talking with physicians. And, really,
the core of what I do is I'm looking at
patients in terms of microbial growths.
So if you have a abscess and we culture it what grows
and helping pick the antibiotic for best cover what
is growing there. So, I'm really it's a dynamic team
with the nursing, physicians, and pharmacists that play
a role. I start my day based in my office and
what I do
is I have a list of every patient in the hospital that's
on antibiotics on any given day.
So, I work at Flower Hospital.
We have an average daily census of about 170 patients.
And about 60 of those everyday are on antibiotics.
And I prioritize patients based on their level of
acutities. So the sicker the patient is, the more
carefully I'll look at them. So I'll evaluate all patient
labs, and all the culture results, and then from there
I'll have a-- I'll create plan based on what the patient
has and what I think we should be treating
and then I'll go up and speak with the physician
and make my recommendations and talk directly with them.
And then from there based on treatment it's always
important to know how deescalate down because the core of
what I do is called stewardship. And that means using
the most narrow and biotic or the antibiotic that covers
the least number of animi--
the least number of microbes as possible to treat
the infection. But typically, for me, a typical
work day, I get-- I like to get into work
around 7 am
that way I'm getting to look at patients as the lab
values are getting back 'cause a lot of times most
the patients have daily labs
that are drawn and if I'm there at 7 am I'm like the
first on the scene to see all the most recent lab
EOS, and that way when the physicians come in to start
to evaluate patients I already have recommendations
and I've already seen the patients that day.