Antimicrobial Stewardship Clinical Pharmacist, ProMedica

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.