WEBVTT 1 00:00:00.150 --> 00:00:03.020 My name is Breck Cascus and I'm in a microbial 2 00:00:03.020 --> 00:00:06.750 stewardship clinical pharmacist. And my job is to help 3 00:00:06.750 --> 00:00:10.120 manage antibiotics for patients admitted to the hospital. 4 00:00:10.120 --> 00:00:14.270 A clinical pharmacist we're, have really cool role because 5 00:00:14.270 --> 00:00:17.420 line:15% we get out from, when people think about hospital pharmacy 6 00:00:17.420 --> 00:00:19.760 line:15% they just think about pharmacists sitting in a basement 7 00:00:19.760 --> 00:00:22.280 line:15% and filling medications and checking IVs and that's 8 00:00:22.280 --> 00:00:25.090 line:15% really not anything what clinical pharmacy is. 9 00:00:25.090 --> 00:00:27.740 I'm up on the floors, I'm evaluating patients, 10 00:00:27.740 --> 00:00:29.840 line:15% I'm talking with physicians. And, really, 11 00:00:29.840 --> 00:00:32.020 line:15% the core of what I do is I'm looking at 12 00:00:32.020 --> 00:00:34.700 line:15% patients in terms of microbial growths. 13 00:00:34.700 --> 00:00:37.890 line:15% So if you have a abscess and we culture it what grows 14 00:00:37.890 --> 00:00:41.810 and helping pick the antibiotic for best cover what 15 00:00:41.810 --> 00:00:44.960 is growing there. So, I'm really it's a dynamic team 16 00:00:44.960 --> 00:00:48.040 with the nursing, physicians, and pharmacists that play 17 00:00:48.040 --> 00:00:51.603 a role. I start my day based in my office and 18 00:00:51.603 --> 00:00:52.436 what I do 19 00:00:52.436 --> 00:00:54.590 is I have a list of every patient in the hospital that's 20 00:00:54.590 --> 00:00:56.540 on antibiotics on any given day. 21 00:00:56.540 --> 00:00:58.281 So, I work at Flower Hospital. 22 00:00:58.281 --> 00:01:02.280 line:15% We have an average daily census of about 170 patients. 23 00:01:02.280 --> 00:01:05.030 line:15% And about 60 of those everyday are on antibiotics. 24 00:01:05.030 --> 00:01:07.820 line:15% And I prioritize patients based on their level of 25 00:01:07.820 --> 00:01:11.410 line:15% acutities. So the sicker the patient is, the more 26 00:01:11.410 --> 00:01:15.120 carefully I'll look at them. So I'll evaluate all patient 27 00:01:15.120 --> 00:01:19.060 labs, and all the culture results, and then from there 28 00:01:19.060 --> 00:01:21.660 I'll have a-- I'll create plan based on what the patient 29 00:01:21.660 --> 00:01:23.620 has and what I think we should be treating 30 00:01:23.620 --> 00:01:25.810 and then I'll go up and speak with the physician 31 00:01:25.810 --> 00:01:28.740 and make my recommendations and talk directly with them. 32 00:01:28.740 --> 00:01:30.990 And then from there based on treatment it's always 33 00:01:30.990 --> 00:01:34.230 line:15% important to know how deescalate down because the core of 34 00:01:34.230 --> 00:01:37.810 line:15% what I do is called stewardship. And that means using 35 00:01:37.810 --> 00:01:40.570 line:15% the most narrow and biotic or the antibiotic that covers 36 00:01:40.570 --> 00:01:42.490 line:15% the least number of animi-- 37 00:01:42.490 --> 00:01:44.640 the least number of microbes as possible to treat 38 00:01:44.640 --> 00:01:48.600 the infection. But typically, for me, a typical 39 00:01:48.600 --> 00:01:52.120 work day, I get-- I like to get into work 40 00:01:52.120 --> 00:01:53.360 around 7 am 41 00:01:53.360 --> 00:01:55.960 that way I'm getting to look at patients as the lab 42 00:01:55.960 --> 00:01:57.770 values are getting back 'cause a lot of times most 43 00:01:57.770 --> 00:01:59.080 the patients have daily labs 44 00:01:59.080 --> 00:02:01.940 line:15% that are drawn and if I'm there at 7 am I'm like the 45 00:02:01.940 --> 00:02:04.490 line:15% first on the scene to see all the most recent lab 46 00:02:04.490 --> 00:02:06.940 line:15% EOS, and that way when the physicians come in to start 47 00:02:06.940 --> 00:02:09.310 line:15% to evaluate patients I already have recommendations 48 00:02:09.310 --> 00:02:11.510 and I've already seen the patients that day.