May 31, 2019 at 11:37 #1829
I’m just curious about how other centres staff renal pharmacists, particularly the ‘have not’ (ie non-teaching) centres with respect to:
a) # renal RPh FTEs
b) # patients they manage (outpatient HD, PD, MCKC, home dialysis, satellite HD units, as well as inpatients, if applicable)
c) what they manage
d) work hours
For instance … my name is Derrick Soong and I work at Windsor Regional Hospital in Windsor, ON.
a) We have 2 full-time renal RPh FTEs.
b) Our program: HD main unit ~230 patients, PD ~80 patients, MCKC ~300 patients. One satellite (Leamington ~ 30 HD patients)
c) We have a hybrid model where the 2 renal RPhs manage all the HD/PD patients, regardless of where they are (outpatient or admitted). We complete med histories for inpatients, update our electronic MAR (ie Nephrocare), refill chronic medications, anemia management (dose Eprex, IV / PO iron), antimicrobial stewardship (ie we review all the cultures and prescribe antibiotics where needed — wounds, blood cultures, peritonitis), anticoagulation (ie dose warfarin, start or stop anticoagulation / bridge therapy for procedures, adjust Fragmin intradialysis), adjust BP meds, round with the nephrologists, patient counselling on any meds / med changes by family MDs, liaise with community pharmacists for LU codes / medication adherence, and take on pharmacy residents / students. Our renal program has 1 satellite (Leamington), where we travel there (no mileage reimbursement) to round on those patients once a month. We are now being asked by our managers to cover the MCKC clinic, on top of our current workload. NB: our program does not have NPs, PAs, or charge nurses, so the renal RPh acts like all 3 roles, including RPh.
d) We work 5 days a week (M-F), usually 8-4 or 9-5 but we split the HD group in half (MWF, TTS) … we each see half of our respective outpatient HD group weekly, so we each have to stay late 1 night/week (to see the late group). We are unofficially on-call while the HD unit is open, and as a courtesy, we help answer inpatient issues on the weekend when the weekend staff are unsure what to do (very rarely called — maybe 1 call / month). Of course, our nephrologists will ask us questions PRN.
How does your site compare? If you could kindly share your program’s demographics / your job description, I’d really like to compare / advocate ORN to standardize the workload across the province, similar to the Manitoba program (https://www.cjhp-online.ca/index.php/cjhp/article/view/1302/1841).
May 31, 2019 at 12:46 #1833
MB Renal Program still funds renal pharmacists at the ratios listed in the linked article but an update is that all renal pharmacists are now 100% clinical (i.e. no duties in inpatient dispensary).
Lori Wazny, PharmD.
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