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Invited Clinical Pharmacist (ICP) Program

By Currents Editor posted 12-12-2022 19:47

  
By Scott DeBoer, MD, PhD, Melissa Dang, PharmD Salia Farrokh, PharmD

The ICP program was designed and implemented in 2017 to provide NCS members a venue to initiate or expand clinical pharmacy services in the neuro ICU. Applicants request that a senior member of the pharmacy section visit their institution to meet appropriate stakeholders, give a presentation, and/or round with the clinical team to provide insight and recommendations on developing pharmacist involvement. Both the applicant and ICP are encouraged to present their experiences at the following annual meeting. This year, the NCS pharmacy section was able to coordinate 2 ICP visits! Below is a summary of one of the visits from the perspectives of the neuro ICU director, the junior pharmacist, and the invited clinical pharmacist.

"The Neurocritical Care Society’s Invited Clinical Pharmacist program was an incredible opportunity to jumpstart our neurosciences pharmacy services, led by Dr. Melissa Dang. The Neurocritical Care Unit at MedStar Franklin Square Medical Center is brand new. We have only been open two years, but in that time, we achieved Thrombectomy-Capable Stroke Center Certification from the Joint Commission. We are aiming for Comprehensive Stroke Center Certification in the upcoming year. Increasingly complex patients require multidisciplinary care, and it was obvious that we needed a dedicated neurocritical care pharmacist to provide safe care for our patients. Our ICP pharmacist, Dr. Salia Farrokh, established standards, educated providers and pharmacists, and provided evidence-based support for policy changes in just two days. I recommend this program for anyone hoping to start a new NCCU or to reset current practices to the most updated evidence-based care."

– By Scott DeBoer, MD, Ph.D. (Neuro ICU Director at Franklin Square)

"The ICP program set an incredible precedent for current literature and practices. As a recent PGY2 critical care graduate and new neurocritical care pharmacist, it was extremely helpful to round with another experienced pharmacist to gain a further understanding on how to maximize my role as a pharmacist on the team and how I can assist as the medication expert in providing quick and safe recommendations for escalation of care and monitoring complex therapeutic regimens. I truly appreciated the opportunity to discuss areas of improvement for our program and to brainstorm policies and guidelines that we can implement. Pharmacy is a small world, and I feel grateful to have made a connection with another neuro ICU pharmacist. Hopefully we can continue to work together and share resources to improve patient care."

– By Melissa Dang, PharmD (Neurocritical Care Clinical Pharmacist Specialist at Franklin Square)

"The ICP program was an absolutely rewarding experience that provided me with dedicated time to visit and help expand a new neurocritical care pharmacy service. The entire neurocritical care and pharmacy teams were incredibly welcoming and eager to learn, listen, and share ideas. We started the first day of this visit with a tour of the facility and a discussion of pharmacy operations related to neurocritical care (e.g., the Pyxis override list, emergency room flow of patients to the neuro ICU, existing protocols regarding ICH reversal, etc.). We then rounded together and discussed some great questions regarding a few very challenging patients admitted with status epilepticus. Later that day I provided a lecture on the management of status epilepticus along with interventions I had implemented in my institution, including the status epilepticus order set in our EMR and a standardized ketogenic diet protocol and order set. On the second day of this visit, I provided a morning lecture that reviewed pharmacological agents used in neurocritical care emergencies, and this was followed by clinical rounds with more patient discussions. We ended the visit with a review of their institution’s existing protocols, and I shared a few protocols of my own that I thought might be helpful (e.g., fixed dose 4-factor PCC for warfarin-related ICH reversal, peripheral administration of 3% hypertonic saline infusions, etc.). We also talked about future collaborations and shared contact information to help Dr. Dang with future questions. I hope to continue to serve as a mentor for Dr. Dang and other new graduate pharmacists who are enthusiastic about neurocritical care and improving care for patients with brain injury."

– Salia Farrokh, PharmD (Invited Clinical Pharmacist)

If you or your institution is interested in applying for this program, please contact Salia Farrokh, PharmD at salia.farrokh@gmail.com or Julia Welch at jwelch@neurocriticalcare.org. All applications are submitted through this online submission link by 11:59 PM CT on Tuesday January 31, 2023.

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