PHARMACIST IMPACT ON ISCHEMIC STROKE CARE IN THE EMERGENCY DEPARTMENT
PHARMACIST IMPACT ON ISCHEMIC STROKE CARE IN THE EMERGENCY DEPARTMENT
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DOI：
10.1016/j.jemermed.2015.07.040
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发表时间：
2016-01-01
影响因子：
1.5
通讯作者：
Dang, Cathyyen H.
中科院分区：
文献类型：
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作者：
Gosser, Rena A.;Arndt, Richard F.;Dang, Cathyyen H.
背景资料：Froedtert急性中风小组（FAST）由各种响应中风呼叫的卫生专业人员组成，但目前还没有正式包括药剂师。然而，急诊科（艾德）药剂师积极参与患者评价和促进静脉注射重组组织纤溶酶原激活剂（rtPA）的制备和给药。艾德药剂师有资格给药和制备rtPA，以及筛选治疗禁忌症。目的：主要目的是比较rtPA给药的准确性，平均门到rtPA时间，并确定禁忌症rtPA治疗时，药剂师在场与不在场的ED. Methods：这是一项回顾性研究的105例患者接受rtPA治疗急性缺血性卒中的艾德在综合性卒中中心从2008年1月1日至2012年10月1日。结果：共105例患者纳入本研究。当药剂师在场与不在场时，给药准确度相似（96.6%与95.6%; p = 0.8953）。当药剂师在场时，中位数门到rtPA时间在统计学上显著短于药剂师不在场时（69.5 vs. 89.5 min; p = 0.0027）。当药剂师在场时，29.9%的时间达到了门到rtPA时间< 60分钟，而药剂师不在场组为15.8%（p = 0.1087）。结论：在ED中，药剂师参与卒中团队可能对门到rtPA时间和患者护理产生有益影响。（C）2016 Elsevier Inc.
Background: The Froedtert Acute Stroke Team (FAST) is composed of various health professionals who respond to stroke calls, but it does not formally include a pharmacist at this time. However, emergency department (ED) pharmacists have been actively involved in patient evaluation and facilitation of i.v. recombinant tissue plasminogen activator (rtPA) preparation and administration in the ED. ED pharmacists are qualified to dose and prepare rtPA, as well as screen for contraindications to therapy. Objective: The primary objective was to compare the accuracy of rtPA dosing, mean door-to-rtPA time, and identification of contraindications to rtPA therapy when a pharmacist was present vs. absent in the ED. Methods: This is a retrospective study of 105 patients who received rtPA for acute ischemic stroke in the ED at a comprehensive stroke center from January 1, 2008 to October 1, 2012. Results: A total of 105 patients were included in this study. Dosing accuracy was similar when a pharmacist was present vs. absent (96.6% vs. 95.6%; p = 0.8953). Themedian door-to-rtPA time when a pharmacist was present was statistically significantly shorter than when a pharmacist was absent (69.5 vs. 89.5 min; p = 0.0027). When a pharmacist was present, a door-to-rtPA time of < 60 min was achieved 29.9% of the time, as compared with 15.8% in the pharmacist-absent group (p = 0.1087). Conclusions: Pharmacist involvement on stroke teams may have a beneficial effect on door-to-rtPA time and patient care in the ED. (C) 2016 Elsevier Inc.