Effects of implementing a clinical pharmacist service in a mixed Norwegian ICU
Effects of implementing a clinical pharmacist service in a mixed Norwegian ICU
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DOI：
10.1136/ejhpharm-2015-000751
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发表时间：
2016-07-01
影响因子：
1.7
通讯作者：
Ytrebo, Lars M.
中科院分区：
文献类型：
--
作者：
Johansen, Elisabeth T.;Haustreis, Stine M.;Ytrebo, Lars M.
目的重症监护室（ICU）收治的患者中出现药物相关问题（DRP）的比例高得令人无法接受。DRP可能会造成伤害，增加费用和住院时间。临床药剂师服务的实施已被证明可以检测到大量的DRP，并有效地帮助解决不同医疗保健系统中的这些问题。然而，这还没有被前瞻性地研究在混合三级挪威ICU.Methods从2012年10月的12个月期间，临床药剂师致力于审查药物每天3小时（周一至周五）。在ICU会议上报告了DRP，并包括药剂师对每个病例的建议。对所有DRP进行分类，并记录临床影响以供后续分析。结果549例ICU患者中有363例接受了药物审查。在这些患者中的194例中检测到641个DRPs（平均每例患者1.8个DRPs，范围0-25）。过高的剂量，显著的药物相互作用和不必要或不适当的药物是最常见的DRPs。87%的药剂师建议被接受或考虑。护理人员提出的典型问题涉及药物制备、仿制药等效物和给药。从医生的问题是最常见的药物剂量，效率和不良反应。结论除了一个专门的临床药剂师的ICU团队提高了药物的质量和安全性在挪威ICU的混合。
Objectives An unacceptably high proportion of patients admitted to intensive care units (ICUs) develop drug-related problems (DRPs). DRPs might cause harm and increase costs and length of stay. The implementation of a clinical pharmacist service has been shown to detect a high number of DRPs and contributes effectively to solving these across different healthcare systems. However, this has not been prospectively studied in a mixed tertiary Norwegian ICU.Methods During a 12-month period from October 2012, a clinical pharmacist was dedicated to review medications 3 h daily (Monday to Friday). DRPs were reported at the ICU conference and included advice by the pharmacist for each case. All DRPs were categorised and the clinical impact was documented for later analysis. Drug-related questions from the staff were categorised and answered.Results 363 of 549 patients admitted to the ICU received medication reviews. 641 DRPs were detected in 194 of these patients (mean 1.8 DRPs per patient, range 0-25). Too high a dose, significant drug interactions and unnecessary or inappropriate drugs were among the most frequently detected DRPs. 87% of advice given by the pharmacist was accepted or taken into consideration. Typical questions from the nursing staff were related to drug preparation, generic equivalents and drug administration. Questions from doctors were most frequently related to drug dosage, efficiency and adverse effects.Conclusions The addition of a dedicated clinical pharmacist to the ICU team improves the quality and safety of medication in a mixed Norwegian ICU.