The ED Pharmacist as a safety measure in Emergency Medi*

急诊室药剂师作为紧急医疗中的安全措施*

• 批准号: 7010128
• 负责人: Rollin J Fairbanks
• 金额: $ 29.99万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7010128
• 关键词: behavioral /social science research tag; clinical research; cooperative study; data collection methodology /evaluation; drug adverse effect; emergency health services; health care model; health care personnel performance; health care professional practice; health care service evaluation; health services research tag; health surveys; hospital patient care; hospital personnel; human data; interview; model design /development; patient care management; patient safety /medical error; pharmacy; shared health service

DESCRIPTION (provided by the applicant): BACKGROUND: The Emergency Department (ED) is a unique environment in medicine, and many safety mechanisms used in other hospital settings cannot be applied in the ED. For example, clinical pharmacists have traditionally provided extra layers of protection to hospital inpatients by cross-checking provider orders for appropriate dosing, contraindications, and interactions. Because medications in the ED must be accessed immediately and are often one-time doses, the use of central pharmacy services would introduce an unacceptable delay to the administration of medication. Although some hospitals have programs in place in which a pharmacist responds to the ED for cardiac arrests or trauma team activations, few have reported programs which involve a clinical pharmacist assigned exclusively to the emergency department. Nonetheless, published reports have asserted that ED-based pharmacists can increase patient safety. Although this concept appears logical, no study has attempted to show that these programs reduce potential adverse drug events in the ED. PROJECT SUMMARY: We propose to implement and optimize an ED Pharmacist (EDP) program as a safe practice intervention in a large ED. The hospital has provided funding for two permanent full time positions starting at the beginning of the award period. In the initial phase interviews of physicians, nurses, pharmacists, and patients will be conducted and the results will be used to optimize the EDP role. A large-scale chart review study will then be conducted to evaluate whether there is a reduction in frequency of potential and adverse drug events during times that the EDP is on duty. Staff perceptions of the effectiveness of this program will also be evaluated. The overall goal of this initiative is to create an effective EDP program that will decrease the rate of adverse drug events in ED patients, and to create a "toolkit" to facilitate the introduction of similar programs into other EDs. This toolkit will include a description of the formal, optimized role of the EDP, challenges and solutions in implementation, and evidence to support the efficacy of such a program. RELEVANCE: The use of a pharmacist has been proven to reduce medication error and adverse events in the hospital setting. Applying this concept to the ED setting is expected to have the same effect, thus will have an impact on public health by reducing the rate of medication error and harm to patients cared for in the ED.

描述（由申请人提供）： 背景：急诊科 (ED) 是医学上一个独特的环境，其他医院环境中使用的许多安全机制无法在 ED 中应用。例如，临床药剂师传统上通过交叉检查提供者的订单以了解适当的剂量、禁忌症和相互作用，为医院住院患者提供额外的保护。由于急诊室的药物必须立即获得，并且通常是一次性剂量，因此使用中央药房服务会给用药带来不可接受的延迟。尽管一些医院制定了由药剂师对急诊室心脏骤停或创伤小组启动做出反应的计划，但很少有医院报告涉及专门分配给急诊科的临床药剂师的计划。尽管如此，已发表的报告声称，急诊室药剂师可以提高患者的安全。尽管这个概念看起来合乎逻辑，但没有研究试图证明这些计划可以减少急诊科潜在的药物不良事件。项目摘要：我们建议实施和优化急诊药剂师 (EDP) 计划，作为大型急诊室的安全实践干预措施。从奖励期开始，医院已为两个永久全职职位提供资金。在初始阶段，将对医生、护士、药剂师和患者进行访谈，结果将用于优化 EDP 的角色。然后将进行大规模图表审查研究，以评估 EDP 执勤期间潜在药物不良事件的发生频率是否有所减少。工作人员对该计划有效性的看法也将得到评估。该计划的总体目标是创建一个有效的 EDP 计划，以降低 ED 患者的药物不良事件发生率，并创建一个“工具包”以促进将类似计划引入其他 ED。该工具包将包括对 EDP 的正式、优化作用的描述、实施中的挑战和解决方案，以及支持此类计划有效性的证据。相关性：事实证明，使用药剂师可以减少医院环境中的用药错误和不良事件。将这一概念应用于急诊室预计会产生相同的效果，从而减少用药错误率和对急诊室护理患者的伤害，从而对公共健康产生影响。