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KMID : 0869620140310040908
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 4 p.908 ~ p.918
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Effects of Pharmacist Interventions in a Surgical Intensive Care Unit
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Jung Jung-Won
Sohn You-Min
Park Hyo-Jung
In Yong-Won
Lee Young-Mee
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Abstract
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Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors. The presence of a pharmacist in the ICU has been shown to reduce the incidence of prescribing errors, the length of stay and to prevent adverse drug events (ADEs). Since 25 March 2013, pharmacists have started to participate in monitoring of medication and in rounding in the surgical ICU (SICU) at the Samsung Medical Center. The purpose of this study was to evaluate the effects of a pharmacist’s role in the SICU. A historical case control study was conducted by a retrospective electronic medical record chart review. Therefore, patients were assigned to either the control group (patients who were admitted to the SICU from 25 March to 30 June 2012) or the intervention group (patients who were admitted to the SICU from 25 March to 30 June 2013). Demographic features, frequency and types of inappropriate prescribing, ADEs and length of stay in SICU were reviewed in both groups. A total of 8,523 medications for 151 patients in the intervention group and a total of 9,642 medication profiles for 160 patients in the control group were reviewed in each group. There were 57(83%) drug-related interventions in the intervention group and 12(17%) information services with pharmacist intervention. Thirty eight (67%) of drug-related interventions were found for an adjustment of the dosage regimen according to organ dysfunctions. The incidence of inappropriate prescribing per 1,000 monitored patient-days in was much lower in the intervention group than in the control group: 1.48 vs. 104.22 p<0.001. In the control group, the majority of inappropriate prescribing counted for an overdose of antibiotics. One preventable ADE occurred in the control group. However, there were none in the intervention group. The length of stay in the ICU tended to be shorter and the number of hospital days to be smaller in the intervention group than
in the control group (3 days vs. 4 days. p=0.089, 16 days vs. 17 days, p=0.059). The intervention of a pharmacist in the SICU was associated with significant reductions in inappropriate prescribing and the number of ADEs.
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KEYWORD
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ICU, Pharmacist’s participation, Inappropriate prescribing, Preventable adverse drug events
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