Clinical impact of pharmacists’ interventions in intensive care units in a tertiary institution in Singapore – A retrospective cohort study

IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Proceedings of Singapore Healthcare Pub Date : 2023-11-24 DOI:10.1177/20101058231218527
Jie Lin Soong, Lee Yi Ang, Jeremy Lin En Chan, S. Lie
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Abstract

Previous studies have deemed pharmacists essential in the intensive care units (ICU) to provide quality healthcare and ensure medication safety. As the impact of pharmacists in ICU varies according to different factors, our study aims to characterise and evaluate the impact of pharmacists’ interventions in ICUs in Singapore, to enable the identification of areas of improvement in our critical care pharmacy practice. We retrospectively evaluated 7 months of pharmacists’ interventions in five ICUs at Singapore General Hospital. Interventions were classified based on the medication-related problems (MRPs) addressed. The impact of pharmacists’ interventions was assessed by rating the severity of error in medication order, the clinical relevance of intervention, and the probability of adverse drug events (pADE) that would have occurred without pharmacists’ interventions. There were 619 interventions addressing 775 MRPs, of which 91.1% were accepted. The main MRP identified was inappropriate drug regimen (49.2%) and the medication class most frequently involved in MRPs was anti-infectives (56.9%). Majority of the interventions were rated as significant for both the severity of error (76.9%) and clinical relevance (72.4%). However, the pADE was deemed to be low (61.2%). The rating of pADE may be affected by the lack of information in patient profiles. This study demonstrated the crucial role of pharmacists in ensuring medication safety in ICUs. Possible areas of service improvement include educating medical residents on common medication errors and empowering pharmacists towards collaborative prescribing.
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新加坡一家三级医院重症监护室药剂师干预措施的临床影响 - 一项回顾性队列研究
以往的研究认为,药剂师在重症监护病房(ICU)提供优质医疗服务和确保用药安全方面至关重要。由于药剂师在重症监护室的影响因不同因素而异,我们的研究旨在描述和评估药剂师在新加坡重症监护室干预措施的影响,从而找出重症监护药学实践中需要改进的地方。我们对新加坡中央医院 5 个重症监护室 7 个月的药剂师干预进行了回顾性评估。干预措施根据解决的药物相关问题(MRPs)进行分类。药剂师干预措施的影响是通过评定用药顺序错误的严重程度、干预措施的临床相关性以及在没有药剂师干预措施的情况下发生药物不良事件(pADE)的概率来评估的。共有 619 项干预措施,涉及 775 个 MRP,其中 91.1%被接受。发现的主要 MRP 是用药方案不当(49.2%),MRP 中最常涉及的药物类别是抗感染药物(56.9%)。大多数干预措施的错误严重程度(76.9%)和临床相关性(72.4%)都被评为显著。然而,pADE 被认为较低(61.2%)。对 pADE 的评分可能会受到缺乏患者资料信息的影响。这项研究表明,药剂师在确保重症监护病房用药安全方面发挥着至关重要的作用。可改进服务的领域包括教育住院医师了解常见的用药错误,以及增强药剂师合作开处方的能力。
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来源期刊
Proceedings of Singapore Healthcare
Proceedings of Singapore Healthcare MEDICINE, GENERAL & INTERNAL-
CiteScore
0.90
自引率
0.00%
发文量
42
审稿时长
15 weeks
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