The medical emergency team pharmacist: describing an overnight service

Abstract

Background

Clinical practice after hours and attendance at medical emergency team (MET) calls are two novel and emerging areas of pharmacy practice. During the COVID-19 pandemic, our institution's pharmacy services expanded from 8 am–5 pm to 24 h daily, including MET call attendance.

Aim

This study aimed to describe pharmacist roles, including medications charted by the general medicine and intensive care unit pharmacists during the period of extended-hours pharmacy practice and the characteristics of MET calls attended.

Method

This descriptive, cross-sectional study included patients admitted to the Alfred Hospital, Victoria, Australia between 3 April 2020–28 February 2021, when a MET was called between 5 pm–8 am, a pharmacist attended, and medication changes occurred. Data collected included whether the MET call was medication related and a description of medication changes. Ethics approval was granted by the Alfred Hospital Human Research Ethics Committee (Reference no: 297/21).

Results

One thousand six hundred and forty-four MET calls (average 5.4 calls per night) were attended by pharmacists during extended hours. Medication changes were made in response to clinical deterioration at 627 (38%) calls. The most frequent change was the initiation of cardiovascular medications (n = 206). Partnered pharmacist medication charting, including commencing, ceasing, or changing medications, occurred at 39% of MET calls with therapy changes.

Conclusion

Pharmacists can play a key role in managing deteriorating patients as part of a MET team. Medications may be implicated in clinical deterioration of patients and are frequently administered at MET calls. The expansion of pharmacy services provided the opportunity for pharmacists to contribute to MET calls across the 24-h period.