评估有药剂师参与的败血症相关医疗急救小组 (MET) 呼叫和抗菌药物给药时间。

IF 3 3区 医学 Q2 CRITICAL CARE MEDICINE Journal of Intensive Care Medicine Pub Date : 2024-09-05 DOI:10.1177/08850666241277507
Li Xian Simon Du, Gail Emily Edwards, Zohal Rashidzada, Harvey Newnham, Steve McGloughlin, Judit Orosz, Erica Y Tong
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引用次数: 0

摘要

目的评估在没有脓毒症认证药剂师或有脓毒症认证药剂师的情况下,脓毒症相关医疗急救小组 (MET) 在确认脓毒症后一小时内接受抗菌药物治疗的患者比例差异。设计:干预前后的回顾性研究。地点:单中心三级转诊医院单中心三级转诊医院。参与者:2019年8月至2020年1月干预前队列和2020年8月至2021年1月干预后队列中每天24小时有脓毒症相关MET呼叫的普通内科病房住院患者,以及17:00-08:00期间所有其他病房的住院患者。干预措施:药剂师参加 MET 电话会议,协助选择抗菌药物,与医务人员合作开具处方,确保供应,并就剂量计算、复方和给药提供建议。干预前队列(2019 年 8 月至 2020 年 1 月)中没有经过认证的药剂师参与 MET 电话会议。结果测量:在 MET 呼叫后一小时内获得抗菌药物的患者比例。结果干预前队列中有 97 次与败血症相关的 MET 呼叫,干预后队列中有 110 次与败血症相关的 MET 呼叫。与对照组相比,有药剂师参与的患者在一小时内获得抗菌药物的比例明显更高(81.3% vs 59.7%,P = .0006)。抗菌药物给药的中位时间也有所缩短(43 分钟 vs 54 分钟,P = .017)。结论:在有药剂师参与的脓毒症相关 MET 呼叫中,脓毒症识别后一小时内接受抗菌药物治疗的患者比例更高,抗菌药物治疗的中位时间也有所缩短。这些结果支持药剂师在 MET 呼叫中的常规参与,以帮助患者及时、高效地接受药物治疗。
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Evaluation of Sepsis-Related Medical Emergency Team (MET) Calls with Pharmacist Involvement and Time to Antimicrobial Administration.

Objective: To evaluate the difference in proportion of patients receiving antimicrobials within one hour of sepsis recognition at sepsis-related Medical Emergency Team (MET) calls, without or with a sepsis-credentialed pharmacist. Design: Retrospective pre and post-intervention study. Setting: Single centre tertiary referral hospital. Participants: Patients admitted to the General Medicine Unit who had a sepsis-related MET call 24 hrs per day, and all other units from 17:00-08:00 hrs from August 2019 to Jan 2020 in the pre-intervention cohort and Aug 2020 to Jan 2021 for the post-intervention cohort. Interventions: Pharmacists attended MET calls to assist selection of antimicrobials, collaboratively prescribe with the medical officers, ensure supply, provide advice on dosing calculations, reconstitution, and administration. The pre-intervention cohort (Aug 2019-Jan 2020) did not have credentialed pharmacists' involvement at MET calls. Outcome Measures: Proportion of patients who received antimicrobials within one hours of MET call. Results: There were 97 sepsis-related MET calls in the pre-intervention cohort and 110 sepsis-related MET calls in the post-intervention cohort. A significantly higher proportion of patients received antimicrobials within one hour with pharmacist involvement, compared to control (81.3% vs 59.7%, P = .0006). A reduction in median time to antimicrobial administration (43 min vs 54 min, P = .017) was observed. Conclusion: Sepsis-related MET calls with pharmacist involvement experienced a greater proportion of patients receiving antimicrobials within one hour of sepsis recognition, and a reduction in median time to antimicrobial administration. These results provide support for routine pharmacist involvement at MET calls to assist patients receiving medications in a timely and efficient manner.

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来源期刊
Journal of Intensive Care Medicine
Journal of Intensive Care Medicine CRITICAL CARE MEDICINE-
CiteScore
7.60
自引率
3.20%
发文量
107
期刊介绍: Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.
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