Medicina intensiva 2018 03 28() pii S0210-5691(18)30052-4
To evaluate incorporation of the hospital pharmacist to the routine activity of an Intensive Care Unit (ICU).
A prospective observational study was carried out to evaluate the impact of pharmacist interventions, made by a pharmacist temporarily assigned to the ICU, upon medical prescriptions.
A medical and surgical ICU with 21 beds.
Patients with at least one ICU stay were included, while patients with admission and discharge in periods when the pharmacist was not present were excluded.
The interventions were made after daily review of the prescriptions, and were communicated verbally or in writing to the supervising physician.
Number of interventions, therapeutic group of the drugs involved, type of intervention and degree of acceptance.
A total of 194 interventions were made in 62 patients. The majority were related to safety aspects (33%) and the optimization of therapy (32%). The most frequent interventions were the administration of drugs via the nasogastric tube (19%) and pharmacokinetic monitoring (14.4%). The most frequently involved groups of drugs were anti-infectious agents (33%) and digestive system medications (27%). A total of 56.2% of the interventions were made verbally, and 80% were accepted.
Pharmacist adscription to an ICU and the implementation of interventions on prescriptions have allowed improvement of safety and the optimization of pharmacotherapy in more than 50% of the patients. The high rate of acceptance of these interventions would support the implementation of such programs in critical care units.