Clinical pharmacist interventions on a UK neurosurgical critical care unit: a 2-week service evaluation
- 524 Downloads
Objective To identify the input of specialist critical care pharmacists into patient care, promoting safe and effective medication therapy by quantifying medicines related interventions on a Neurocritical Care Unit. Setting UK 19-bedded Neurocritical Care Unit providing a tertiary referral service for Neurosurgical and Neurology patients. Method Prospective observational study of clinical pharmacist interventions conducted over a 2 week period in July 2010. Interventions were recorded, categorised and independently assessed by a panel of 5 healthcare professionals for potential patient harm if the intervention had not been made. Main outcome measure Quantity and potential severity of clinical pharmacist interventions recorded. Results 246 interventions were made in 55 patients over the 10 day observational period. A median of 7.0 (1.5; 12.0) and 2.0 (1.0; 4.0) interventions were made in Level 3 and 2 patients respectively. Mean potential severity of patient harm per intervention was 3.7 (1.12); range 0.8–7.0. Central Nervous System medicines comprised the most common therapeutic group affected (37.8%). Medication errors accounted for 87 of the 246 interventions (35.4%). Conclusion The results of the clinical pharmacist intervention evaluation demonstrated an important role for critical care pharmacists in the safe and effective use of medicines in a UK Neurocritical care unit.
KeywordsClinical pharmacist Critical care Medication errors Neurosurgery United Kingdom
The authors wish to acknowledge the assistance of Miss Christine LawMin, Dr Stefan Jankowski and Sr Lynda Gunn with the panel medicine intervention assessments. They are also grateful to Dr Rob Shulman for providing the intervention record form used in the evaluation.
No special funding obtained.
Conflicts of interest
- 2.The Best Medicine: The management of medicines in acute and specialist trusts. Commission for healthcare audit and inspection report, 2007. Available from the World-Wide-Web. http://www.cqc.org.uk/_db/_documents/The_Best_Medicine_acute_trust_tagged.pdf.
- 3.Allied health professionals and health care scientists. Critical care staffing guidance: Department of Health, 2003. Available from the World-Wide-Web. www.ukcpa.org/ukcpadocuments/2.pdf.
- 4.Adult critical care: Specialist pharmacy practice: Department of Health, 2005. Available from the World-Wide-Web. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4114093.pdf.
- 6.Levels of critical care for adult patients: Intensive Care Society, 2009. Available from the World-Wide-Web. http://www.ics.ac.uk/intensive_care_professional/standards_and_guidelines/levels_of_critical_care_for_adult_patients.
- 10.Saokaew S, Maphanta S, Thangsomboon P. Impact of pharmacist’s interventions on cost of drug therapy in intensive care unit. Pharm Pract. 2009;7:81–7.Google Scholar