Clinical pharmacist interventions on a UK neurosurgical critical care unit: a 2-week service evaluation

Abstract

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.