Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, USA.
Ann Emerg Med. 2013 Feb;61(2):209-14.e1. doi: 10.1016/j.annemergmed.2012.04.011. Epub 2012 May 24.
We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists.
This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service.
The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction.
Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers.
我们确定了与急诊药师审查从急诊部门（ED）出院患者的出院处方相关的干预措施的速度和详细信息。此外，我们评估了护理提供者对急诊药师提供的此类服务的满意度。
这是一项在为成人和儿科患者服务的学术医疗中心的 ED 中进行的前瞻性观察研究。使用标准化表格编译了急诊药师对出院处方进行干预的详细信息。干预措施分为预防错误和优化治疗。ED 的工作人员接受了与这项新的急诊药师提供的服务的影响和满意度相关的调查。
在研究期间，急诊药师审查了 674 份出院处方，其中 602 份（89.3%）为成人患者，72 份（10.7%）为儿科患者。急诊药师对 68 份处方进行了干预，干预率为 10.1%（95%置信区间[CI]8.0%至 12.7%）。成人处方的干预率为 8.5%（95% CI 6.4%至 11.1%），儿科处方的干预率为 23.6%（95% CI 14.7%至 35.3%）（差异 15.1%；95% CI 5.1%至 25.2%）。有同样数量的干预措施被归类为预防错误和优化药物治疗，分别为 37 项（54%）和 31 项（46%）。超过 95%的调查受访者认为新的药剂师服务提高了患者安全性，优化了药物治疗方案，并提高了患者满意度。
急诊药师审查出院 ED 患者的出院处方有可能显著改善与处方不规范相关的患者护理，并受到 ED 护理提供者的高度重视。
