Larochelle Joseph M, Ghaly Marina, Creel Amy M
Xavier University of Louisiana College of Pharmacy, New Orleans, Louisiana ; Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.
J Pediatr Pharmacol Ther. 2012 Jul;17(3):263-9. doi: 10.5863/1551-6776-17.3.263.
The American Academy of Pediatrics and the Society of Critical Care Medicine have documented the importance of pharmacist involvement in pediatric care. Numerous studies have reported the impact of clinical pharmacy interventions in various adult care settings. However, in the pediatric critical care setting, the impact has not been well documented. The purpose of this study was to describe clinical pharmacy faculty interventions in a pediatric intensive care unit (PICU).
A pediatric clinical pharmacy faculty member performed and documented clinical interventions in a level I, 18-bed, tertiary care PICU. Information gathered included medication name, specific intervention performed, basic patient demographics, and length of stay from May to December 2009.
During the study period, there were 893 interventions performed on 159 patients over 66 days of service. (Average of 5.5 interventions/patient, and 34 interventions/100 patient PICU days.) Dosing recommendations and pharmacokinetics were the most common type of intervention (28.8% and 21.4%, respectively). Antibiotics and sedatives/analgesia were the most common drug classes in which interventions were made (34.4% and 20.3%, respectively). Ninety-eight percent of all interventions were accepted by the medical staff. The estimated annual cost savings from these interventions was $119,700.
The average number of interventions per patient in this study was higher than that reported in the literature to date. Dosing recommendations and pharmacokinetics were the most commonly recommended interventions documented. Although this study showed considerable cost savings by a pharmacy clinical faculty member, further study of economic benefits is needed.
美国儿科学会和危重病医学会已证明药剂师参与儿科护理的重要性。众多研究报告了临床药学干预在各种成人护理环境中的影响。然而,在儿科重症监护环境中,其影响尚未得到充分记录。本研究的目的是描述儿科临床药学教员在儿科重症监护病房(PICU)的干预措施。
一名儿科临床药学教员在一家拥有18张床位的一级三级护理PICU中实施并记录临床干预措施。收集的信息包括药物名称、实施的具体干预措施、患者基本人口统计学资料以及2009年5月至12月的住院时间。
在研究期间,在66天的服务期内,对159名患者进行了893次干预。(平均每位患者5.5次干预,每100个PICU患者日34次干预。)给药建议和药代动力学是最常见的干预类型(分别为28.8%和21.4%)。抗生素和镇静剂/镇痛药是进行干预最常见的药物类别(分别为34.4%和20.3%)。所有干预措施中有98%被医务人员接受。这些干预措施估计每年节省成本119,700美元。
本研究中每位患者的平均干预次数高于迄今为止文献报道的次数。给药建议和药代动力学是记录中最常推荐的干预措施。尽管本研究显示药房临床教员可节省大量成本,但仍需进一步研究经济效益。