Borthwick Mark, Barton Greg, Bourne Richard S, McKenzie Catherine
Departments of Pharmacy and Critical Care, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Departments of Pharmacy and Critical Care, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK.
Int J Pharm Pract. 2018 Aug;26(4):325-333. doi: 10.1111/ijpp.12408. Epub 2017 Oct 11.
Clinical pharmacists reduce medication errors and optimize the use of medication in critically ill patients, although actual staffing level and deployment of UK pharmacists is unknown. The primary aim was to investigate the UK deployment of the clinical pharmacy workforce in critical care and compare this with published standards.
An electronic data entry tool was created and distributed for UK critical care pharmacy services to record their critical care workforce deployment data.
Data were received for 279 critical care units in 171 organizations. Clinical pharmacist input was identified for 98.6% of critical care units. The median weekday pharmacist input to critical care was 0.045 whole time equivalents per Level 3 (ICU) bed with significant interregional variation. Weekend services were sparse. Pharmacists spent 24.5% of time on the multidisciplinary team ward round, 58.5% of time on independent patient review and 17% of time on other critical care professional support activities. There is significant variation in staffing levels when services are stratified by highest level of competence of critical care pharmacist within an organization (P = 0.03), with significant differences in time spent on the multi-disciplinary ward round (P = 0.010) and on other critical care activities (P = 0.009), but not on independent patient review.
Investment in pharmacy services is required to improve access to clinical pharmacy expertise at weekends, on MDT ward rounds and for other critical care activities.
临床药师可减少重症患者的用药错误并优化药物使用，尽管英国药师的实际人员配备水平和部署情况尚不清楚。主要目的是调查英国临床药学人员在重症监护领域的部署情况，并将其与已公布的标准进行比较。
创建了一个电子数据录入工具，并分发给英国的重症监护药房服务机构，以记录其重症监护人员部署数据。
收到了171个组织中279个重症监护病房的数据。98.6%的重症监护病房有临床药师参与。每个三级（重症监护病房）床位的临床药师工作日投入中位数为0.045个全时当量，地区间差异显著。周末服务较少。药师将24.5%的时间用于多学科团队查房，58.5%的时间用于独立患者评估，17%的时间用于其他重症监护专业支持活动。当按组织内重症监护药师的最高能力水平对服务进行分层时，人员配备水平存在显著差异（P = 0.03），在多学科查房（P = 0.010）和其他重症监护活动（P = 0.009）上花费的时间存在显著差异，但在独立患者评估上没有差异。
需要对药学服务进行投资，以改善周末、多学科团队查房及其他重症监护活动中临床药学专业知识的可及性。
