McDaniel Joshua, Bass Lynn, Pate Toni, DeValve Michael, Miller Susan
Cape Fear Valley Health System, Fayetteville, NC, USA.
Southern Regional Area Health Education Center, Fayetteville, NC, USA.
Hosp Pharm. 2017 Sep;52(8):564-569. doi: 10.1177/0018578717723997. Epub 2017 Aug 3.
National professional organizations have recognized pharmacists as essential members of the intensive care unit (ICU) team. Critical care pharmacists' clinical activities have been categorized as fundamental, desirable, and optimal, providing a structure for gauging ICU pharmacy services being provided. To determine the impact the addition of a second ICU pharmacist covering 30 adult ICU beds at a large regional medical center has on the complexity of pharmacists' interventions, the types of clinical activities performed by the pharmacists, and the ICU team members' satisfaction. A prospective mixed-method descriptive study was conducted. Pharmacists recorded their interventions and clinical activities performed. A focus group composed of randomly selected ICU team members was held to qualitatively describe the impact of the additional pharmacist coverage on patient care, team dynamics, and pharmacy services provided. The baseline period consisted of 33 days, and the intervention period consisted of 20 days. The average complexity of interventions was 1.72 during the baseline period (mode = 2) versus 1.69 (mode = 2) during the intervention period. The number of desirable and optimal clinical activities performed daily increased during the intervention from 8.4 (n = 279) to 16.4 (n = 328) and 2.3 (n = 75) to 8.6 (n = 171) compared with the baseline, respectively. Focus group members qualitatively described additional pharmacist coverage as beneficial. The additional critical care pharmacist did not increase pharmacy intervention complexity; however, more interventions were performed per day. Additional pharmacist coverage increased the daily number of desirable and optimal clinical activities performed and positively impacted ICU team members' satisfaction.
国家专业组织已认可药剂师是重症监护病房(ICU)团队的重要成员。重症监护药剂师的临床活动已被分类为基本、理想和最佳活动,为衡量所提供的ICU药学服务提供了一个框架。为了确定在一家大型地区医疗中心增加一名负责30张成人ICU床位的第二名ICU药剂师对药剂师干预的复杂性、药剂师开展的临床活动类型以及ICU团队成员满意度的影响。开展了一项前瞻性混合方法描述性研究。药剂师记录了他们的干预措施和开展的临床活动。举行了一个由随机挑选的ICU团队成员组成的焦点小组,以定性描述增加药剂师覆盖对患者护理、团队动态和所提供药学服务的影响。基线期为33天,干预期为20天。基线期干预的平均复杂性为1.72(众数=2),而干预期为1.69(众数=2)。与基线相比,干预期间每天开展的理想和最佳临床活动数量分别从8.4(n=279)增加到16.