Roman Cristina, Edwards Gail, Dooley Michael, Mitra Biswadev
Pharmacy Department and Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Australia
Pharmacy Department, The Alfred Hospital, Melbourne, Australia.
Am J Health Syst Pharm. 2018 Jun 1;75(11):796-806. doi: 10.2146/ajhp170321.
Results of a systematic literature review to identify roles for emergency medicine (EM) pharmacists beyond traditionally reported activities and to quantify the benefits of these roles in terms of patient outcomes are reported.
Emergency department (ED)-based clinical pharmacy is a rapidly growing practice area that has gained support in a number of countries globally, particularly over the last 5-10 years. A systematic literature search covering the period 1995-2016 was conducted to characterize emerging EM pharmacist roles and the impact on patient outcomes. Six databases were searched for research publications on pharmacist participation in patient care in a general ED or trauma center that documented interventions by ED-based pharmacists; 15 results satisfied the inclusion criteria. Six reported studies evaluated EM pharmacist involvement in the care of critically ill patients, 5 studies evaluated antimicrobial stewardship (AMS) activities via pharmacist review of positive cultures, 2 studies assessed pharmacist involvement in generating orders for nurse-administered home medications and 2 reviewed publications focused on EM pharmacist involvement in management of healthcare-associated pneumonia and dosing of phenytoin. A diverse range of positive patient outcomes was identified. The included studies were assessed to be of low quality.
A systematic review of the literature revealed 3 key emerging areas of practice for the EM pharmacist that are associated with positive patient outcomes. These included involvement in management of critically ill patients, AMS roles, and ordering of home medications in the ED.
报告一项系统文献综述的结果，以确定急诊医学（EM）药师在传统报道活动之外的作用，并从患者结局方面量化这些作用的益处。
基于急诊科（ED）的临床药学是一个快速发展的实践领域，在全球许多国家都得到了支持，尤其是在过去5至10年。进行了一项涵盖1995年至2016年期间的系统文献检索，以描述急诊医学药师的新兴作用及其对患者结局的影响。检索了六个数据库，以查找关于药师参与综合急诊科或创伤中心患者护理的研究出版物，这些出版物记录了基于急诊科的药师的干预措施；15项结果符合纳入标准。六项报告的研究评估了急诊医学药师参与重症患者护理的情况，五项研究通过药师对阳性培养结果的审查评估了抗菌药物管理（AMS）活动，两项研究评估了药师参与生成护士给药的家庭用药医嘱的情况，两项综述性出版物关注急诊医学药师参与医疗相关肺炎的管理和苯妥英钠的给药。确定了一系列不同的积极患者结局。纳入的研究质量较低。
对文献的系统综述揭示了急诊医学药师三个关键的新兴实践领域，这些领域与积极的患者结局相关。这些领域包括参与重症患者的管理、抗菌药物管理作用以及在急诊科开具家庭用药医嘱。
