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使用远程药学服务的 ICU 和非 ICU 临床药学服务的系统评价

A Systematic Review of ICU and Non-ICU Clinical Pharmacy Services Using Telepharmacy.

机构信息

1 UPMC Presbyterian Shadyside, Pittsburgh, PA, USA.

2 University of Florida College of Pharmacy, Gainesville, FL, USA.

出版信息

Ann Pharmacother. 2018 Dec;52(12):1250-1258. doi: 10.1177/1060028018787213. Epub 2018 Jul 9.

Abstract

OBJECTIVE

To assess the impact of telepharmacy services in the acute care setting.

DATA SOURCES

EMBase, MEDLINE, and SCOPUS database searches were performed through April 2018.

STUDY SELECTION AND DATA EXTRACTION

PRISMA guidelines were applied for this systematic review. All English-language studies meeting the criteria of the following population, intervention, comparison, and outcome question were included: What impact does the provision of inpatient clinical pharmacy services delivered via telemedicine have on patient outcomes compared with standard of care?

DATA SYNTHESIS

A total of 11 studies were identified for the acute care setting, including 3 for critically ill patients. All studies demonstrated a positive impact on patient outcomes, nursing satisfaction, and disease management. Varying modes of telepharmacy technology were used, such as remote access to electronic medical records, faxing or scanning documents, pictures or webcams. For communication purposes, telepharmacists used email or electronic communication, facsimile, video review, or telephone to speak directly with hospital personnel and patients. Relevance to Patient Care and Clinical Practice: Inpatient telepharmacy is feasible and should be leveraged to further enhance patient care by complementing existing service models.

CONCLUSIONS

Telepharmacy services enhanced patient outcomes, improved nursing satisfaction, and expanded services within inpatient settings. Similar technologies were leveraged in non-intensive care units (ICUs) and ICUs, but the goals of telepharmacy appeared to differ. ICUs focused on an expansion of services in the ICU and non-ICUs addressed improved patient outreach in rural areas.

摘要

目的

评估远程药学服务在急性护理环境中的影响。

资料来源

通过 2018 年 4 月在 EMBase、MEDLINE 和 SCOPUS 数据库进行检索。

研究选择和资料提取

本系统评价采用 PRISMA 指南。所有符合以下人群、干预、比较和结果问题标准的英文研究均被纳入:与常规护理相比,通过远程医疗提供的住院临床药学服务对患者结局有何影响?

资料综合

共确定了 11 项针对急性护理环境的研究,其中 3 项针对危重症患者。所有研究均表明对患者结局、护理满意度和疾病管理有积极影响。远程药学技术的使用方式各不相同,如远程访问电子病历、传真或扫描文件、图片或网络摄像头。为了进行沟通,药剂师使用电子邮件或电子通讯、传真、视频审查或电话直接与医院人员和患者进行交流。

与患者护理和临床实践的相关性

住院远程药学是可行的,应通过补充现有服务模式来进一步增强患者护理。

结论

远程药学服务提高了患者结局,改善了护理满意度,并在住院环境中扩大了服务范围。类似的技术在非重症监护病房(ICU)和 ICU 中得到了利用,但远程药学的目标似乎有所不同。ICU 专注于扩大 ICU 内的服务范围,而非 ICU 则致力于改善农村地区的患者服务。

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