Cross Verity J, Parker James T, Law Min Marie-Christine Y L, Bourne Richard S
Department of Pharmacy, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK.
Departments of Pharmacy and Critical Care, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK.
Eur J Hosp Pharm. 2018 Mar;25(e1):e2-e6. doi: 10.1136/ejhpharm-2017-001267. Epub 2017 Aug 9.
To evaluate the introduction of pharmacist independent prescribing activity across three general critical care units within a single large UK teaching hospital. To identify the prescribing demographics including total of all prescriptions, number prescribed by pharmacists, reason for pharmacist prescription, range of medications prescribed, pharmacist prescribing error rate and the extent of pharmacist second 'clinical check'.
Retrospective evaluation of e-prescribing across all general critical care units of a single large UK teaching hospital. All prescribing data were downloaded over a 1-month period (May to June 2016) with analysis of pharmacist prescribing activity including rate, indication, therapeutic class and error rate.
In total, 5374 medicines were prescribed in 193 patients during the evaluated period. Prescribing pharmacists were available on the units on 60.4% (58/96) of days, during their working hours and accounted for 576/5374 (10.7%) of medicines prescribed in 65.2% (126/193) of patients. The majority (342/576) of pharmacist prescriptions were for new medicines. Infections, central nervous system, and nutrition/blood were the top three British National Formulary (BNF) therapeutic categories, accounting for 63.4% (349/576) of all pharmacist prescriptions. The critical care pharmacist prescribing error rate was 0.18% (1/550).
Pharmacist independent prescribers demonstrated a high degree and wide-ranging scope of prescribing activity in general critical care patients. Pharmacists contributed a significant proportion of total prescribing, despite less than full service coverage. Prescribing activity was also safe with a very low error rate recorded.
评估在英国一家大型教学医院的三个普通重症监护病房引入药剂师独立处方活动的情况。确定处方人口统计学数据，包括所有处方总数、药剂师开具的处方数量、药剂师处方的原因、所开药物的范围、药剂师处方错误率以及药剂师二次“临床检查”的程度。
对英国一家大型教学医院所有普通重症监护病房的电子处方进行回顾性评估。在1个月期间（2016年5月至6月）下载所有处方数据，并分析药剂师的处方活动，包括开具率、适应证、治疗类别和错误率。
在评估期间，193名患者共开具了5374种药物。在工作日的工作时间内，各病房有药剂师开处方的天数占60.4%（58/96），药剂师开具的药物占所开药物总数的576/5374（10.7%），涉及65.2%（126/193）的患者。药剂师开具的大多数处方（342/576）是新药。感染、中枢神经系统和营养/血液是英国国家处方集（BNF）中排名前三的治疗类别，占所有药剂师处方的63.4%（349/576）。重症监护药剂师的处方错误率为0.18%（1/550）。
药剂师独立处方者在普通重症监护患者中表现出高度且广泛的处方活动范围。尽管服务覆盖不完全，但药剂师在总处方中占了很大比例。记录的处方活动也很安全，错误率非常低。
