HCA Holdings Inc, Nashville, TN, USA.
J Pharm Pract. 2022 Apr;35(2):184-189. doi: 10.1177/0897190020961655. Epub 2020 Oct 5.
As the COVID-19 pandemic swept through the United States, our heath-system mobilized clinical pharmacy services to address critical clinical medication management needs. Reinforcing recommended medication management strategies for clinical pharmacists was key to successful implementation. Best practice strategies include converting patients from intravenous (IV) to oral medication, transitioning to IV push medication administration, evaluating standard medication administration timing, reviewing metered dose inhaler (MDI) and nebulizer utilization, using alternatives for medications in short supply, reviewing coronavirus disease COVID-19 treatment recommendations, reviewing COVID-19 patient care on interdisciplinary rounds, de-prescribing and de-escalating to eliminate unnecessary medications, and assessing for appropriate venous thromboembolism prophylaxis. These strategies served to help protect medication supply, reduce number of staff entries into patient rooms to conserve personal protective equipment, limit nursing time in patient rooms to reduce COVID-19 exposure risk, and to conserve compounding supplies. Here we present example medication management guidance as used by a large healthcare system during the COVID-19 pandemic.
随着 COVID-19 疫情在美国蔓延,我们的医疗系统调动临床药学服务来满足关键的临床用药管理需求。强化推荐的临床药师用药管理策略是成功实施的关键。最佳实践策略包括将患者从静脉(IV)用药转为口服用药,转为 IV 推注药物管理,评估标准药物给药时间,审查计量吸入器(MDI)和雾化器的使用情况,使用短缺药物的替代品,审查冠状病毒病 COVID-19 治疗建议,在跨学科查房时审查 COVID-19 患者护理,减药和降级以消除不必要的药物,以及评估适当的静脉血栓栓塞预防。这些策略有助于保护药物供应,减少进入患者房间的工作人员数量以节省个人防护设备,限制护士在患者房间的时间以降低 COVID-19 暴露风险,并节省配制用品。在此,我们展示了在 COVID-19 大流行期间,一家大型医疗系统使用的示例药物管理指南。