Department of Pharmacy, Massachusetts General Hospital, Boston, MA.
Am J Health Syst Pharm. 2020 Dec 4;77(24):2101-2106. doi: 10.1093/ajhp/zxaa273.
To provide pharmacy residents' perspective on how the department of pharmacy at a large academic medical center prepared and managed the surge in admissions of patients with coronavirus disease 2019 (COVID-19), to describe how residents were trained for intensive care unit (ICU) staffing, and to provide recommendations on how residency programs nationally could navigate a second wave of COVID-19 admissions or other disaster response situations.
The majority of postgraduate year 1 (PGY1) pharmacy residents at the institution were trained for ICU staffing and deployed throughout the hospital to ICU units converted to dedicated COVID-19 ICUs to assist in patient care. The training process included live videoconference lectures about relevant ICU topics and on-site experiences with critical care clinical pharmacists. Based on their experience in training for and participating in ICU care of patients with COVID-19, the pharmacy residents recommend considering additional cross-training of residents, integration of additional clinical education, creation of opportunities for resident involvement in telehealth, advancement of residents' roles in emergency responses, building robust mental health services, and continued advocacy for the advancement of pharmacists' and pharmacy residents' scope of practice.
The onset of the COVID-19 pandemic caused the institution to reevaluate the allocation of resources, and the department of pharmacy elected to deploy PGY1 pharmacy residents with previous ICU experience to assist in caring for an ICU patient census that had doubled. This experience will be valuable in preparing for another potential wave of COVID-19 cases and a surge in admissions of other groups of patients who deferred care due to the pandemic.
提供药房住院医师的观点,了解大型学术医疗中心的药房部门如何为 2019 年冠状病毒病(COVID-19)患者的大量入院做准备和管理,描述住院医师如何接受重症监护病房(ICU)人员配备的培训,并就全国住院医师培训计划如何应对 COVID-19 第二波入院或其他灾害应对情况提供建议。
该机构的大多数第一年住院医师(PGY1)药房住院医师接受了 ICU 人员配备的培训,并被部署到整个医院的 ICU 病房,以协助 COVID-19 患者的护理。培训过程包括关于相关 ICU 主题的现场视频讲座和与重症监护临床药师的现场经验。根据他们在培训和参与 COVID-19 患者 ICU 护理方面的经验,药房住院医师建议考虑对住院医师进行额外的交叉培训,整合更多的临床教育,为住院医师参与远程医疗创造机会,推进住院医师在应急响应中的角色,建立强大的心理健康服务,并继续倡导扩大药剂师和药房住院医师的执业范围。
COVID-19 大流行的爆发促使该机构重新评估资源配置,药房部门选择部署具有先前 ICU 经验的 PGY1 药房住院医师,以协助照顾 ICU 患者人数增加了一倍。这一经验将有助于为另一波 COVID-19 病例和因大流行而推迟治疗的其他患者群体的入院高峰做好准备。