Chaverri-Fernández Jose Miguel, Zavaleta-Monestel Esteban, Murillo-Cubero Josué, Díaz-Madriz José Pablo, Leiva-Montero Brayan, Arguedas-Chacón Sebastián, Arguedas-Herrera Raquel
Department of Pharmacology, Toxicology and Pharmacodependence, University of Costa Rica, San José 11501, Costa Rica.
Department of Pharmacy, Hospital Clínica Bíblica, San José 10104, Costa Rica.
Pharmacy (Basel). 2022 Jun 30;10(4):74. doi: 10.3390/pharmacy10040074.
FASTHUG is a mnemonic used by intensive care physicians to ensure the proper management of patients admitted to an Intensive Care Unit (ICU). FASTHUG-MAIDENS is a modified version that incorporates key pharmacotherapeutic elements such as delirium management, drug dosing, and drug interactions for an appropriate medication assessment of critically ill patients. An analytical cross-sectional study of hospitalized patients was carried out to determine aspects related to the pharmacotherapeutic management of critically ill patients that required to be optimized, to design and implement a protocol based on the FASTHUG-MAIDENS mnemonic. A total of 435 evaluations were performed to assess the status of current critical patient management. The main parameters with opportunities to be improved were analgesia, feeding, and sedation. With the implementation of MAIDENS, the parameters of analgesia, sedation, and thromboprophylaxis showed an increase in the percentage of optimal management. Furthermore, 103 drug-related problems were detected, and most of them were associated with feeding (21.3%), glucose control (11.7%), and delirium (9.7%). The FASTHUG MAIDENS protocol implementation allows for the evaluation of more vital aspects in the management of critically ill patients. The daily review of patients admitted to the ICU by a clinical pharmacist (CP) using the FASTHUG-MAIDENS checklist instead of the FASTHUG mnemonic facilitates the identification of DRPs for the performance of possible interventions by the CP to improve the pharmacotherapeutic management.
FASTHUG是重症监护医师使用的一种记忆方法,以确保对入住重症监护病房(ICU)的患者进行妥善管理。FASTHUG-MAIDENS是一个经过修改的版本,纳入了关键的药物治疗要素,如谵妄管理、药物剂量和药物相互作用,以便对重症患者进行适当的药物评估。对住院患者进行了一项分析性横断面研究,以确定重症患者药物治疗管理中需要优化的方面,并基于FASTHUG-MAIDENS记忆方法设计和实施一项方案。共进行了435次评估,以评估当前重症患者管理的状况。有改进机会的主要参数是镇痛、营养供给和镇静。随着MAIDENS的实施,镇痛、镇静和血栓预防的参数显示最佳管理的百分比有所增加。此外,检测到103个与药物相关的问题,其中大多数与营养供给(21.3%)、血糖控制(11.7%)和谵妄(9.7%)有关。FASTHUG MAIDENS方案的实施有助于评估重症患者管理中更重要的方面。临床药师(CP)使用FASTHUG-MAIDENS检查表而非FASTHUG记忆方法对入住ICU的患者进行每日评估,有助于识别药物相关问题,以便CP进行可能的干预,从而改善药物治疗管理。