Keats Kelli, Sikora Andrea, Heavner Mojdeh S, Chen Xianyan, Smith Susan E
Department of Pharmacy, Augusta University Medical Center, Augusta, GA.
Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA.
Crit Care Explor. 2023 Aug 25;5(9):e0956. doi: 10.1097/CCE.0000000000000956. eCollection 2023 Sep.
The workload of healthcare professionals including physicians and nurses in the ICU has an established relationship to patient outcomes, including mortality, length of stay, and other quality indicators; however, the relationship of critical care pharmacist workload to outcomes has not been rigorously evaluated and determined. The objective of our study is to characterize the relationship of critical care pharmacist workload in the ICU as it relates to patient-centered outcomes of critically ill patients.
Optimizing Pharmacist Team-Integration for ICU patient Management is a multicenter, observational cohort study with a target enrollment of 20,000 critically ill patients. Participating critical care pharmacists will enroll patients managed in the ICU. Data collection will consist of two observational phases: prospective and retrospective. During the prospective phase, critical care pharmacists will record daily workload data (e.g., census, number of rounding teams). During the retrospective phase, patient demographics, severity of illness, medication regimen complexity, and outcomes will be recorded. The primary outcome is mortality. Multiple methods will be used to explore the primary outcome including multilevel multiple logistic regression with stepwise variable selection to exclude nonsignificant covariates from the final model, supervised and unsupervised machine learning techniques, and Bayesian analysis.
Our protocol describes the processes and methods for an observational study in the ICU.
This study seeks to determine the relationship between pharmacist workload, as measured by pharmacist-to-patient ratio and the pharmacist clinical burden index, and patient-centered outcomes, including mortality and length of stay.
包括重症监护病房（ICU）内科医生和护士在内的医护人员工作量与患者预后（包括死亡率、住院时间及其他质量指标）之间的关系已得到确认；然而，重症监护药师工作量与预后之间的关系尚未得到严格评估和确定。我们研究的目的是描述ICU中重症监护药师工作量与危重症患者以患者为中心的预后之间的关系。
优化ICU患者管理的药师团队整合是一项多中心观察性队列研究，目标入组20000例危重症患者。参与研究的重症监护药师将纳入在ICU接受治疗的患者。数据收集将包括两个观察阶段：前瞻性和回顾性。在前瞻性阶段，重症监护药师将记录每日工作量数据（如患者总数、查房团队数量）。在回顾性阶段，将记录患者人口统计学信息、疾病严重程度、药物治疗方案复杂性及预后。主要结局是死亡率。将使用多种方法探讨主要结局，包括采用逐步变量选择的多水平多逻辑回归以从最终模型中排除无显著意义的协变量、监督和非监督机器学习技术以及贝叶斯分析。
我们的方案描述了ICU观察性研究的流程和方法。
本研究旨在确定以药师与患者的比例及药师临床负担指数衡量的药师工作量与以患者为中心的预后（包括死亡率和住院时间）之间的关系。
