Du Li Xian Simon, Edwards Gail Emily, Rashidzada Zohal, Newnham Harvey, McGloughlin Steve, Orosz Judit, Tong Erica Y
Pharmacy Department, Alfred Health, Melbourne, VIC, Australia.
General Medicine Unit, Alfred Health, Melbourne, VIC, Australia.
J Intensive Care Med. 2025 Mar;40(3):247-252. doi: 10.1177/08850666241277507. Epub 2024 Sep 5.
To evaluate the difference in proportion of patients receiving antimicrobials within one hour of sepsis recognition at sepsis-related Medical Emergency Team (MET) calls, without or with a sepsis-credentialed pharmacist. Retrospective pre and post-intervention study. Single centre tertiary referral hospital. Patients admitted to the General Medicine Unit who had a sepsis-related MET call 24 hrs per day, and all other units from 17:00-08:00 hrs from August 2019 to Jan 2020 in the pre-intervention cohort and Aug 2020 to Jan 2021 for the post-intervention cohort. Pharmacists attended MET calls to assist selection of antimicrobials, collaboratively prescribe with the medical officers, ensure supply, provide advice on dosing calculations, reconstitution, and administration. The pre-intervention cohort (Aug 2019-Jan 2020) did not have credentialed pharmacists' involvement at MET calls. Proportion of patients who received antimicrobials within one hours of MET call. There were 97 sepsis-related MET calls in the pre-intervention cohort and 110 sepsis-related MET calls in the post-intervention cohort. A significantly higher proportion of patients received antimicrobials within one hour with pharmacist involvement, compared to control (81.3% vs 59.7%, = .0006). A reduction in median time to antimicrobial administration (43 min vs 54 min, = .017) was observed. Sepsis-related MET calls with pharmacist involvement experienced a greater proportion of patients receiving antimicrobials within one hour of sepsis recognition, and a reduction in median time to antimicrobial administration. These results provide support for routine pharmacist involvement at MET calls to assist patients receiving medications in a timely and efficient manner.
评估在与脓毒症相关的医疗应急团队（MET）呼叫中，在识别脓毒症后一小时内接受抗菌药物治疗的患者比例差异，有无具备脓毒症资质的药剂师参与。回顾性干预前后研究。单中心三级转诊医院。2019年8月至2020年1月干预前队列中，每天24小时入住普通内科病房且有与脓毒症相关MET呼叫的患者，以及2020年8月至2021年1月干预后队列中其他所有病房在17:00 - 08:00期间有与脓毒症相关MET呼叫的患者。药剂师参与MET呼叫以协助抗菌药物的选择，与医务人员共同开处方，确保供应，提供剂量计算、复溶和给药方面的建议。干预前队列（2019年8月至2020年1月）在MET呼叫中没有具备资质的药剂师参与。MET呼叫后一小时内接受抗菌药物治疗的患者比例。干预前队列中有97次与脓毒症相关的MET呼叫，干预后队列中有110次与脓毒症相关的MET呼叫。与对照组相比，有药剂师参与时，在一小时内接受抗菌药物治疗的患者比例显著更高（81.3%对59.7%，P = 0.0006）。观察到抗菌药物给药的中位时间有所缩短（43分钟对54分钟，P = 0.017）。有药剂师参与的与脓毒症相关的MET呼叫中，在脓毒症识别后一小时内接受抗菌药物治疗的患者比例更高，且抗菌药物给药的中位时间缩短。这些结果为药剂师常规参与MET呼叫以协助患者及时、高效地接受药物治疗提供了支持。
