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评估风险类别在一家四级医院对患者进行优先级排序以实现最佳用药史完善的有效性。

Evaluating the Effectiveness of Risk Categories for Prioritising Patients for Best Possible Medication History Completion at a Quaternary Hospital.

作者信息

Ryan Marissa, Dunsdon Jane, Winckel Karl, Ziser Kate, Phi Linh, Tominaga Manae, Currey Elizabeth, Falconer Nazanin, Snoswell Centaine L

机构信息

Princess Alexandra Hospital, Brisbane, QLD, Australia.

The University of Queensland, Brisbane, Australia.

出版信息

Hosp Pharm. 2025 Aug 28:00185787251365525. doi: 10.1177/00185787251365525.

Abstract

BACKGROUND

The Pharmacist Workload Prioritisation Work Instruction (PWPWI) was developed to optimise clinical pharmacy services, such as best possible medication history (BPMH) completion. Inpatients are assigned a risk category and associated BPMH completion timeframe.

AIM

To determine the proportion of inpatients who met criteria for urgent, high, moderate, and low risk, and the proportion in each category who were reviewed within 24 hours of admission, to inform PWPWI updates.

METHOD

Clinical, pathologic, medication data, and whether or not the BPMH was completed within 24-hours, was retrospectively collected for inpatients from a single institution and the PWPWI was used to assign risk category.

RESULTS

Data was collected for 280 patients. Prioritisation risk categories were assigned as 3% urgent and requiring immediate review, 61% high risk requiring review within 24-hours, 2% moderate risk requiring review within 48-hours, and 34% low risk. Overall, BPMHs were completed within 24-hours for 54% patients; 50% of the urgent risk individuals, 57% of the high risk, 100% of the moderate risk, and 46% of the low risk.

CONCLUSION

This study found that nearly two-thirds of patients were urgent or high risk, affecting the completion timeframes. The study's findings, including four key recommendations, will update the PWPWI. Regular evaluations of such tools are suggested to adapt to changes in clinical care and local context. Following the update, the pharmacy department will receive training to optimise BPMH prioritisation.

摘要

背景

制定了药剂师工作量优先级工作指南(PWPWI)以优化临床药学服务,例如完善尽可能完整的用药史(BPMH)。为住院患者分配风险类别以及相关的BPMH完成时间框架。

目的

确定符合紧急、高、中、低风险标准的住院患者比例,以及各风险类别中在入院后24小时内接受评估的患者比例,为更新PWPWI提供依据。

方法

回顾性收集来自单一机构的住院患者的临床、病理、用药数据以及BPMH是否在24小时内完成的数据,并使用PWPWI来分配风险类别。

结果

收集了280名患者的数据。优先级风险类别分配如下:3%为紧急情况,需要立即评估;61%为高风险,需要在24小时内评估;2%为中度风险,需要在48小时内评估;34%为低风险。总体而言,54%的患者在24小时内完成了BPMH;紧急风险患者中有50%,高风险患者中有57%,中度风险患者中有100%,低风险患者中有46%。

结论

本研究发现近三分之二的患者为紧急或高风险,这影响了完成时间框架。该研究结果,包括四项关键建议,将更新PWPWI。建议定期评估此类工具,以适应临床护理和当地情况的变化。更新后,药房部门将接受培训以优化BPMH的优先级。

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