Evaluation of pharmacist interventions documented by an evening pharmacist in a paediatric intensive care unit (PICU)

Abstract

Aims & Objectives: To evaluate pharmacist interventions documented by the evening PICU pharmacist. Methods The evening pharmacist role commenced April 2017 working from 10:30am till 7pm weekdays assisting with afternoon and evening theatre and retrieval admissions, and reconciliation of medication charts for ward transfers. The review period was 18th April to 16th June. Analysis included: Proportion of pharmacist's clinical interventions recorded in electronic pharmacy program (iPharmacy). Independent risk rating of likelihood of harm from clinical interventions by a multidisciplinary team consisting of nurse, doctor and pharmacist. Results 144 pharmacist interventions were recorded over the 40-day period. An average four interventions were documented per day; half of the patients reviewed had a pharmacist intervention. 92% pharmacist interventions were associated with prescribing/transcribing, with the remainder addressing administration and monitoring. Of the prescribing/transcribing interventions 52% were associated with medication(s) omission (e.g. pain medications omitted), 20% with optimising medication therapies (frequencies and dose modifications) and 28% with no allergies or monitoring documentation. The medication categories for the pharmacist interventions consisted high-risk medications: antimicrobials, analgesics, electrolytes, anticoagulants, and immunosuppressants. Risks rating of pharmacist interventions results were: No risk of harm interventions: nurse 55%, doctor 24%, pharmacist 47%, Low risk of harm interventions: nurse 43%, doctor 68%, pharmacist 44%, Moderate risk of harm interventions: nurse 2%, doctor 8% and pharmacist 9%, No serious risk of harm interventions. Conclusions The evening pharmacist interventions were primarily related to prescribing/transcribing. There was a difference in risk rating of pharmacist interventions between the disciplines. The pharmacist and nurse underestimated the pharmacist interventions compared to the doctor.L6238158802018-09-13 <br />