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Effects of implementing a clinical pharmacist service in a mixed Norwegian ICU
  1. Elisabeth T Johansen1,
  2. Stine M Haustreis1,
  3. Ann S Mowinckel1,
  4. Lars M Ytrebø2
  1. 1Hospital Pharmacy of North Norway Trust, University Hospital of North Norway, Tromsø, Norway
  2. 2Critical Care Unit, University Hospital of North Norway and Institute of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
  1. Correspondence to Elisabeth T Johansen, Department of Pharmacy, University Hospital of North Norway, Tromsø 9017, Norway; elisabeth.t.johansen{at}sykehusapotek-nord.no

Abstract

Objectives An unacceptably high proportion of patients admitted to intensive care units (ICUs) develop drug-related problems (DRPs). DRPs might cause harm and increase costs and length of stay. The implementation of a clinical pharmacist service has been shown to detect a high number of DRPs and contributes effectively to solving these across different healthcare systems. However, this has not been prospectively studied in a mixed tertiary Norwegian ICU.

Methods During a 12-month period from October 2012, a clinical pharmacist was dedicated to review medications 3 h daily (Monday to Friday). DRPs were reported at the ICU conference and included advice by the pharmacist for each case. All DRPs were categorised and the clinical impact was documented for later analysis. Drug-related questions from the staff were categorised and answered.

Results 363 of 549 patients admitted to the ICU received medication reviews. 641 DRPs were detected in 194 of these patients (mean 1.8 DRPs per patient, range 0–25). Too high a dose, significant drug interactions and unnecessary or inappropriate drugs were among the most frequently detected DRPs. 87% of advice given by the pharmacist was accepted or taken into consideration. Typical questions from the nursing staff were related to drug preparation, generic equivalents and drug administration. Questions from doctors were most frequently related to drug dosage, efficiency and adverse effects.

Conclusions The addition of a dedicated clinical pharmacist to the ICU team improves the quality and safety of medication in a mixed Norwegian ICU.

  • DRUG MANUFACTURING / PREPARATION / COMPOUNDING
  • DOCUMENTATION AND ARCHIVES
  • EDUCATION & TRAINING (see Medical Education & Training)
  • DRUG PROCUREMENT

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