Background and Importance The presence of pharmacists as members of the multi-professional critical care team is increasingly accepted and welcome. However, the impact of this presence is not always easy to measure since the offered service portfolio varies widely from hospital to hospital.
Aim and Objectives This study measures the intervention impact of the rotation of a pharmacy resident in the critical care unit of a hospital after assessing the unit's complexity level.
Material and Methods Critical care complexity was measured as the mean Medication Regimen Complexity-ICU (MRC-ICU) throughout the study period and compared to previous studies.1
Pharmacist interventions in the critical care unit over 7 weeks were prospectively recorded.
There were three types of interventions: clinical (affecting the pharmacotherapy of an admitted patient), informative (regarding general information of medicines), and logistical (regarding the critical unit organisation and medicines distribution).
Interventions were also classified by the addressee (medical, nursery staff, or both) and by intensity (low, medium, or high), measured as previously described.2
Acceptance of the interventions was also recorded.
Interventions regarding parenteral nutrition and therapeutic drug monitoring were excluded from this study since they were already standard care in our hospital.Results
The mean MRC-ICU score was 10.46 (standard deviation 5.4).
Among the 108 interventions recorded, for 83 patients, 75 (70%) were clinical, 22 (20%) informative and 11 (10%) logistical. In 85 cases (79%), the addressee of the intervention was the medical staff, 18 (17%) the nurses, and 5 (4%) both. Regarding the intensity, 11/108 (10%) were classified as low, 37/108 (35%) medium and 58 (55%) as high. The acceptance of interventions was high: 106/108 (98%).
Conclusion and Relevance Critical care complexity in this study was above average compared to previous studies.1
A clinical pharmacist, even a trainee pharmacy resident, can improve critical healthcare and clinical decision-making by the critical care team.
A high intervention acceptance rate shows how valuable the rest of the professionals in the intensive care team consider the clinical pharmacist.
References and/or Acknowledgements 1. Crit Care Med 2022 Sep 1;50(9):1318–1328. doi: 10.1097/CCM.0000000000005585.
2. Crit Care Med 2022 Sep 1;50(9):1318–1328. doi: 10.1097/CCM.0000000000005585. Supplemental Digital Content – Table 3. (http://links.lww.com/CCM/H141).
Conflict of Interest No conflict of interest