Pharmacological Interventions on Surgical Intensive Care Units Initiated by Pharmacists

초록

Purpose: The severity of a patient’s medical condition, changing pharmacodynamics andpharmacokinetics, and variability in medication highlight the importance of pharmacologicalintervention by intensive care unit (ICU) specialized pharmacists. Methods: Retrospective observations of ICU interventions (omission, changes in medicine, sideeffects, changes in administration route and dosage, redundancy, and nutritional care) performedbetween April 2017 and March 2018, determined by an interdisciplinary team (including aspecialized ICU pharmacist and a surgical intensivist) on their surgical ICU round, were analyzed. Medicinal prescriptions were screened weekly during the surgical ICU round, and interventions weremade if any corrections were necessary. Two days later another team including a surgical intensivist,a pharmacist, and a nutritionist evaluated the patients’ nutritional status (performed weekly). Results: In the 23-bed ICU, the average number of patients whose prescriptions were examinedwas 22.38 per surgical round. There were 382 interventions made over 1 year, which was 9.68interventions per day. The interventions were for nutritional care (161 cases, 42.2%), followedby changes in administration route and dosage (94 cases, 24.6%), omission (59 cases, 15.5%),redundancy (40 cases, 10.4%), changes in medicine (15 cases, 3.9%), and side effects (13 cases, 3.4%). Conclusion: The conditions of patients admitted to ICU are typically unstable. Pharmacologicalinterventions suggested by a specialized pharmacist may help control the changing medicalcondition of patients in ICU. A higher participation of pharmacists specialized in working in aninterdisciplinary ICU team-based system could lead to safer treatments.

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