Clinical pharmacist interventions on a UK neurosurgical critical care unit: a 2-week service evaluation.

摘要

OBJECTIVE: To identify the input of specialist critical care pharmacists into patient care, promoting safe and effective medication therapy by quantifying medicines related interventions on a Neurocritical Care Unit. Setting UK 19-bedded Neurocritical Care Unit providing a tertiary referral service for Neurosurgical and Neurology patients. METHOD: Prospective observational study of clinical pharmacist interventions conducted over a 2 week period in July 2010. Interventions were recorded, categorised and independently assessed by a panel of 5 healthcare professionals for potential patient harm if the intervention had not been made. MAIN OUTCOME MEASURE: Quantity and potential severity of clinical pharmacist interventions recorded. RESULTS: 246 interventions were made in 55 patients over the 10 day observational period. A median of 7.0 (1.5; 12.0) and 2.0 (1.0; 4.0) interventions were made in Level 3 and 2 patients respectively. Mean potential severity of patient harm per intervention was 3.7 (1.12); range 0.8-7.0. Central Nervous System medicines comprised the most common therapeutic group affected (37.8%). Medication errors accounted for 87 of the 246 interventions (35.4%). CONCLUSION: The results of the clinical pharmacist intervention evaluation demonstrated an important role for critical care pharmacists in the safe and effective use of medicines in a UK Neurocritical care unit.