Artikel
Benefit of a clinical pharmacist on a German surgical intensive care unit – A controlled interventional study
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Autoren
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Nora Kessemeier
- Gesundheit Nordhessen Holding AG, Kassel, Germany
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Damaris Meyn
- Gesundheit Nordhessen Holding AG, Kassel, Germany
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Michael Höckel
- Gesundheit Nordhessen Holding AG, Kassel, Germany
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Jörg Reitze
- MoReDATA GmbH, Gießen, Germany
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Carsten Culmsee
- Philipps-University Marburg, Department of Pharmacy, Marburg, Germany
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Michael Tryba
- Kassel School of Medicine, Kassel, Germany
| Veröffentlicht: | 23. November 2018 |
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Gliederung
Text
Background: Previous international studies suggested beneficial effects of a clinical pharmacist’s participation on an intensive care unit (ICU) on a variety of relevant parameters such as reduction of medication errors, drug costs and improvements of clinical outcomes such as ICU length of stay. Clinical pharmacist’s influence on these outcomes on German ICUs has not been investigated so far. International findings are not transferable to the German healthcare system. On one hand establishing clinical pharmacy services on the ward is not well-advanced in Germany. On the other hand, the countries requirements differ concerning education, qualification and work tasks of the pharmacists. This controlled interventional study was designed to investigate a clinical pharmacists’ impact on medication errors on a German surgical ICU.
Setting: The study was divided in three phases. One control phase P0 and two intervention phases P1 and P2. Throughout the control phase P0 the data were collected without the clinical pharmacists’ intervention. In the following intervention periods P1 and P2, two clinical pharmacists screened the medical records for drug related problems (DRP) and discussed them with the senior physician. During P2 clinical pharmacists attended ward rounds additionally. DRP detected by the clinical pharmacists according to defined criteria, were taken into account as medication error if a consensus with the physician was achieved.
Main outcome measures: The investigation aimed to determine if the medication review by a clinical pharmacist results in a significant reduction of medication errors related to a control period. Secondary outcomes were the reduction of potentially severe medication errors, the number of days without systemic anti-infective therapy the length of stay.
Results: The medication orders of 336 patients were reviewed. The number of medication errors was significantly reduced from 1660 to 622 respectively 401 (P0 vs. P1/P2; both P<0.05; Fisher’s Exact Test) in total, respective 14.1% in P0 vs. 5.1% in P1 respectively 3.3% in P2 related to the monitored medications (P0 11755; P1 12134; P2 12329).
Conclusion: Clinical pharmacists’ interventions led to a significant reduction of medication errors in a German ICU, contributing to a safer medication process. We strongly recommend a broad implementation of clinical pharmacists on German ICUs .
References
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- Al-Jazairi AS, Al-Agil AA, Asiri YA, Al-Kholi TA, Akhras NS, Horanieh BK. The impact of clinical pharmacist in a cardiac-surgery intensive care unit. Saudi Med J. 2008;29:277-81.
