Billy Sin1, Linda Yee2, Maria Claudio-Saez3, Qazi Halim4, Lewis Marshall5, Mary Hayes-Quinn6. 1. Emergency Medicine Clinical Pharmacist, Brookdale University Hospital Medical Center , Brooklyn, New York. 2. Clinical Pharmacist, Internal Medicine, Brookdale University Hospital Medical Center , Brooklyn, New York. 3. Assistant Director, Pharmacy Services, Brookdale University Hospital Medical Center , Brooklyn, New York. 4. Director, Pharmacy Services, Brookdale University Hospital Medical Center , Brooklyn, New York. 5. Chairman, Emergency Medicine, Brookdale University Hospital Medical Center , Brooklyn, New York. 6. Director, Emergency Medicine Nursing Services, Brookdale University Hospital Medical Center , Brooklyn, New York.
Abstract
BACKGROUND: It is reported that more than 128 million patients are seen in emergency departments (EDs) annually. Patient overcrowding had been associated with an increased occurrence of medication errors. PURPOSE: Due to increased patient volume and the need for improved patient safety, a 24-hour pharmacy service was established for our institution's ED. The purpose of the study is to quantify and demonstrate the impact of a 24-hour pharmacy service in an urban ED. METHODS: This was a retrospective descriptive study conducted at a regional level 1 trauma center. The study period occurred between December 2012 and July 2013. The following variables were quantified and analyzed: number of medication orders reviewed, number of intravenous medications compounded, and number of clinical interventions that were recommended by the ED pharmacy team (EDPT) and accepted by ED clinicians. RESULTS: A total of 3,779 medication orders were reviewed by the EDPT. Of these orders, 3,482 (92%) were prospectively reviewed. A total of 3,068 (81.2%) and 711 (18.8%) orders were reviewed for the adult and pediatric ED, respectively. During the study period, the EDPT procured 549 intravenous admixtures and conducted 642 clinical interventions. Most of the interventions involved providing drug information for physicians and nurses (45.9%), adjusting drug dosages (21.1%), and recommending antimicrobial therapy (15.1%). CONCLUSION: The implementation of a 24-hour pharmacy service at our institution was an innovative practice that increased the role of pharmacists in the ED. The EDPT conducted prospective medication review, procured intravenous admixtures from a sterile environment, and provided therapeutic recommendations for the ED interdisciplinary team.
BACKGROUND: It is reported that more than 128 million patients are seen in emergency departments (EDs) annually. Patient overcrowding had been associated with an increased occurrence of medication errors. PURPOSE: Due to increased patient volume and the need for improved patient safety, a 24-hour pharmacy service was established for our institution's ED. The purpose of the study is to quantify and demonstrate the impact of a 24-hour pharmacy service in an urban ED. METHODS: This was a retrospective descriptive study conducted at a regional level 1 trauma center. The study period occurred between December 2012 and July 2013. The following variables were quantified and analyzed: number of medication orders reviewed, number of intravenous medications compounded, and number of clinical interventions that were recommended by the ED pharmacy team (EDPT) and accepted by ED clinicians. RESULTS: A total of 3,779 medication orders were reviewed by the EDPT. Of these orders, 3,482 (92%) were prospectively reviewed. A total of 3,068 (81.2%) and 711 (18.8%) orders were reviewed for the adult and pediatric ED, respectively. During the study period, the EDPT procured 549 intravenous admixtures and conducted 642 clinical interventions. Most of the interventions involved providing drug information for physicians and nurses (45.9%), adjusting drug dosages (21.1%), and recommending antimicrobial therapy (15.1%). CONCLUSION: The implementation of a 24-hour pharmacy service at our institution was an innovative practice that increased the role of pharmacists in the ED. The EDPT conducted prospective medication review, procured intravenous admixtures from a sterile environment, and provided therapeutic recommendations for the ED interdisciplinary team.
Authors: Kenneth E Bizovi; Brandon E Beckley; Michelle C McDade; Annette L Adams; Robert A Lowe; Andrew D Zechnich; Jerris R Hedges Journal: Acad Emerg Med Date: 2002-11 Impact factor: 3.451
Authors: Ross Koppel; Joshua P Metlay; Abigail Cohen; Brian Abaluck; A Russell Localio; Stephen E Kimmel; Brian L Strom Journal: JAMA Date: 2005-03-09 Impact factor: 56.272
Authors: Pat Croskerry; Marc Shapiro; Sam Campbell; Connie LeBlanc; Douglas Sinclair; Patty Wren; Michael Marcoux Journal: Acad Emerg Med Date: 2004-03 Impact factor: 3.451