TY - JOUR
T1 - Pharmacist's review and outcomes
T2 - Treatment-enhancing contributions tallied, evaluated, and documented (PROTECTED-UK)
AU - Shulman, R.
AU - McKenzie, C. A.
AU - Landa, J.
AU - Bourne, R. S.
AU - Jones, A.
AU - Borthwick, M.
AU - Tomlin, M.
AU - Jani, Y. H.
AU - West, D.
AU - Bates, I.
AU - Shulman, Rob
AU - Mc, CathyKenzie
AU - Landa, June Alberdi
AU - Bourne, Richard
AU - Tomlin, Mark
AU - Jones, Andy
AU - Ian, Bates
AU - West, David
AU - Jani, Yogini
AU - Sapsford, David
AU - McHale, Helen
AU - Hylands, Jane
AU - Graham-Clarke, Emma
AU - Rudall, Nicola
AU - Cadman, Brit
AU - Barton, Greg
AU - Forrest, Ruth
AU - Boxall, Emma
AU - Timmins, Alan
AU - Borthwick, Mark
AU - Roadley, Ruth Battin
AU - Thacker, Meera
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Purpose: The purpose was to describe clinical pharmacist interventions across a range of critical care units (CCUs) throughout the United Kingdom, to identify CCU medication error rate and prescription optimization, and to identify the type and impact of each intervention in the prevention of harm and improvement of patient therapy. Materials and methods: A prospective observational study was undertaken in 21 UK CCUs from November 5 to 18, 2012. A data collection web portal was designed where the specialist critical care pharmacist reported all interventions at their site. Each intervention was classified as medication error, optimization, or consult. In addition, a clinical impact scale was used to code the interventions. Interventions were scored as low impact, moderate impact, high impact, and life saving. The final coding was moderated by blinded independent multidisciplinary trialists. Results: A total of 20. 517 prescriptions were reviewed with 3294 interventions recorded during the weekdays. This resulted in an overall intervention rate of 16.1%: 6.8% were classified as medication errors, 8.3% optimizations, and 1.0% consults. The interventions were classified as low impact (34.0%), moderate impact (46.7%), and high impact (19.3%); and 1 case was life saving. Almost three quarters of interventions were to optimize the effectiveness of and improve safety of pharmacotherapy. Conclusions: This observational study demonstrated that both medication error resolution and pharmacist-led optimization rates were substantial. Almost 1 in 6 prescriptions required an intervention from the clinical pharmacist. The error rate was slightly lower than an earlier UK prescribing error study (EQUIP). Two thirds of the interventions were of moderate to high impact.
AB - Purpose: The purpose was to describe clinical pharmacist interventions across a range of critical care units (CCUs) throughout the United Kingdom, to identify CCU medication error rate and prescription optimization, and to identify the type and impact of each intervention in the prevention of harm and improvement of patient therapy. Materials and methods: A prospective observational study was undertaken in 21 UK CCUs from November 5 to 18, 2012. A data collection web portal was designed where the specialist critical care pharmacist reported all interventions at their site. Each intervention was classified as medication error, optimization, or consult. In addition, a clinical impact scale was used to code the interventions. Interventions were scored as low impact, moderate impact, high impact, and life saving. The final coding was moderated by blinded independent multidisciplinary trialists. Results: A total of 20. 517 prescriptions were reviewed with 3294 interventions recorded during the weekdays. This resulted in an overall intervention rate of 16.1%: 6.8% were classified as medication errors, 8.3% optimizations, and 1.0% consults. The interventions were classified as low impact (34.0%), moderate impact (46.7%), and high impact (19.3%); and 1 case was life saving. Almost three quarters of interventions were to optimize the effectiveness of and improve safety of pharmacotherapy. Conclusions: This observational study demonstrated that both medication error resolution and pharmacist-led optimization rates were substantial. Almost 1 in 6 prescriptions required an intervention from the clinical pharmacist. The error rate was slightly lower than an earlier UK prescribing error study (EQUIP). Two thirds of the interventions were of moderate to high impact.
KW - Critical care
KW - Impact coding
KW - Interventions
KW - Medication errors
KW - Optimizations
KW - Specialist critical care pharmacist
UR - http://www.scopus.com/inward/record.url?scp=84930761079&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2015.04.008
DO - 10.1016/j.jcrc.2015.04.008
M3 - Article
AN - SCOPUS:84930761079
SN - 0883-9441
VL - 30
SP - 808
EP - 813
JO - Journal of Critical Care
JF - Journal of Critical Care
IS - 4
ER -