In 2000, the Society of Critical Care Medicine (SCCM) and the American College of Clinical Pharmacy (ACCP) published a position paper that defined critical care pharmacy services as fundamental, desirable, and optimal. A task force was developed that included individuals who are members of the ACCP Critical Care Practice and Research Network, the SCCM clinical pharmacy and pharmacology section, and the American Society of Health‐System Pharmacists to develop an opinion paper with three primary objectives: to provide recommendations for the level of preparation and training of pharmacists to practice in critical care, to develop recommendations for the credentialing of pharmacists providing critical care services, and to develop mechanisms for documenting and justifying intensive care unit (ICU) pharmacy services. Each objective was addressed to accommodate the levels of services defined as fundamental, desirable, or optimal, and are targeted at all pharmacists providing or wanting to provide pharmacy services to critically ill patients. The training and preparing of the pharmacist caring for critically ill patients is discussed in the context of the knowledge and skills required to provide pharmacy services in the ICU. Credentialing of the critical care pharmacist and the documentation of services take into account the various scopes of practice, and recommendations are based on current and idealistic mechanisms. A detailed outline is provided for the process of services justification. This paper provides a foundation that is focused on delivering direct and proactive patient care services, particularly at the desirable and optimal levels, with the ultimate goal of enhancing the level of pharmacy services provided to the care of critically ill patients. This commentary should be of interest to numerous stakeholders including pharmacists, other pharmacy department staff, other ICU health care professionals, hospital and academic administrators, accrediting agencies, government officials, and payers. The task force encourages the profession of pharmacy in general to incorporate key recommendations provided in this document with respect to specialized training, credentialing, and service justification.

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