1137: Characterization of Telepharmacist Interventions in Hyponatremia Management

Kosmisky, Desiree; Everhart, Sonia

doi:10.1097/01.ccm.0000509812.18615.ba

Cited by 3 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the impact, the second shift pharmacist made in both hyponatremia management and glycemic control, in July 2017, pharmacy services expanded to the first shift 7,8 . The first shift pharmacist covers 3 days per week (Monday, Wednesday, and Friday) from 7 am to 12 pm .…”

Section: Introductionmentioning

confidence: 99%

Impact of first and second shift tele‐critical care pharmacy services and virtual rounds on interventions at Atrium Health Lincoln

Griffiths

Kosmisky²,

Everhart³

et al. 2021

J Am Coll Clin Pharm

View full text Add to dashboard Cite

BackgroundIn 2015, Atrium Health (AH) established second shift pharmacy services in the tele‐critical care (TCC) setting to optimize medication therapy and serve as a drug information resource to facilities across the health care system. TCC pharmacy services expanded to the first shift in July 2017. In September 2017, the first shift pharmacist began participating in virtual multidisciplinary rounds 1 day per week, which increased to 3 days per week in October 2019 at AH Lincoln, a community hospital with a 10‐bed intensive care unit (ICU).MethodsThis was a nonrandomized retrospective cohort study of adult ICU patients at AH Lincoln across two different time periods. The primary outcome was the number and type of pharmacy interventions made on rounding day(s) vs nonrounding days and first vs second shifts. Data are reported using descriptive statistics.ResultsDuring time period 1, a total of 1174 patients were admitted to the ICU for a total of 2115 patient days, with an average length of stay (LOS) of 1.8 days (SD ± 1.8 days). During time period 2, a total of 812 patients were admitted to the ICU for a total of 1775 patient days with an average LOS of 2.2 days (SD ± 2.7 days). During time period 1, a total of 753 interventions (297 on first shift and 456 on second shift) were performed as compared to time period 2, which had 1276 interventions (816 on first shift and 460 on second shift). For both time periods, the most common intervention on the first shift was medication management (45%) vs glycemic control (36%) on the second shift.ConclusionsThe addition of TCC pharmacy services to AH Lincoln has resulted in a positive impact on medication management, with the largest impact demonstrated through virtual rounding by the first shift TCC pharmacist.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of first and second shift tele‐critical care pharmacy services and virtual rounds on interventions at Atrium Health Lincoln

Griffiths

Kosmisky²,

Everhart³

et al. 2021

J Am Coll Clin Pharm

View full text Add to dashboard Cite

show abstract

“…With improved outcomes in both glucose and hyponatraemia management demonstrated on second shift, pharmacy services were expanded further to the dayshift in July of 2017. 4,5 Services are provided by one pharmacist approximately 16 hours per week due to the pharmacist also being a faculty member at a local school of pharmacy. Six community/rural facilities are routinely monitored for a total of 76 mixed medical-surgical ICU beds.…”

Section: Introductionmentioning

confidence: 99%

Characterization of dayshift tele-ICU pharmacist activities

2020

View full text Add to dashboard Cite

Background Critical care services have expanded over the last decade to include tele-ICU. In 2015, Atrium Health’s pharmacy services began covering tele-ICU patients from 3–11 PM. In 2017, dayshift tele-ICU pharmacy services were added on Monday, Wednesday and Friday from 8 AM to 12 PM. Cutting-edge technology and software integration allow alerts to be generated in areas of abnormal glucose, electrolyte and lactate levels. This analysis was conducted to describe the interventions recommended during dayshift hours. Methods Data collected from 1 August 2017 to 30 June 2018, the first 11 months of dayshift pharmacist coverage, include number of charts reviewed per shift, interventions and specific types logged, if the intervention was tied to an alert and if it was accepted or rejected. Interventions can originate from alerts or from proactive assessment by the pharmacist. Descriptive statistics were reported. Results On average, 41 charts were reviewed per shift. Over an 11-month period, 1024 interventions were made for 634 patient chart reviews. Some 89% of all interventions were accepted or accepted with modifications. Of the total interventions, 37 (3.6%) were adverse drug events avoided and 658 (64.4%) were interventions unrelated to alert data. Medication management accounted for 44.3% of all interventions. Discussion Proactive assessment rather than alert review resulted in the majority of interventions, demonstrating that reviewing every ICU patient is vital for improving patient care. Determining optimal avenues for intervention delivery and integration with the bedside multidisciplinary teams remains one of the biggest challenges. Dayshift innovations included weekly virtual rounds and providing drug information for the bedside teams.

show abstract

Implementation, Evolution and Impact of ICU Telepharmacy Services Across a Health care System

Kosmisky¹,

Everhart²,

Griffiths

2019

Hosp Pharm

View full text Add to dashboard Cite

Purpose: A review of the implementation and development of telepharmacy services that ensure access to a critical care-trained pharmacist across a healthcare system. Summary: Teleintensive care unit (tele-ICU) services use audio, video, and electronic databases to assist bedside caregivers. Telepharmacy, as defined by the American Society of Health-System Pharmacists, is a method in which a pharmacist uses telecommunication technology to oversee aspects of pharmacy operations or provide patient care services. Telepharmacists can ensure accurate and timely order verification, recommend interventions to improve patient care, provide drug information to clinicians, assist in standardization of care, and promote medication safety. This tele-ICU pharmacy team is one of the only entirely clinical-based tele-ICU pharmacy models among the tele-ICU programs across the United States. The use of technology for customized alert generation and intervention proposal with medication orders and chart notation are unique. In a 34-month period from September 2015 to July 2018, more than 110 000 alerts were generated and 13 000 interventions were performed by telepharmacists. Conclusions: Tele-ICU pharmacists employ limited resources to provide critical care pharmacy expertise to multiple sites within a healthcare system during nontraditional hours with documented clinical and financial benefits. Further study is needed to determine the impact of tele-ICU pharmacists on ICU and hospital length of stay, morbidity, and mortality.

show abstract

1137: Characterization of Telepharmacist Interventions in Hyponatremia Management

Cited by 3 publications

References 0 publications

Impact of first and second shift tele‐critical care pharmacy services and virtual rounds on interventions at Atrium Health Lincoln

Impact of first and second shift tele‐critical care pharmacy services and virtual rounds on interventions at Atrium Health Lincoln

Characterization of dayshift tele-ICU pharmacist activities

Implementation, Evolution and Impact of ICU Telepharmacy Services Across a Health care System

Contact Info

Product

Resources

About