Critical requirements for health-system pharmacy practice models that achieve optimal use of medicines

Shane, Rita

doi:10.2146/ajhp110058

Cited by 16 publications

(8 citation statements)

References 51 publications

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“…The presence of critical care pharmacist services should result in improved medication related outcomes (eg, adverse drug event avoidance, cost avoidance, antimicrobial stewardship) and patient outcomes (eg, mortality, hospital length of stay, duration of mechanical ventilation), but the observed practice model variation may reflect the lack of literature and guidance supporting the optimal pharmacist to patient ratio . Indeed, the supporting evidence for pharmacy services is largely based on pre‐post design evaluations of new pharmacy services supporting the presence of a pharmacist or pharmacy service which is better than no pharmacist or no service; however, the effect of pharmacist to patient ratio or practice model (eg, 24‐7‐365 coverage) on patient outcomes is unknown.…”

Section: Discussionmentioning

confidence: 99%

A survey of critical care pharmacists to patient ratios and practice characteristics in intensive care units

Newsome

Smith

Jones

et al. 2019

J Am Coll Clin Pharm

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Introduction Pharmacists are widely recognized members of the critical care health care team. However, unlike other health care professions, critical care pharmacists do not have standardized pharmacist to patient ratios that establish maximal cost‐efficiency while maintaining optimal patient safety. Though many prior recommendations claim a ratio of 1:15 for safe pharmacy practice, recommendations have ranged as low as 1:8 to as high as 1:30. Objectives To determine critical care pharmacists' perceptions of pharmacist to patient ratios within the intensive care unit (ICU) and qualitatively and quantitatively describe critical care pharmacist work environments. Methods A cross‐sectional survey of pharmacists was conducted to identify current pharmacist to patient ratios and identify pharmacist perceptions of the safety of these ratios. Responses were presented using descriptive statistics. Multiple linear regression was conducted to determine factors associated with perceptions of workload and patient safety. Results The response rate was 11% (n = 185). The majority of respondents reported participating in activities beyond patient care. The majority of pharmacists cared for more than 15 patients daily (n = 155, 84%), and 16% took care of 15 or fewer patients. About 30% of pharmacists did not feel the pharmacist to patient ratio optimized patient safety, and over half reported perceptions overwork. A majority of participants (n = 130, 76%) expressed a need for additional critical care pharmacists at their institutions. Higher pharmacist to patient ratios were associated with increased perception of unsafe patient care −.343 (−.507 to −.180, P < .001). Conclusions Heterogeneity exists among critical care pharmacy activities that may influence pharmacists' perceptions of workload and patient safety. Critical care pharmacists report that their institutions should have more critical care pharmacists. Pharmacists' perceptions of workload vary based on differences in their activities outside of patient care.

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Section: Discussionmentioning

confidence: 99%

A survey of critical care pharmacists to patient ratios and practice characteristics in intensive care units

Newsome

Smith

Jones

et al. 2019

J Am Coll Clin Pharm

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“…The literature search yielded publications related to the following key elements: standards of practice 11,12,[19][20][21] ; practice model experiences and considerations, in terms of services offered by the clinical pharmacy and workforce/staffing 1,3,[22][23][24][25][26][27] ; and training, competencies, and skills of clinical pharmacists.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

Redesign of the Clinical Pharmacy Practice Model in a Tertiary Academic Hospital in Medellín, Colombia

Aguirre

Quintero

Vega

2017

CJHP

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“…To help accomplish these practice changes, multiple practice models have been developed; one is the integrated practice model, in which clinical generalists are responsible for both clinical and distributive activities. 1 This model allows the integration of all of the pharmacists' daily practice responsibilities, making these personnel accessible full-time on patient care units and during physician rounds.…”

mentioning

confidence: 99%

Assessing the impact of mobile technology on order verification during pharmacist participation in patient rounds

Ray

Clark

Jeter³

et al. 2013

American Journal of Health-System Pharmacy

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Critical requirements for health-system pharmacy practice models that achieve optimal use of medicines

Cited by 16 publications

References 51 publications

A survey of critical care pharmacists to patient ratios and practice characteristics in intensive care units

A survey of critical care pharmacists to patient ratios and practice characteristics in intensive care units

Redesign of the Clinical Pharmacy Practice Model in a Tertiary Academic Hospital in Medellín, Colombia

Assessing the impact of mobile technology on order verification during pharmacist participation in patient rounds

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