Effect of pharmaceutical pre-assessment on post-operative interventions

Abstract

Focal points □ The study determined the extent of post‐operative interventions required for patients admitted for elective hip or knee arthroplasty □ In Phase 1, patients were pre‐assessed by nurses at admission, according to existing practice; in Phase 2, patients received pharmacist‐led pre‐assessment □ There were 131 interventions (2.05 per patient) in Phase 1 compared with 40 (0.68 per patient) in Phase 2, a reduction of approximately 70 per cent □ This study demonstrates that pharmaceutical pre‐assessment substantially reduces the number of interventions made during patients' post‐operative stay.

Clinical benefits and economic impact of post-surgical care provided by pharmacists in a Canadian hospital

“…The benefits and cost avoidance of a clinical pharmacist on a surgical service are not yet well described. Published literature suggests pharmacists in a surgical preadmission clinic can reduce medication errors and improve documentation of drug allergies and drug interactions . Limited services, such as weekly chart reviews and health provider education, have also decreased medication errors and produced cost savings.…”

“…Published literature suggests pharmacists in a surgical preadmission clinic can reduce medication errors and improve documentation of drug allergies and drug interactions. [6][7][8] Limited services, such as weekly chart reviews [9] and health provider education, [10] have also decreased medication errors and produced cost savings. Pharmacist-managed antimicrobial prophylaxis programmes for surgical patients have been associated with decreased mortality rates, LOS and healthcare costs.…”

Drug-Related Problems in Patients Undergoing Elective Total Joint Arthroplasty of the Hip or Knee

“…6 Optimization of a patient's medication therapy is one area where postoperative outcomes can be improved through preoperative assessment and management. 7 It has been well established that the clinical activities of pharmacists improve patient care in the surgical setting [1][2][3][4][5] and other patient care areas, 8 which could include preadmission and prehabilitation.…”

“…9,10 The literature describing the prevalence of drug-related problems among patients undergoing preparation for surgery in preadmission clinics is limited. [1][2][3][4][5] A prehabilitation clinic was recently created within the Winnipeg Regional Health Authority, a large Canadian regional health authority serving about 700 000 people. This health region has 3 community hospitals that together account for about 3000 hip and knee total joint arthroplasty procedures annually.…”

“…Preadmission clinics allow diagnostic tests to be scheduled and performed, preoperative assessments to be conducted, patient education to be provided, and discharge requirements to be identified on an outpatient basis. [1][2][3][4] The goals of such clinics include preventing surgical complications and reducing the length of the hospital stay. 3 Studies describing pharmacists' involvement in preadmission clinics have shown that such involvement can reduce the number of discrepancies in patients' medication histories.…”