Emergency Medicine Pharmacy Practice

Rudis, Maria I.; Attwood, R.J.

doi:10.1177/0897190011400549

Cited by 17 publications

(11 citation statements)

References 62 publications

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“…physician assistants and ED scribes) suggests there might be some benefit to ED flow and efficiency . Allied Health Practitioners in referral models within EDs do little to improve congestion but value add; for example, clinical pharmacists within the ED reduce the number of medication errors and resulting adverse events, and radiographer‐led radiology services might reduce interpretive errors . A systematic review inferred that in some studies Care Coordination Teams were effective in reducing unnecessary social admissions in elderly populations and significantly reduced re‐presentations .…”

Section: Resultsmentioning

confidence: 99%

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Wylie

Crilly

Toloo

et al. 2015

Emerg Medicine Australasia

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To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness.

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Section: Resultsmentioning

confidence: 99%

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Wylie

Crilly

Toloo

et al. 2015

Emerg Medicine Australasia

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“…1,2,[20][21][22][23] Pharmacists play active roles in creating programs that improve antimicrobial use, prevent adverse drug events, enhance pain and anticoagulation management, and optimize medication inventory. 23,24 Pharmacists' interventions have also been associated with cost avoidance. Lada et al 25 reported that during a 3-month period, the potential cost avoidance attributed to 1,393 pharmacist interventions was over $1 million.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a 24-Hour Pharmacy Service with Prospective Medication Review in the Emergency Department

et al. 2015

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Background:It is reported that more than 128 million patients are seen in emergency departments (EDs) annually. Patient overcrowding had been associated with an increased occurrence of medication errors. Purpose: Due to increased patient volume and the need for improved patient safety, a 24-hour pharmacy service was established for our institution's ED. The purpose of the study is to quantify and demonstrate the impact of a 24-hour pharmacy service in an urban ED. Methods: This was a retrospective descriptive study conducted at a regional level 1 trauma center. The study period occurred between December 2012 and July 2013. The following variables were quantified and analyzed: number of medication orders reviewed, number of intravenous medications compounded, and number of clinical interventions that were recommended by the ED pharmacy team (EDPT) and accepted by ED clinicians. Results: A total of 3,779 medication orders were reviewed by the EDPT. Of these orders, 3,482 (92%) were prospectively reviewed. A total of 3,068 (81.2%) and 711 (18.8%) orders were reviewed for the adult and pediatric ED, respectively. During the study period, the EDPT procured 549 intravenous admixtures and conducted 642 clinical interventions. Most of the interventions involved providing drug information for physicians and nurses (45.9%), adjusting drug dosages (21.1%), and recommending antimicrobial therapy (15.1%). Conclusion:The implementation of a 24-hour pharmacy service at our institution was an innovative practice that increased the role of pharmacists in the ED. The EDPT conducted prospective medication review, procured intravenous admixtures from a sterile environment, and provided therapeutic recommendations for the ED interdisciplinary team.

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“…On the contrary, many institutions in most developed countries have pharmacists to review orders prospectively and this function provides significant safety benefits in the emergency department. [23] Furthermore, another study identified 7.8 medication errors per 100 patients and 2.9 per 100 medication orders were recovered by the emergency department pharmacists. Most of the recovered medication errors were intercepted potential ADEs (90.3%), with fewer mitigated ADEs (3.9%) and ameliorated ADEs (0.2%).…”

Section: Discussionmentioning

confidence: 99%

Medication errors in the adult emergency unit of a tertiary care teaching hospital in Addis Ababa

2013

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Background:The emergency unit is a high risk environment for inappropriate medication use due to stressors and time sensitive nature of the service. Objective: To assess incidence and type of Medication Errors in Tikur Anbesa Specialized Hospital. Materials and Methods:A prospective cross-sectional study was conducted on the interventions by prescribing physicians and attending nurses for patients seen at the emergency unit of Tikur Anbesa Specialized Hospital from May 2-20, 2011. Data about interventions were collected from the medication charts. Medication errors were identified by comparing prescriptions and administration records with standard treatment algorithms. Descriptive statistics was used to meet the objective of the study. Results: A total of 742 patient charts were reviewed which contained 1058 prescriptions containing 2968 orders. Medication errors were found to be 22781 (54.84%) with rate of 30.70 errors per patient and 1627.21 errors per day. Prescription errors, administration errors from recorded ones, absence of administration record were 7314 (32.11%), 991 (4.35%), and 14476 (63.54%) respectively. Conclusion: Incidence and types of medication errors committed in Tikur Anbesa Specialized Hospital Adult Emergency Unit were substantiated; moreover, necessary information on factors within the healthcare delivery system that predispose healthcare professionals to commit errors have been pointed, which should be addressed by healthcare professionals through multidisciplinary efforts and involvement of decision makers at national level.

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Emergency Medicine Pharmacy Practice

Cited by 17 publications

References 62 publications

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Implementation of a 24-Hour Pharmacy Service with Prospective Medication Review in the Emergency Department

Medication errors in the adult emergency unit of a tertiary care teaching hospital in Addis Ababa

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