The State of US Emergency Care: A Call to Action for Hospital Pharmacists

Idrees, Umbreen; Clements, Elizabeth

doi:10.1345/aph.1h448

Cited by 8 publications

(3 citation statements)

References 11 publications

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] This lack of data has led to great debate over the need to allocate resources for clinical pharmacy services in the ED and how to implement such services in a way that would improve quality and safety within the ED setting. [24][25][26][27] Recently, the American Society of Health-System Pharmacists (ASHP) convened a panel of emergency medicine providers and pharmacists that resulted in the release of a statement on pharmacy services to the ED. 28 ASHP believes that hospital pharmacy departments should provide EDs Purpose.…”

mentioning

confidence: 99%

Effect of clinical pharmacists on care in the emergency department: A systematic review

Cohen

Jellinek²,

Hatch³

et al. 2009

American Journal of Health-System Pharmacy

118

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A review of the literature revealed that pharmacists have been involved in the ED for decades. Services provided by pharmacists in the ED included traditional clinical pharmacy services, responding to medical emergencies, providing consultations on medication issues, identifying and reducing medication errors, and conducting medication histories at hospital admission. Some services were shown to be cost saving or cost avoiding.

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mentioning

confidence: 99%

Effect of clinical pharmacists on care in the emergency department: A systematic review

Cohen

Jellinek²,

Hatch³

et al. 2009

American Journal of Health-System Pharmacy

118

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“…7 ED practitioners are faced with many obstacles such as high patient volume, limited patient history, diagnostic uncertainty, varying levels of acuity, and the need for quick decision-making. 8 This may lead to the overprescribing of antimicrobials, inadequate antimicrobial selection and dosing, adverse drug events, and drug interactions. 9,10 Studies have found that antimicrobials account for roughly 19.3% of drug-related adverse events, which increase morbidity, mortality, and health care costs.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Antibiotic Utilization in an Emergency Department After Implementation of an Antimicrobial Stewardship Pharmacist Culture Review Service

2019

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Background: Antimicrobial stewardship programs (ASP) have been widely implemented in hospitals to improve antimicrobial use and prevent resistance. However, the role of ASP in the emergency department (ED) setting is not well defined. Objective: The objective of this study is to evaluate the impact of an ASP pharmacist culture review service in an ED. Methods: This was a retrospective, quasi-experimental study of all patients discharged from the ED with a positive culture. Patients discharged from the ED from February 1, 2015 to October 31, 2015 were managed by ED providers (pre-ASP), and those discharged from February 1, 2016 to October 31, 2016 were managed by a pharmacist-driven ASP (post-ASP implementation). The primary outcome was median time to change of antibiotic(s) in patients with inadequate antimicrobial therapy based on culture results. Secondary outcomes included time to culture evaluation, appropriateness of antimicrobials, and 30-day readmissions. Results: A total of 790 patients were included in the analysis (398 in pre-ASP group vs 392 in post-ASP implementation group). Median time to modification of inadequate antibiotic therapy decreased from 6.79 days in the pre-ASP group to 1.99 days in the post-ASP implementation group ( P < .0001). Median time to culture review decreased in the post-ASP implementation group from 9.83 to 0.32 days ( P < .0001). Appropriateness of culture-guided therapy increased in the post-ASP implementation group from 85.7 to 91.8% ( P = .047). The rate of combined ED revisits and hospital readmissions was similar between groups ( P = .367). Conclusion: ASP pharmacist evaluation of positive cultures in the ED was associated with a significant decrease in the time to appropriate therapy in patients discharged with inadequate therapy and higher rates of appropriate antimicrobial therapy.

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“…Although the nature of these services will vary according to each institution's needs and resources. Due to increased development of ED pharmacy services and increased involvement of pharmacist in improving the care provision through ED to the patients, the demand for ED pharmacists is increasing and to cope with it the initiative of incorporating emergency training programs should be taken (10) . In the light of the above background, the purpose of this systematic review is to investigate the role of clinical pharmacists in increasing medication safety through reduction in EDs medication error and to look into the rate of acceptance of such interventions by healthcare providers in the ED.…”

Section: Introductionmentioning

confidence: 99%

Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department

Bahaa,

Al_Sabagh,

Abbas

2013

INJNS

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Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on preventor reduced the medication error.Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient'sfile in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, andrecorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysisof the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) ofMedication Error Reporting and Prevention error classification system.Results: Four of intervention that have the greatest incidence which represent the majority of the cases, and theywere related to: dosage 500 (38.7%), route of administration 300 (23.2%), frequency 100 (7.7%), andincompatibility 120 (9.3%). The severity of medication errors that was judged as potentially life threatening (67;5.1%), serious (135; 10.4%), significant (634; 49.1%), and insignificant (454; 35.1%). The acceptance to thepresence and intervention of pharmacist was as follow: senior physicians 75%, permanent physicians 20%, residentphysicians 77%, and nurses 30%.Recommendation: Hospitals should contemplate assigning well-trained knowledgeable, efficient and skilled EDclinical pharmacists to prospectively review medication orders whenever clinically possible. It is also recommendedthat each hospital performs acquainted analysis of medication errors occurring in its ED, in order to determinetheir origin and then establish the necessary ED-based clinical pharmacy services. The sets of actions needed toprovide such services, as well as the skills, which their ED pharmacists must possess or acquire in order to becapable of producing desired outcomes

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The State of US Emergency Care: A Call to Action for Hospital Pharmacists

Cited by 8 publications

References 11 publications

Effect of clinical pharmacists on care in the emergency department: A systematic review

Effect of clinical pharmacists on care in the emergency department: A systematic review

Evaluation of Antibiotic Utilization in an Emergency Department After Implementation of an Antimicrobial Stewardship Pharmacist Culture Review Service

Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department

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