The clinical impact of pharmacist interventions in an emergency unit

By Maria Alonso-Jura

Abstract

Aim

To evaluate the clinical impact, quantity and quality of pharmacist interventions in potential patients’ outcomes in a high risk area, in this case an emergency assessment unit. These interventions were related to identifying, preventing and resolving drug related problems.

Design

A pharmaceutical care plan form was issued for every patient entering the study, where the investigator pharmacist would record any possible drug-related issue and the way a solution had been attempted. Each drug-related issue was blinded and assessed by two experienced healthcare professionals according to its potential to cause medical harm using the trust categorisation matrix.

Subjects and setting

190 patients admitted to the emergency assessment unit at New Cross hospital, a 700-bed general hospital in Wolverhampton, West Midlands, over a period of four months.

Main outcome measures

The assessment of drug-related issues by two healthcare professionals using the trust categorisation matrix.

Results

The pharmacist intervened in 159 of a total of 190 patients (83.7%) giving rise to a total of 360 interventions with the mean number of interventions being 1.9 per patient. According to the external pharmacist, there were 134 red alerts before intervention by the pharmacist of which 126 (94%) were converted into green after intervention by the pharmacist. According to the assessor doctor there were 54 red alerts before intervention by the clinical pharmacist and all of them were converted to green after intervention by the pharmacist.

Conclusion

Pharmacist interventions were common and most of them related to preventable prescribing errors. The intervention of the clinical pharmacist significantly improved the predicted patient outcome by reducing the risk of harm in most cases.

 

Citation: The Salvadore DOI: 10.1211/PJ.2013.11124785

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