Charge and Reimbursement Analysis for Intensive Care Unit Patients in a Large Tertiary Teaching Hospital

Delirium is common in the ICU setting and is associated with increased morbidity, manpower requirement, and costs. This study aims to investigate the prevalence of delirium and its outcome in terms of 14-days mortality and length of ICU stay in ICU patients. The study was done at a 150-bed tertiary teaching hospital, located in Quezon City, Metro Manila, February to September 2016. This is a prospective studyinvolving 136 adults. Screening for delirium was done within 24 hours of ICU admission using both CAM-ICU scoring method and DSM-IV-TR criteria for delirium. Delirium prevalence was found to be 5.15%. The average age was higher in the subjects positive for delirium (70.14 + 21.15 years versus 60.43 + 16.10 years, p=0.1286). At the time of ICU admission, 11.54% of sedated patients were positive for delirium compared to 3.64% of non-sedated patients, p=0.1513 ;OR 3.457. Delirium was associated with higher 14 days mortality (OR 16.8, p=0.0212). Subjects positive for delirium had 2.74 longer days average ICU stay compared to the other group, with p=0.026. We concluded delirium was associated with higher 14-days mortality and longer ICU stay. Keywords : delirium, prevalence, Intensive Care Unit

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Analysis of clinical pharmacist interventions in a tertiary teaching hospital in Brazil

Einstein (São Paulo) ◽

10.1590/s1679-45082013000200010 ◽

2013 ◽

Vol 11 (2) ◽

pp. 190-196 ◽

Cited By ~ 10

Author(s):

Wálleri Christini Torelli Reis ◽

Carolinne Thays Scopel ◽

Cassyano Januário Correr ◽

Vânia Mari Salvi Andrzejevski

Keyword(s):

Intensive Care ◽

Drug Therapy ◽

Teaching Hospital ◽

Clinical Pharmacist ◽

Solution Stability ◽

Clinical Cardiology ◽

Pharmacist Interventions ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital ◽

Drug Therapy Problems

OBJECTIVE: To analyze the clinical pharmacist interventions performed during the review of prescription orders of the Adult Intensive Care, Cardiologic Intensive Care, and Clinical Cardiology Units of a large tertiary teaching hospital in Brazil. METHODS: The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. RESULTS: During the study, a total of 6,438 drug orders were assessed and 933 interventions were performed. The most prevalent drug therapy problems involved ranitidine (28.44%), enoxaparin (13.76%), and meropenem (8.26%). The acceptability of the interventions was 76.32%. The most common problem found was related to dose, representing 46.73% of the total. CONCLUSION: Our study showed that up to 14.6% of the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes in seven to ten of these prescriptions.

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