Analysis of clinical pharmacist interventions in the neurology unit of a Brazilian tertiary teaching hospital

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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Effectiveness of continuous improvement by a clinical pharmacist-led guidance team on the prophylactic antibiotics usage rationality in intervention procedure at a Chinese tertiary teaching hospital

Therapeutics and Clinical Risk Management ◽

10.2147/tcrm.s131937 ◽

2017 ◽

Vol Volume 13 ◽

pp. 469-476 ◽

Cited By ~ 4

Author(s):

Ping Yang ◽

Sai-Ping Jiang ◽

Xiao-Yang Lu

Keyword(s):

Continuous Improvement ◽

Teaching Hospital ◽

Clinical Pharmacist ◽

Prophylactic Antibiotics ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital ◽

Intervention Procedure

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Continuous improvement on the rationality of prophylactic injectable PPIs usage by a clinical pharmacist-led guidance team at a Chinese tertiary teaching hospital

Journal of International Medical Research ◽

10.1177/0300060520954729 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052095472

Author(s):

Yun Hong ◽

Ziqi Ye ◽

Zhe Gao ◽

Yuefeng Rao

Keyword(s):

Teaching Hospital ◽

Clinical Pharmacist ◽

Compliance Rate ◽

Outcome Analysis ◽

Clinician Education ◽

Pdca Cycle ◽

Tertiary Teaching ◽

Before And After ◽

Tertiary Teaching Hospital ◽

Effective Role

Objective We aimed to evaluate the effects of a clinical pharmacist-led-guidance-team (CPGT) on improving rational prophylactic injectable proton pump inhibitor use (PIPU) and to explore the application of the Plan–Do–Check–Act (PDCA) method in promoting rational PIPU. Methods We conducted a retrospective study among 814 patients at a Chinese tertiary teaching hospital from January 2017 to December 2018. We enrolled 98 patients before the PDCA; 297 and 419 patients were included in first- and second-round PDCA cycles, respectively. The CPGT established the criteria for PIPU and conducted interventions, including medical record reviews, provision of feedback, clinician education, and outcome analysis. We analyzed the appropriateness and costs of PIPU before and after establishment of the PDCA cycle. Results Implementation of continuous CPGT-led intervention and a PDCA cycle significantly decreased the rate of irrational PIPU (53.06% vs. 8.57%), including duration, administration route, indication, and dosing frequency. Costs of total (USD 211.28 ± 162.33 vs. 53.17 ± 22.32) and inappropriate (USD 76.70 ± 59.78 vs. 2.25 ± 3.86) PIPU per patient were significantly reduced. The target compliance rate was 107.56%. Conclusion A CPGT can have an effective role in improving rational PIPU and optimizing administration through a PDCA cycle, to attain improved clinical and economic outcomes.

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