title: Effect of a pharmacist's and a nurse's interventions on cost of drug therapy in a medical intensive-care unit.
abstract: The effect of interventions by a pharmacist and a nurse on the cost of drug therapy in a medical intensive-care unit (ICU) was determined. A pharmacist taught cost-avoidance concepts related to medication use to a senior member of the nursing staff. The pharmacist and the nurse documented during a 91-day period all interventions that resulted in a discontinuation or change in drug therapy or involved nonformulary drug requests or serum drug concentration determinations. Costs that were avoided or added as a result of these interventions were determined using drug acquisition costs and (for interventions involving i.v. therapy) the cost of related supplies. Costs were calculated for both the initial 24-hour period after each intervention and the expected duration of therapy. The 345 interventions of the pharmacist and the nurse represented $6,383 in 24-hour cost avoidance and $23,993 in total cost avoidance. The majority of interventions resulted in discontinuation of medications or changes in drug dosage; most of those interventions involved antimicrobial agents. Other frequent interventions involved changes in route of administration and the interchange of therapeutic alternates. A pharmacist and a nurse had a positive impact on the cost of drug therapy in a medical ICU.
authors.affiliation: Department of Pharmacy, Francis Scott Key Medical Center, Baltimore, MD 21224.
authors.forename: B G
authors.initials: BG
authors.lastname: Katona
authors.forename: P R
authors.initials: PR
authors.lastname: Ayd
authors.forename: J K
authors.initials: JK
authors.lastname: Walters
authors.forename: M
authors.initials: M
authors.lastname: Caspi
authors.forename: B W
authors.initials: BW
authors.lastname: Finkelstein
mesh_terms: D015142:Baltimore; D004358:Drug Therapy / Q000191:economics*; D006745:Hospital Bed Capacity, 300 to 499; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D009726:Nurses; D010348:Patient Care Team; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010595:Pharmacists
chemical_list: D004364:Pharmaceutical Preparations