Evaluation of a dedicated pharmacist staffing model in the medical intensive care unit.
OBJECTIVE
Published studies have shown that pharmacists on medical rounds reduce the incidence of preventable adverse drug events (ADEs). However, the impact of a dedicated pharmacist who provides consistent patient care in a critical care unit remains to be evaluated.


OBJECTIVE
To determine the impact of a pharmacist who is permanently assigned to the medical intensive care unit (MICU) on the incidence of preventable ADEs, drug charges, and length of stay (LOS) in the MICU.


METHODS
A randomized, experimental versus historical control group design was used. Preventable ADEs were identified and validated by 2 pharmacists and a critical care physician. Information about MICU drug charges and LOS were obtained from the hospital administrative database.


RESULTS
The intervention group had fewer occurrences of ADEs (10 ADEs/1,000 patient days) when compared to the control group (28 ADEs/1,000 patient days) at a significance level of .03. No significant differences were found between the 2 groups in MICU drug charges and LOS. The vast majority of the 596 documented recommended interventions (99%) were accepted by the medical team. Nutrition monitoring, medication indicated but not prescribed, and dosage modification were the top 3 problems identified by the pharmacist.


CONCLUSIONS
The addition of a dedicated critical care pharmacist to the MICU medical team improves the safe use of medication. The services of a dedicated critical care pharmacist should be expanded to include weekend hours to ensure the benefits of improved medication safety.
Assistant Professor, University of Michigan, College of Pharmacy, Ann Arbor, Michigan;
Suzan N
SN
Kucukarslan
Medical Intensive Care Unit Clinical Pharmacy Specialist.
Kim
K
Corpus
Pharmacist, Jesse Brown VA Medical Center, Chicago, Illinois;
Nisha
N
Mehta
Surgical Intensive Care Unit Clinical Pharmacy Specialist.
Mark
M
Mlynarek
Critical Care Clinical Pharmacy Specialist.
Mike
M
Peters
Critical Care Medicine Physician, Henry Ford Health System, Detroit, Michigan;
Lisa
L
Stagner
Clinical Pharmacist Specialist Informatics, University of Michigan Health System, Ann Arbor, Michigan. [Dr. Kucukarslan is now Medication Safety Officer at McLaren Hospital and CompleteRx, Inc, Flint, Michigan.] Corresponding author: Suzan N. Kucukarslan, PhD, McLaren Hospital-Flint, 401 S Ballenger Highway, Flint, MI 48532; phone: 810-342-2426; e-mail: skucukar@gmail.com.
Chris
C
Zimmerman
adverse drug events; medication safety; pharmacist; staffing model