title: Implementation of a 24-hour pharmacy service with prospective medication review in the emergency department.
abstract: BACKGROUND
  It is reported that more than 128 million patients are seen in emergency departments (EDs) annually. Patient overcrowding had been associated with an increased occurrence of medication errors.
  
  
  OBJECTIVE
  Due to increased patient volume and the need for improved patient safety, a 24-hour pharmacy service was established for our institution's ED. The purpose of the study is to quantify and demonstrate the impact of a 24-hour pharmacy service in an urban ED.
  
  
  METHODS
  This was a retrospective descriptive study conducted at a regional level 1 trauma center. The study period occurred between December 2012 and July 2013. The following variables were quantified and analyzed: number of medication orders reviewed, number of intravenous medications compounded, and number of clinical interventions that were recommended by the ED pharmacy team (EDPT) and accepted by ED clinicians.
  
  
  RESULTS
  A total of 3,779 medication orders were reviewed by the EDPT. Of these orders, 3,482 (92%) were prospectively reviewed. A total of 3,068 (81.2%) and 711 (18.8%) orders were reviewed for the adult and pediatric ED, respectively. During the study period, the EDPT procured 549 intravenous admixtures and conducted 642 clinical interventions. Most of the interventions involved providing drug information for physicians and nurses (45.9%), adjusting drug dosages (21.1%), and recommending antimicrobial therapy (15.1%).
  
  
  CONCLUSIONS
  The implementation of a 24-hour pharmacy service at our institution was an innovative practice that increased the role of pharmacists in the ED. The EDPT conducted prospective medication review, procured intravenous admixtures from a sterile environment, and provided therapeutic recommendations for the ED interdisciplinary team.
authors.affiliation: Emergency Medicine Clinical Pharmacist, Brookdale University Hospital Medical Center , Brooklyn, New York.
authors.forename: Billy
authors.initials: B
authors.lastname: Sin
authors.affiliation: Clinical Pharmacist, Internal Medicine, Brookdale University Hospital Medical Center , Brooklyn, New York.
authors.forename: Linda
authors.initials: L
authors.lastname: Yee
authors.affiliation: Assistant Director, Pharmacy Services, Brookdale University Hospital Medical Center , Brooklyn, New York.
authors.forename: Maria
authors.initials: M
authors.lastname: Claudio-Saez
authors.affiliation: Director, Pharmacy Services, Brookdale University Hospital Medical Center , Brooklyn, New York.
authors.forename: Qazi
authors.initials: Q
authors.lastname: Halim
authors.affiliation: Chairman, Emergency Medicine, Brookdale University Hospital Medical Center , Brooklyn, New York.
authors.forename: Lewis
authors.initials: L
authors.lastname: Marshall
authors.affiliation: Director, Emergency Medicine Nursing Services, Brookdale University Hospital Medical Center , Brooklyn, New York.
authors.forename: Mary
authors.initials: M
authors.lastname: Hayes-Quinn
keywords: emergency department; pharmacy practice; prospective medication review