title: Impact of Clinical Pharmacist on the Pediatric Intensive Care Practice: An 11-Year Tertiary Center Experience.
abstract: OBJECTIVE
  With increasing complexity of critical care medicine comes an increasing need for multidisciplinary involvement in care. In many institutions, pharmacists are an integral part of this team, but long-term data on the interventions performed by pharmacists and their effects on patient care and outcomes are limited. We aimed to describe the role of pediatric clinical pharmacists in pediatric intensive care unit (PICU) practice.
  
  
  METHODS
  We retrospectively reviewed the records of pharmacy interventions in the PICU at the Mayo Clinic in Rochester, Minnesota, from 2003-2013, with a distinct period of increased pharmacist presence in the PICU from 2008 onward. We compared demographic and outcome data on patients who did and who did not have pharmacy interventions during 2 periods (2003-2007 and 2008-2013).
  
  
  RESULTS
  We identified 27,773 total interventions by pharmacists during the 11-year period, of which 79.8% were accepted by the clinical team. These interventions were made on 10,963 unique PICU admissions and prevented 5867 order entry errors. Pharmacists' interventions increased year over year, including a significant change in 2008. Patients who required pharmacy involvement were younger, sicker, and had longer intensive care unit, hospital, and ventilator duration. Average central line infections and central line entry rates decreased significantly over the study period.
  
  
  CONCLUSIONS
  Increased pharmacist presence in the PICU is associated with increased interventions and prevention of adverse drug events. Pharmacist participation during rounds and order entry substantially improved the care of critically sick children and should be encouraged.
authors.affiliation: Department of Pediatric Critical Care Medicine.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Tripathi
authors.affiliation: Pharmacy Services, Mayo Clinic, Rochester, Minnesota.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Crabtree
authors.affiliation: Department of Pediatric Critical Care Medicine.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Fryer
authors.affiliation: Pharmacy Services, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Graner
authors.affiliation: Department of Pediatric Critical Care Medicine.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Arteaga
keywords: adverse drug reaction; catheter-related infections; medication errors; pediatric intensive care units; pharmacists