title: An evaluation of clinical pharmacist service on a neurology care unit.
abstract: BACKGROUND
  Medications used to treat neurological diseases may result in adverse effects. Research is needed to demonstrate pharmacist value and their roles in patient care.
  
  
  OBJECTIVE
  To categorize the types and severities of the prescribing errors intercepted and to describe clinical activities conducted by neurology ward pharmacists.
  
  
  METHODS
  Pharmacists prospectively reviewed medication orders over an 18-month period with inventions documented and categorized.
  
  
  RESULTS
  A total of 341 prescribing errors in 1183 patients were intercepted. The most common error types were dosing frequency (35.8 %) and medication selection (21.5 %). The top five most detected error medications were those indicated for hyperhomocysteinemia (22.0 %), stress ulcer prophylaxis (12.3 %), poor circulation (10.9 %), hyperglycemia (6.5 %), and infections (5.9 %). Although 67.5 % of the detected errors having the potential causing no harm, 26.4 % of the errors may require intervention, and 6.2 % may increase the length of stay. The number of errors decreased from 19 to 10 per month during the study period. Clinical pharmacists also actively engaged in medication use evaluation, clinical decision support system optimization, and education to patients and providers.
  
  
  CONCLUSIONS
  Presence of clinical pharmacists at the neurology unit may help in early detection of prescribing errors with increased patient safety.
authors.affiliation: Peking University Third Hospital, Beijing, China.
authors.forename: Zhan-Miao
authors.initials: ZM
authors.lastname: Yi
authors.affiliation: College of Pharmacy, Western New England University, Springfield, MA, USA.
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Sun
authors.affiliation: Peking University Third Hospital, Beijing, China.
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Li
authors.affiliation: Peking University Third Hospital, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.affiliation: Peking University Third Hospital, Beijing, China. zhaisuodi@163.com.
authors.forename: Suo-Di
authors.initials: SD
authors.lastname: Zhai
mesh_terms: D004334:Drug Administration Schedule; D004339:Drug Compounding; D011307:Drug Prescriptions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D006757:Hospital Units; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D059065:Medication Reconciliation / Q000379:methods*; D054539:Medication Therapy Management; D009462:Neurology; D061214:Patient Safety; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D024382:Professional Role; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment
keywords: China; Clinical pharmacist; Medication review; Neurology; Prescription errors; Quality improvement