title: Evaluation of Neuroleptic Utilization in the Intensive Care Unit During Transitions of Care.
abstract: OBJECTIVE
  The purpose of this study was to identify risk factors associated with inappropriate continuation of neuroleptics postdischarge from the intensive care unit (ICU) and hospital.
  
  
  METHODS
  A retrospective chart review was performed including all patients greater than 18 years of age who received neuroleptic medications in an ICU.
  
  
  RESULTS
  One hundred sixty-one patients were included during the 12- month study period. There were 85 (53%) patients discharged from the ICU with inappropriate continuation of a neuroleptic medication. There were 54 (34%) patients discharged from the hospital with inappropriate continuation of a neuroleptic medication. Patients were more likely to be discharged from the ICU with an inappropriate neuroleptic if they were prescribed multiple neuroleptics ( P = .02), did not have a urine drug screen collected at admission ( P = .023), or if trazodone was utilized in their therapy ( P = .004). Patients were more likely to be discharged from the hospital with a neuroleptic if they had multiple neuroleptic orders ( P = .0001) or if trazodone was utilized in their therapy ( P = .0023).
  
  
  CONCLUSIONS
  Risk factors associated with the continuation of inappropriate neuroleptic medications upon discharge from the ICU or the hospital include multiple neuroleptic medications prescribed, the lack of a urine drug screen upon admission, and the utilization of trazodone.
authors.affiliation: 1 Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Gilbert
authors.affiliation: 2 UF Health Jacksonville, Jacksonville, FL, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Morales
authors.affiliation: 2 UF Health Jacksonville, Jacksonville, FL, USA.
authors.forename: Randi J
authors.initials: RJ
authors.lastname: Searcy
authors.affiliation: 2 UF Health Jacksonville, Jacksonville, FL, USA.|3 College of Pharmacy, University of Florida, FL, USA.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Johnson
authors.affiliation: 2 UF Health Jacksonville, Jacksonville, FL, USA.|3 College of Pharmacy, University of Florida, FL, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Ferreira
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016638:Critical Illness / Q000523:psychology*; D003693:Delirium / Q000188:drug therapy*; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007362:Intensive Care Units; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents
keywords: critical care; intensive care unit; interhospital transfer; quality; safety