Purpose: 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. Design: 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. Conclusion: 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.Key Words-adverse drug events, medication safety, pharmacist, staffing model Hosp Pharm-2013;48(11):922-930 A dverse drug events (ADEs), injuries resulting from the administration of a drug, levy serious costs on health care institutions and patients by requiring further complex care, prolonged lengths of hospital stay, and increased risk of death. The incidence rates of ADEs range from 10 ADEs per 1,000 patient days, of which 56% were preventable, 1 to 6.5 ADEs per 100 patient admissions, of which 28% of all ADEs were preventable.2 The cost of ADEs is estimated to be $2,000 per admission.2 This amount varies by institution and is a conservative estimate for 2013. Systems-related factors, such as drug ordering and administration processes, are likely contributing factors to preventable ADEs rather than patient-related characteristics.2 Specifically, drug information not available to physicians at the time of ordering medication was found to account for 29% of errors.3 The availability of up-to-date drug information, including guidelines and recommendations about monitoring, doses, drug interactions, and duration of therapy, is critical when prescribing medication.
