332 Impact of Emergency Department Clinical Pharmacist Response to an Automated Electronic Notification System on Timing and Appropriateness of Antimicrobials in Severe Sepsis or Septic Shock in the Emergency Department

Attwood, R.J.; Garofoli, Adrian C.; Baudoin, M.R.; Smith, Vernon D.; Woloszyn, Amanda V.; Berg, Alexander; Hess, Erik P.; Russi, Christopher S.; Rudis, Maria I.

doi:10.1016/j.annemergmed.2012.06.310

Annals of Emergency Medicine

2012

DOI: 10.1016/j.annemergmed.2012.06.310

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332 Impact of Emergency Department Clinical Pharmacist Response to an Automated Electronic Notification System on Timing and Appropriateness of Antimicrobials in Severe Sepsis or Septic Shock in the Emergency Department

R.J. Attwood

Adrian C. Garofoli

M.R. Baudoin

et al.

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Cited by 7 publications

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“…The contribution of clinical pharmacists on multidisciplinary teams has been shown to reduce patient mortality,3 hospital readmissions4 and medication errors 5. Further, EM clinical pharmacists have demonstrated improvement in time-sensitive therapies in the ED, such as reductions in time to administration of antibiotics in sepsis,6 analgesics in trauma,7 sedatives and analgesics after rapid sequence intubation,8 and thrombolytic therapy in acute ischaemic stroke 9…”

mentioning

confidence: 99%

Emergency medicine pharmacists on an international scale

Coralic

Hayes

2017

Emerg Med J

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mentioning

confidence: 99%

Emergency medicine pharmacists on an international scale

Coralic

Hayes

2017

Emerg Med J

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Pharmacists as members of an interdisciplinary pulmonary embolism response team

Groth

Acquisto

Wright

et al. 2021

J Am Coll Clin Pharm

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Introduction: Pulmonary embolism response teams (PERTs) were developed to assist with diagnosis, risk stratification, and management of intermediate and high-risk pulmonary embolism (PE) and have been shown to reduce 90-day mortality. The pharmacist's role on the PERT is not well defined. Objectives: Describe the pharmacist's role as a PERT member and determine if pharmacists can improve time to anticoagulation and promote use of low molecular weight heparin (LMWH) instead of unfractionated heparin (UFH). Methods: A retrospective, observational study of adult patients with massive or submassive PE between January 2014 and May 2020. Patient demographics, clinical variables, anticoagulation treatment/timing, and pharmacist activities during PERT response were evaluated. Patients were divided into three groups for comparisons (pre-PERT vs post-PERT with a pharmacist vs post-PERT without a pharmacist). Wilcoxon rank-sum or Kruskal-Wallis test and chi-squared analysis were used for continuous and categorical data, respectively. Results: A total of 573 patients were included (mean age 63.2 ± 15.6 years, 54% male, 78% submassive PE); 137 in the pre-PERT and 436 in the post-PERT groups. Within the post-PERT group, 305 patients (70%) had a pharmacist as a member of the PERT, of which 222 (73%) had a documented pharmacotherapy-related intervention/activity. Most (n = 178, 58%) involved a pharmacist facilitating ordering/ administration of an anticoagulant/thrombolytic. Median time from diagnosis to anticoagulation was significantly reduced in the post-PERT groups (pre-PERT: 104 minutes [IQR 124.5], post-PERT with a pharmacist: 63 minutes [IQR 84], post-PERT without a pharmacist: 75.5 minutes [IQR 113], P = .0001). More patients in the post-PERT groups received LMWH compared to UFH when a pharmacist was involved vs without a pharmacist (69.5% vs 53.3%, P = .0019) and major bleeding events were reduced

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Development of the Manchester framework for the evaluation of emergency department pharmacy services

et al. 2022

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Background Many countries, including the United Kingdom, have established Emergency Department (ED) pharmacy services where some ED pharmacists now work as practitioners. They provide both traditional pharmaceutical care and novel practitioner care i.e. clinical examination, yet their impact on quality of care is unknown. Aim To develop a framework of structures, processes and potential outcome indicators to support evaluation of the quality of ED pharmacy services in future studies. Method Framework components (structures, processes and potential outcome indicators) were identified in three ways: from a narrative review of relevant international literature, and separate panel meetings with ED pharmacists and then other ED healthcare professionals. Structures and processes were collated into categories developed iteratively throughout data collection, with outcome indicators collated into six domains of quality as proposed by the Institute of Medicine. These raw data were then processed e.g. outcome indicators screened for clarity i.e. those which explicitly stated what would be measured were included in the framework. Results A total of 190 structures, 533 processes, and 503 outcome indicators were identified. Through data processing a total of 153 outcome indicators were included in the final framework divided into the domains safe (32), effective (50), patient centred (18), timely (24), efficient (20) and equitable (9). Conclusions The first framework specific to the quality evaluation ED pharmacy services, service evaluators should validate potential outcome indicators prior to their use. The minimum expected of a high-quality service should also be defined to enable interpretation of relevant measurements.

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332 Impact of Emergency Department Clinical Pharmacist Response to an Automated Electronic Notification System on Timing and Appropriateness of Antimicrobials in Severe Sepsis or Septic Shock in the Emergency Department

Cited by 7 publications

References 0 publications

Emergency medicine pharmacists on an international scale

Emergency medicine pharmacists on an international scale

Pharmacists as members of an interdisciplinary pulmonary embolism response team

Development of the Manchester framework for the evaluation of emergency department pharmacy services

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