Contribution to Medical Safety and Medicine-Related Incident Reduction by Allocation of a Supervising Clinical Pharmacist in the Wards

This study investigated whether the review of systems (ROS), an evaluation method that covers all organ systems, improves the quality of pharmaceutical care provided in intensive care units (ICUs). We retrospectively examined patients from the respiratory and emergency intensive care departments admitted to the ICU of our hospital in 2012 (before the introduction of ROS; non-ROS group, n = 93) and in 2014 (after the introduction of ROS; ROS group, n = 65). The number of pharmaceutical interventions and adverse drug events prevented by pharmacists per 1000 patient days were higher in the ROS group (265.7 and 57.8 for the ROS group and 190.8 and 39.9 for the non-ROS group). Pharmacists＇ proposals were accepted at a significantly higher rate in the ROS group than in the non-ROS group (89.5％ vs 72.3％, P < 0.01), and the accepted proposals in the ROS group were implemented for a wider range of organ systems. These results indicate that the ROS was helpful in terms of identifying the patients＇ clinical manifestations and evaluating the adequacy and safety of medication administered in the ICU, which resulted in improved and precise proposals by pharmacists. Moreover, the ROS approach introduced in this study was considered to be suitable for pharmaceutical activities in the ICU and to contribute to improving the quality of pharmaceutical care.

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The Effects of Inducing the Review of Systems to the Pharmaceutical Care in Intensive Care Units

Yoshihiro

Tomita

Hashimoto

2016

Jpn. J. Pharm. Health Care Sci.

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Effect of Pharmacist Intervention for Patients Staying in Long-term Care Beds for more than 9 Weeks

Watanabe¹,

Maiguma²,

Namba³

et al. 2016

Jpn. J. Pharm. Health Care Sci.

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In April 2014, when the medical insurance system for medical service fees was revised, the required assessment of inpatients＇ conditions for the addition of inpatient pharmaceutical service fees in long-term care beds was changed from being conducted at 4 weeks after hospitalization to being conducted 8 weeks after hospitalization. However, there have been no reports on the changes this has brought to inpatient pharmaceutical services in long-term care beds. Additionally, there have been no reports comparing the content of inpatient pharmaceutical services during the first 8 weeks with that after 9 weeks. Therefore, we investigated inpatient pharmaceutical services for 58 long-term care beds in Kibikougen Lumiere Hospital over 1 year. The rate of pharmacist interventions for prescription optimization was eventually 60.9％ and the number of pharmacist intervention categorized according to subject was a total of 465. In addition, there were no significant differences between the first 8 weeks of hospitalization and after 9 weeks in the content of inpatient pharmaceutical services and in the rates of doctor acceptance of pharmacist interventions. Notably, we estimated that there would be a reduction in the cost of medication of around 515,633 yen per year (8,890 yen per bed) as a result of withdrawal of medication through pharmacist intervention. Therefore, inpatient pharmaceutical services in long-term care beds should be continuously offered for patients staying at the hospital for more than 9 weeks.

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Effect of Allocation of Ward Pharmacists on Interventions and Consultations

Ogue

Ohno

Oriyama

et al. 2016

Jpn. J. Pharm. Health Care Sci.

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At the University of Tokyo hospital, we began allocation of ward pharmacists to some wards in August 2012 and to all wards in August 2014. In this study, we qualitatively and quantitatively reviewed cases reported by ward pharmacists to evaluate the effects of this allocation on intervention and consultation that required positive participation. We retrospectively reviewed the pharmaceutical interventions＇ record from April 2012 through March 2015. We also analyzed cases for three months after the allocation of pharmacists to every ward. We found a highly positive correlation (R 2 = 0.928, P < 0.0001) between the number of wards and pharmaceutical interventions. Intervention cases per month increased by 21.5 after allocating a pharmacist to a ward. There were a total of 2,438 intervention cases over three months. Active and passive approaches were employed in 1,833 cases and 605 cases, respectively. High-risk medicines were associated with 39.3％ of cases. The prescription change rate was 86.2％ for active interventions and 50.9％ for passive interventions. Results showed that the allocation of a ward pharmacist could assist pharmaceutical approaches through the evaluation of patient complaints and clinical conditions, participation in the treatment plan, and consultation from medical staff. There were also reports that an active approach led to critical adverse event avoidance and pharmacotherapy effect improvement. These findings suggest that the allocation of ward pharmacists results in the promotion of healthcare services and medical safety.

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Contribution to Medical Safety and Medicine-Related Incident Reduction by Allocation of a Supervising Clinical Pharmacist in the Wards

Cited by 5 publications

References 2 publications

The Effects of Inducing the Review of Systems to the Pharmaceutical Care in Intensive Care Units

The Effects of Inducing the Review of Systems to the Pharmaceutical Care in Intensive Care Units

Effect of Pharmacist Intervention for Patients Staying in Long-term Care Beds for more than 9 Weeks

Effect of Allocation of Ward Pharmacists on Interventions and Consultations

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