병원약사회지

  • 자료실
  • 병원약사회지
[논문] 심장외과 중환자실에서 임상약사의 약처방 중재 활동 분석(Analysis of Clinical Pharmacist Interventions in the Cardio-Surgical Intensive Care Unit)
Date

2021년 Vol.38 No.02

Authors
손유민a*, 고민지a*, 박효정a, 이재현a, 이용석a, 이후경a, 김정미a, 조양현b, 민명숙a†(삼성서울병원 약제부a, 삼성서울병원 심장외과분과b)
Keyword
Clinical pharmacist, Intervention, Cardio-surgical intensive care unit
Abstract

Background : It has been reported that clinical pharmacists’ participation in the multidisciplinary intensive care unit (ICU) team reduces the number of medication errors and improves the clinical outcome. However, studies assessing the role of pharmacists in a cardio-surgical ICU (CSICU) are limited. The aim of this study was to analyze pharmacologic interventions and identify pharmacologic problems that require pharmacist intervention in a CSICU.


Methods : The research was conducted by retrospectively reviewing the electronic medical records of patients aged 18 years or older who were admitted to the CSICU of Samsung Medical Center from April 1 2019 to June 30 2019.


Results : During the study, the clinical pharmacist monitored 12,021 drug prescriptions for 205 patients and conducted 379 pharmacologic interventions. The most common pharmacologic intervention recommended by the pharmacist was nutritional support (19.0%), followed by therapeutic drug monitoring (TDM) (18.5%) and provision of drug information (14.8%). The most frequently mediated group of drugs was antibiotics (31.1%), and the causes for pharmacologic intervention of antibiotics were mostly TDM (51.7%) and inappropriate dosage (20.3%). The intervention rate of ‘pain, sedation and delirium-related drugs’ was 17.2%, while the intervention rate of ‘antiarrhythmics, anticoagulant, and antiplatelet agents’ was 13.2%. The most common reason for intervention in both groups was missed prescriptions, followed by adverse drug events and inappropriate dosages. The acceptance rate of intervention was 92.2%.


Conclusion : Clinical pharmacists’ participation in the ICU has enabled active drug prescription monitoring, proper nutrition support, and TDM. The acceptance rate of intervention is high. The CSICU requires pharmacologic intervention of pain, sedation and delirium-related drugs specific to critically ill patients, as well as drugs indicated for cardio-surgery.

Full-Text
185-194학술보고3손유민.pdf