Authors (including presenting author) :
Lau PWA (1), Cheung YHT (1), Mak WMR (1), Chui CMW (1), Chan WM (2)
Affiliation :
(1) Department of Pharmacy, Queen Mary Hospital (2) Adult Intensive Care Unit, Queen Mary Hospital
Introduction :
A clinical pharmacist plays a significant and multi-faceted role in AICU in that he/she helps reduce medication errors, adverse drug reactions & their negative impacts, as well as their pertaining healthcare costs. The services of the AICU pharmacist are two- pronged. First, the AICU pharmacist enhances patients’ quality of care in drug safety. Second, the AICU pharmacist helps enhance transitional care to facilitate early stepdown to general ward. The impact of AICU pharmacist is significant.
Objectives :
To assess the quality of care in drug safety and during transition of care of Clinical Pharmacy Service in AICU.
Methodology :
Regarding quality of care in drug safety, retrospective data was collected from Jan 2022 to Dec 2022. Secondly, since AICU pharmacist also plays another key role in transitional care of critically ill patients. a pilot service of transitional care was initiated by AICU pharmacist with full support from AICU department and orthopedics surgery team since mid-Aug 2022 to observe their patients in AICU. Prospective data was analyzed for this pilot.
Result & Outcome :
In 2022, a total of 373 interventions were made with reference to drug related problems; of which 372 interventions were accepted by doctors. The acceptance rate for the intervention is well over 97%. These interventions can be medications indication related, including the addition of drugs, drugs with no indications and duplications. Other clinical interventions are safety related and these include checking drug interactions, drug monitoring, dosing adjustment, and discontinuation of drugs. The AICU pharmacist also helped in establishing AICU drug sets for commonly used drugs in AICU which require adjustment in dosage and these drugs include most of the antibiotics, inotropes and sedatives. 19 orthopedic patients in total were in the observation pool. 8 of them were discharged from AICU to general wards during office hours with a Clinical Pharmacist Discharge Note, with recommendations like (1) tentative duration of antibiotics; (2) resuming of chronic regular medications when clinically appropriate; (3) dosage adjustment and monitoring required when patients experience renal or liver function changes; (4) discontinuation of drugs that are no longer indicated. (e.g. stress-induced ulcer medications); (5) newly prescribed drugs for new indications during AICU stay. With strong support from AICU doctors and nurses, Queen Mary Hospital Pharmacy takes the lead to implement the clinical service of AICU Pharmacist to enhance the quality of patient care.
