7. Integrating pharmaceutical care into the interdisciplinary model of care in the emergency...
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408 JOURNAL OF EMERGENCY NURSING 29:5 October 2003 RESEARCH ABSTRACTS 7. Integrating Pharmaceutical Care Into the Interdisciplinary Model of Care in the Emergency Department. Jean Taylor, RN, Kathleen Bergeron, RN, CEN, Alicia ZuWallack, RPh, PharmD, Rany Cover, RPh, PharmD, Trudy Charboneau, BSRN, Kent Hospital, 455 Tollgate Rd, Warwick, RI 02886 (E-mail: [email protected]) Purpose: Adverse drug events are a dangerous and costly reality in health care today. Has adding a pharmacist to the ED interdiscipli- nary team reduced adverse drug events and been cost effective? Design: A prospective review of admission orders and docu- mented interventions by pharmacists. A retrospective review of qualitative and observational data, utilizing chart review and oc- currence screens. Setting: An emergency department with an annual volume of 60,000 patients within a 359-bed community hospital in central Rhode Island. Sample: Those presented to the emergency department who are admitted to the hospital between 10 AM and 6 PM. This is between 12 and 15 charts per day. Methods: Data were collected by prospective review of all patient charts and admission orders. Interventions are recorded in the pharmacy computer system. Default dollar value is assessed. Oc- currence screens for adverse drug events reviewed retrospectively within patient safety/quality priorities identified. Results: Data collection analysis is ongoing; however for the first 3 months of fiscal 2003 the results were supportive as follows: Number of missed medications on admission that orders were obtained for: 43 Code blues attended/assisted: 11 Patients’ counseling and medication histories obtained by pharmacist: 382 Significant drug interactions intercepted: 4 Doses or frequencies of drugs questioned: 43 Diseases state contraindications/recommendations: 8 Significant medication errors averted: 6 Nonformulary or nonstocked drugs changed: 37 Orders clarified: 27 Allergic reactions avoided: 8 Total estimated cost savings/avoidance for this time period: $13,807 Conclusion: To date, we have observed significant numbers of interventions and cost savings that would not be likely to occur during the standard medication review process without a pharma- cist in the emergency department. We anticipate nurse and physi- cian satisfaction surveys to support the continuation of this novel program.
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Transcript of 7. Integrating pharmaceutical care into the interdisciplinary model of care in the emergency...
408 JOURNAL OF EMERGENCY NURSING 29:5 October 2003
RESEARCH ABSTRACTS
7. Integrating Pharmaceutical Care Into the InterdisciplinaryModel of Care in the Emergency Department. Jean Taylor, RN,Kathleen Bergeron, RN, CEN, Alicia ZuWallack, RPh, PharmD, RanyCover, RPh, PharmD, Trudy Charboneau, BSRN, Kent Hospital, 455Tollgate Rd, Warwick, RI 02886 (E-mail: [email protected])Purpose: Adverse drug events are a dangerous and costly reality inhealth care today. Has adding a pharmacist to the ED interdiscipli-nary team reduced adverse drug events and been cost effective?
Design: A prospective review of admission orders and docu-mented interventions by pharmacists. A retrospective review ofqualitative and observational data, utilizing chart review and oc-currence screens.
Setting: An emergency department with an annual volume of60,000 patients within a 359-bed community hospital in centralRhode Island.
Sample: Those presented to the emergency department who areadmitted to the hospital between 10 AM and 6 PM. This is between12 and 15 charts per day.
Methods: Data were collected by prospective review of all patientcharts and admission orders. Interventions are recorded in thepharmacy computer system. Default dollar value is assessed. Oc-currence screens for adverse drug events reviewed retrospectivelywithin patient safety/quality priorities identified.
Results: Data collection analysis is ongoing; however for the first3 months of fiscal 2003 the results were supportive as follows:
Number of missed medications on admission that orderswere obtained for: 43
Code blues attended/assisted: 11Patients’ counseling and medication histories obtained by
pharmacist: 382Significant drug interactions intercepted: 4Doses or frequencies of drugs questioned: 43Diseases state contraindications/recommendations: 8Significant medication errors averted: 6Nonformulary or nonstocked drugs changed: 37Orders clarified: 27Allergic reactions avoided: 8Total estimated cost savings/avoidance for this time period:
$13,807
Conclusion: To date, we have observed significant numbers ofinterventions and cost savings that would not be likely to occurduring the standard medication review process without a pharma-cist in the emergency department. We anticipate nurse and physi-cian satisfaction surveys to support the continuation of this novelprogram.
