[Clinical pharmacist in a multidisciplinary team in a paediatric department]

Clinical pharmacists have not been a part of multidisciplinary teams at Rikshospitalet, University Hospital, Norway, which is in contrast with common practice in other countries. We wanted to investigate how such specialists could contribute to quality assurance of drug treatment in a paediatric ward.

A clinical pharmacist reviewed medical charts from patients admitted to the paediatric ward at Rikshospitalet in the period 1.2.2006-31.3.2007. Drug related problems (DRP), identified by the pharmacist, were discussed with physicians and nurses before the ward round. In the period 31.7.2006-31.3.2007, DRPs were recorded on a quantitative and qualitative level. Nurses and physicians evaluated the project by responding to a questionnaire.

The pharmacist identified 137 DRPs in 103 of the 384 screened charts. Immediate action was taken in 73 of the 137 cases, 39 DRP were considered relevant, but without requiring action, and 25 of the DRP recordings had no consequence for the treatment. The most commented DRPs were "dosage" (n = 48), "drug choice" (n = 35) and "need for monitoring" (n = 32). The pharmacist responded to DRPs, educated nurses, developed internal guidelines and recommended cost-saving measures. Seven of eight doctors and all the 15 nurses thought that the ward had benefited from the pharmacist's contribution. Interpretation. Clinical pharmacists may make a positive contribution to quality assurance of drug treatment in hospital wards.