Characterization of dayshift tele-ICU pharmacist activities

Area of Science:

• Critical care medicine
• Telehealth services
• Pharmacy practice

Background:

• Tele-intensive care unit (tele-ICU) services have expanded, with pharmacy coverage increasing to include dayshift hours.
• Advanced technology enables alerts for critical lab values like glucose, electrolytes, and lactate.
• This analysis focuses on pharmacist interventions during dayshift tele-ICU hours.

Purpose of the Study:

• To describe the types and impact of pharmacist interventions during dayshift tele-ICU hours.
• To evaluate the effectiveness of alert-driven versus proactive pharmacist assessments.
• To identify challenges and innovations in tele-ICU pharmacy services.

Main Methods:

• Data collected over 11 months (August 2017-June 2018) of dayshift tele-ICU pharmacy coverage.
• Recorded number of charts reviewed, interventions made, and intervention types.
• Noted if interventions were alert-related and if they were accepted or rejected by the care team.

Main Results:

• An average of 41 charts were reviewed per shift, with 1024 interventions for 634 patient reviews.
• 89% of interventions were accepted or accepted with modifications.
• Medication management comprised 44.3% of interventions, with 3.6% preventing adverse drug events.

Conclusions:

• Proactive pharmacist assessment, rather than solely relying on alerts, led to the majority of interventions.
• Comprehensive review of all ICU patients is crucial for enhancing care quality.
• Integrating tele-ICU pharmacy interventions with bedside teams remains a key challenge.