Comprehensive pharmaceutical services in a medical intensive-care unit

Area of Science:

• Pharmacy Practice
• Critical Care Medicine
• Hospital Pharmacy Services

Background:

• Clinical pharmacists have provided services in a 1600-bed urban teaching hospital's medical intensive care unit (MICU) for 14 years.
• The MICU pharmacy staff comprises 4.3 full-time equivalent pharmacists offering 24-hour daily services.

Purpose of the Study:

• To describe the clinical and distributive pharmacy services in the MICU.
• To discuss the skills and educational requirements for MICU pharmacists.
• To highlight the impact of pharmacists on patient care and hospital efficiency.

Main Methods:

• Pharmacists are actively involved in all pharmacological decisions, from drug preparation to administration.
• Services include maintaining medication records, monitoring patients, identifying adverse reactions, and intervening in crises.
• Pharmacists provide pharmacokinetic services, select drug administration routes, prepare IV medications, and manage nutritional support therapy.

Main Results:

• Pharmacists' involvement leads to optimal drug therapy, increased productivity, and enhanced efficiency.
• Services are prompt and accurate, contributing to patient safety and care.
• The program is well-accepted by physicians and nurses, though only 20% of inpatient pharmacists desire MICU work.

Conclusions:

• Clinical pharmacists are integral to the MICU, improving patient outcomes through comprehensive medication management.
• Specialized skills and education are necessary for effective practice in the MICU setting.
• The described model demonstrates the value of dedicated pharmacy services in critical care environments.