定制电子健康记录临床决策支持工具对药剂师脏剂量干预措施的影响
Brandyn Wilcox1, James Sanders2, Candace Sutton1
1Department of Pharmacy, University of Texas Southwestern Medical Center, Dallas, TX, USA.
概括
一种新的脏剂量调整工具通过增加68.2%的干预和减少47.2%的警报来改善药物管理. 这种系统提高了药剂师的效率和对需要脏剂量调整的药物的患者护理.
科学领域:
- 药理学和药房实践中的药理学和药房实践
- 医疗信息学 医疗信息学
背景情况:
- 对需要脏剂量调整的药物的手动审查是耗时的,容易出现错误.
- 现有的系统可能无法有效地识别或管理需要剂量调整的患者.
- 优化治疗功能障碍的药物管理对于患者的安全和有效治疗至关重要.
研究的目的:
- 开发和实施一个定制的Epic评分工具,以自动化和改进对需要脏剂量调整的药物的监测.
- 用高效的数字解决方案取代手动审查和干预 (i-Vent) 文档程序.
- 为了提高成年患者脏剂量调整的准确性和及时性.
主要方法:
- 一个回顾性,观察性队列研究比较了药剂师的干预措施和工具实施前后的抗菌剂剂量.
- 包括需要脏剂量调整的成年患者,但不包括患有特定疾病或接受脏替代疗法的患者.
- 数据是在2022年 (干预前) 和2023年 (干预后) 的两个月内收集的.
主要成果:
- 在实施后,脏剂量干预增加了68.2% (P < 0.0001).
- 需要药剂师审查的独特警报减少了47.2% (P < 0.0001).
- 每个警报可采取行动的干预比例从11.1%上升到39.4% (P < 0.0001),药剂师满意度有所改善.
结论:
- 定制的Epic脏剂量调整工具显著提高了功能障碍患者药物管理的效率和有效性.
- 实施导致了更完整的干预,更少的警报和更好的抗菌剂剂量.
- 该工具提高了药剂师的工作流的满意度,并优化了对脏剂量调整的患者护理.
相关概念视频
01:11Renal Failure: Dose Adjustments
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
45
01:17Factors Affecting Renal Clearance: Renal Impairment
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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
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01:09Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
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Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
74
01:15Drug Dosage Regimen: Overview
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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
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01:06Renal Drug Clearance: Overview
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Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
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01:22Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa
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The pH of urine, the drug's pKa, and the urine flow rate are vital parameters for drug reabsorption and excretion. Urinary pH varies between 4.6 and 8.0 and is influenced by diet, drug intake, and the patient's pathophysiology. It affects a drug's ionization state and reabsorption. For instance, carbohydrate-rich food produces alkaline urine promoting drug excretion, while proteins and certain medications like ascorbic acid lead to acidic urine enhancing reabsorption.
The pKa of a...
The pKa of a...
113