Pharmaceutical care in paediatric intensive care unit: Activities and interdisciplinary learning in a Spanish hospital

Abstract

Objectives To describe and quantify the clinical and logistic activities of a resident pharmacist in a paediatric intensive care unit (PICU) and to identify the key areas for improvements in training. Methods A prospective quasi-experimental cross-sectional study was conducted in an 11-bed PICU over a 3-month period. Pharmacist recommendations (clinical interventions) were made on patient care during the validation stage of medical orders. All interventions performed were recorded in a database and included the following information: reason for the intervention, clinical significance and acceptance by the physician. A record was also kept of the number of interventions per patient-day and the number of drugs whose profiles for dispensing from an automatic cabinet automatic dispensing system (ADS) were modified. Results There were 40 interventions (13% recommendations issued in the absence of error, 59% concerned drug safety issues, 20% related to efficacy and 8% to the indication), of which 72.5% were classified as significant or very significant; 95% were accepted by the physician. There were 4.0 interventions per 100 patient-days. No single drug was involved in more than 5% of interventions. The profiles of 16.6% of the drugs included in the ADS were modified. Conclusions The action of the pharmacist enabled prevention of prescription errors of critically ill paediatric patients. It is necessary to broaden and systematise clinical training in this discipline in order to identify a larger number of negative outcomes associated with medications.