담당약사의 처방중재활동에 대한 약물유해반응 예방의 비교 분석
The Comparison Analysis of the Prevention of Adverse Drug Events through Order Interventions by Designated-pharmacists
분당서울대학교병원 약제부
Department of Pharmacy, Seoul National University Bundang Hospital
J. Kor. Soc. Health-Syst. Pharm. 2014; 31(1): 638-643
Published February 27, 2014
© The Korean Society of Health-system Pharmacists.
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회원학술보고
J. Kor. Soc. Health-Syst. Pharm. 2014; 31(1): 638-643
Published online February 27, 2014
Copyright © The Korean Society of Health-system Pharmacists.
The Comparison Analysis of the Prevention of Adverse Drug Events through Order Interventions by Designated-pharmacists
Tae-young Park, Yoon-hee Kim, Young-mi Jung, Jung-wha Lee and Eun-sook Lee
Department of Pharmacy, Seoul National University Bundang Hospital
Abstract
Background : It is well known that adverse drug events(ADEs) increase the length of
stay and charges in the hospital setting. Interventions by clinical pharmacists have been shown to be a first step to prevent these medication errors and are associated with safe and effective pharmacotherapy.
As an effort to increase appropriate interventions, Bundang Seoul National University
Hospital(SNUBH) has designated clinical pharmacists who are in charge of medical intensive care unit(MICU), neonatal intensive care unit(NICU), surgical intensive care unit(SICU), geriatric care center(GC). and respiratory care center(RC). Interventions conducted are supposed to be recorded in electronic medical records(EMR) and can be shared between pharmacists, which maximizes work efficiency.
Objective : In order to measure the effect of designated-pharmacists on interventions, interventions performed by designated-pharmacists and non designated-pharmacists were analyzed.
Methods : A retrospective database review of recorded clinical interventions by pharmacists was conducted to classify interventions by types and an acceptance. One resident pharmacist(post graduate year 1 or PGY1) and two clinical pharmacists not involved in the data collection valuated a prevention of ADEs. Cost avoidance was calculated to estimate the seriousness of ADEs and potential extra cost in the absence of the intervention.
Results : Five hundreds ninety interventions were documented during 1-month study period.
The intervention rate by designated-pharmacists was 0.44%, which was higher than non designated pharmacists by 0.32%. An acceptance rate by designated-pharmacists and non designatedpharmacists was 76.1% and 68.5% respectively. Sixty three interventions were judged to have prevented potential ADEs, of which thirty seven interventions had been conducted by designated- pharmacists. The estimated cost avoidance from interventions by designated-pharmacists was approximately 10,030,000won and counts for 77% of total.
Conclusions : In respect of the intervention rate, the acceptance rate, the prevention of ADEs, and the cost avoidance, designated-pharmacist policy has positive effect on pharmacotherapy.
Keywords: Adverse drug events, Intervention, Designated-pharmacists