January 25, 2021
Direct pharmacy services were available, at least in part, in all intensive care units (ICUs) in the United States that responded to a recent survey, the results of which were reported online in Critical Care Explorations.
Some 70.8% of respondents said the most common mode of providing pharmacy services to the ICU was direct, with at least a portion of a pharmacist full-time equivalent dedicated to the ICU. Another 29.2% indicated a combination of direct and indirect delivery of pharmacy services.
“Past surveys conducted in 2004 and 1988 showed only 62.2% of respondents provided direct patient care services and the role of the ICU pharmacist with direct patient care responsibilities was uncertain, respectively,” researchers wrote. “The results of this survey suggest that conventional care in the ICU includes direct pharmacy services provided in a proactive manner, and performance benchmarks for ICUs should ensure a pharmacist is part of the multidisciplinary ICU team.”
The 27-question electronic survey was sent to 1220 facilities in the United States in 2018 to assess the current state of clinical pharmacist involvement in ICU care. Some 401 surveys representing 493 ICUs were completed.
The daily ICU census was a median 12 beds with one pharmacist full-time equivalent per ICU, researchers reported. Typically, a pharmacist’s work week consisted of 50% direct ICU patient care, 10% teaching, 8% order processing, 5% direct non-ICU patient care, 5% administration, and 5% scholarship. Reviewing drug histories, assessing adverse events, and evaluating, monitoring, and managing drug therapies were common clinical duties.
Nearly two-thirds of pharmacists had some form of prescriptive authority, according to the study, with 51.1% able to write prescriptions through protocols or practice agreements and 13.4% having independent prescriptive authority.
“Compared with the results of the survey published in 2004, educational and scholarly activities have expanded greatly,” researchers reported, “while administrative responsibilities of ICU pharmacists have remained consistently broad.”
MacLaren R, Roberts RJ, Dzierba AL, Buckley M, Lat I, Lam SW. Characterizing Critical Care Pharmacy Services Across the United States. Crit Care Explor. 2021;3(1):e0323. Published 2021 Jan 8. doi:10.1097/CCE.0000000000000323