Model for ICU Pharmacists Addresses Common Dilemma for Hospitals

Improves Care for Critically Ill Patients

A new team-based model for intensive care unit (ICU) pharmacists, developed by Rutgers and RWJ Barnabas Health System, resolves a common dilemma for hospitals and improves care for critically ill patients.

The model, believed to be the first of its kind, allows non-specialty pharmacists in the ICU to provide a full range of patient interventions that were previously limited to critical care specialists. Typically, only a specialist can respond to complex, ICU-specific issues, such as determining whether a delirious patient needs to switch medications. However, specialists are not always readily available.

Lead researcher Liza Barbarello Andrews, a clinical associate professor at Rutgers University’s Ernest Mario School of Pharmacy, developed a solution at Robert Wood Johnson University Hospital Hamilton, where she is the sole critical care pharmacy specialist. Under the new model, several non-specialists on Hamilton ICU’s pharmacy staff underwent six months of intensive classroom and clinical training on such topics as the complications that patients face while they are attached to mechanical ventilators, infectious disease risk, and blood-flow management for non-mobile patients. Eventually, all pharmacists on the newly formed Critical Care Pharmacist Team (CCPT) were able to provide the full range of patient interventions that had been previously limited to the critical care specialist.

After implementing the new model, the overall quality of patient pharmacy services has improved. Pharmacists who underwent this training report being comfortable and confident when providing the specialized levels of care. Other ICU staff, including physicians and nurses, also reported improvements in pharmacy care, not least a consistent, high level of care even when the specialist was not on duty.

Andrews said that the new model “effectively empowers all of our pharmacists to act as specialists.” In addition, the model was adopted without significant cost and should therefore benefit other community-based hospitals with limited resources.

Source: MedicalXpress, August 5, 2019