Abstracts highlight drug information, NICU benefits

Here’s a snapshot of two Professional Posters presentation abstracts from the American Society of Health-System Pharmacists Midyear Clinical Meeting in December.

• Implementation of a web-based, multisite drug information service database, Amy F. Wilson, PharmD, and Cathy L. Bartels, PharmD, FAAIM, assistant professor and associate professor, respectively, of pharmacy practice for the Drug Information Service at Creighton University School of Pharmacy and Health Professions in Omaha, NE. Creighton University Medical Center School of Pharmacy and Health Professions (SPAHP) supports three full-time drug information services in Omaha. A high-tech drug information database was implemented in 2005 to assist in the effective management and efficient collaboration between and among the services. The goal of the project was to provide a searchable database of questions and responses received by the various drug information services.

To do this, a computer consultant development company was contracted to develop the database. The database was designed to allow users to enter the question, along with a verbal or written response, and document the resources used to answer the questions, as well as any notes for clarification. The system has capabilities to produce PDF files ready for electronic e-mailing, as well as autogeneration of cover sheets for fax transmission. Because the majority of question intake and responses are done by pharmacy clerkship students, the database requires faculty approval, via password, before responses can be completed.

Implementation of the database has allowed the drug information services to evolve toward a paperless environment, providing storage for all drug information requests and responses. The database has improved efficiency of the services, avoiding time being spent researching previously answered questions. In addition, reporting capabilities of the system have allowed monthly service reports to be generated and shared with administration.

Persistence of improved medication use safety in the NICU after adding a neonatal pharmacist, Pauline Chan, RPH, MBA, BCPP, pharmacy manager, and Ronald Floyd, PharmD, at Sharp Mary Birch Hospital for Women in San Diego. After implementing nearly all published recommendations, guidelines, and actions for prevention of medication error in pediatrics, the pharmacists decided in 2002 that the medication error rate could be further reduced only by bringing pharmacists knowledgeable about neonatal pharmacology and pharmacotherapy into close proximity with prescribers and nursing staff. They reported that in 2003 — as compared to earlier years — a neonatal pharmacist providing coverage from 0700 to 1530 hours on weekdays to the neonatal intensive care unit (NICU) at Sharp Mary Birch Hospital for Women was associated with statistically significant changes in medication use process error detection, prevention, and reporting. The improvements over baseline have been maintained throughout 2004.

Data documenting the impact of the pharmacists’ efforts to improve the safety of medication prescribing, dispensing, and delivery were collected from the Clinical Pharmacy Intervention system on the Sharp Intranet for 2004. These data were compared to those from 2002 through 2003, which were collected in the same manner.

The average monthly number of clinical interventions reported by pharmacists for the NICU increased significantly between 2002 and 2003, more than doubling the rate from 24 to 58. For 2004, this higher level of average monthly clinical interventions was maintained at 57. For 2004, as well as for 2003, the number of reported potential adverse drug events also increased over baseline. While all types of clinical interventions increased, those involving the antibiotic and miscellaneous categories appeared to increase more than did those involving total nutrient admixture (TNA).

This reflects the NICU pharmacists’ ability to affect prescribing within the context of the clinical environment, their increased awareness of specific clinical situations from immediate nursing communication, as well as pharmacy’s previous close scrutiny of TNAs, the pharmacists say.