Lec1 Flashcards
The pharmacist’s time is dedicated to critical
care patients, with few commitments outside the ICU area.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist prospectively evaluates all
drug therapy for appropriate indications, dosage, drug interactions, and drug allergies; monitors the patient’s pharmacotherapeutic regimen for effectiveness and ADEs; and intervenes as needed.
Critical Care Pharmacist Activities
Fundamental Activities
In conjunction with the clinical dietitian,
the pharmacist evaluates all orders for parenteral nutrition and recommends modifications as indicated to optimize the nutritional regimen.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist identifies ADEs and assists
in their management and prevention, and develops process improvements to reduce drug errors and preventable ADEs.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist uses the medical record as
one means to communicate with other health care professionals and to document specific pharmacotherapeutic recommendations.
member of the multidisciplinary critical care
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist provides pharmacokinetic
monitoring when a targeted drug is
prescribed.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist provides drug information
and intravenous compatibility information
to the ICU team and uses the regional
poison information center when indicated.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist maintains current tertiary
drug references.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist provides drug therapy-
related education to ICU team members.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist participates in reporting
ADEs to institutional committees and to the
Food and Drug Administration’s MedWatch
program.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist documents clinical activities
that include, but are not limited to, disease-
state management, general pharmaco-
therapeutic monitoring, pharmacokinetic
monitoring, ADEs, education, and other
patient care activities.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist acts as a liaison between
pharmacy, nursing, and the medical staff to
educate health professionals regarding
current drug-related procedures, policies,
guidelines, and pathways.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist contributes to the hospital
newsletters and drug monographs on issues
related to drug use in the ICU.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist implements and maintains
departmental policies and procedures
related to safe and effective use of drugs in
the ICU.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist collaborates with nursing,
medical staff, and hospital administration to
prepare the ICU for the Joint Commission
on the Accreditation of Healthcare
Organizations (JCAHO) survey and
responds to any deficiencies identified.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist provides consultation to
hospital committees, such as Pharmacy and
Therapeutics, when critical care pharmaco-
therapy issues are discussed.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist identifies how drug costs
may be minimized through appropriate use
of drugs in the ICU and through implemen-
tation of cost-containment measures.
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist participates in quality
assurance programs to enhance pharma-
Critical Care Pharmacist Activities
Fundamental Activities
The pharmacist regularly makes rounds as a
member of the multidisciplinary critical care team (if available) to provide pharmaco- therapeutic management for all ICU patients.
Desirable Activities
The pharmacist maintains knowledge of
current primary references pertinent to critical care pharmacotherapy.
Desirable Activities
The pharmacist reviews a patient’s drug history to determine which maintenance drugs should be continued during the acute illness. A. The pharmacist clarifies previously effective dosages and dosage regimens. B. For all suspected drug-related ICU admissions, the pharmacist assesses the patient drug history for causality and documents in the medical record any findings that will impact patient management.
Desirable Activities
In collaboration with the clinical dietitian,
the pharmacist provides formal nutrition
consultation on request and responds within
24 hours.
Desirable Activities
The advanced cardiac life support-certified
(or pediatric advanced life support-certified)
pharmacist responds to all resuscitation
events in the hospital 7 days/week, 24
hours/day.
Desirable Activities
The pharmacist provides didactic lectures to
health professional students in critical care
pharmacology and therapeutics, where
applicable.
Desirable Activities
The pharmacist participates in training
pharmacy students, residents, and fellows
through experiential critical care rotations,
where applicable.
Desirable Activities
The pharmacist coordinates the develop-
ment and implementation of drug therapy
protocols and/or critical care pathways to
maximize benefits of drug therapy.
Desirable Activities
The pharmacist uses a documentation
program that attaches both a clinical
significance and an economic value to
clinical interventions.
Desirable Activities
The pharmacist is actively involved in
critical care pharmacotherapy research by
assisting in the screening and enrollment of
patients and by serving as a study coordinator
or contact person, where applicable.
Desirable Activities
The pharmacist participates in research
design and data analysis, where applicable.
Desirable Activities
The pharmacist contributes to the pharmacy
and medical literature, e.g., case reports,
letters to the editor, and therapeutic,
pharmacokinetic, and pharmacoeconomic
reports.
Desirable Activities
The pharmacist is involved in nonpatient
care activities including multidisciplinary
committees and educational in-services.
Desirable Activities
The pharmacist assists physicians in
discussions with patients and/or family members to help make informed decisions regarding treatment options.
Optimal Activities
The pharmacist provides formal accredited
educational sessions, such as medical grand rounds or intensive care rounds, for medical staff, students, and residents.
Optimal Activities
The pharmacist participates in teaching
advanced cardiac life support
Optimal Activities
The pharmacist develops residencies and/or
fellowships in critical care pharmacy
practice.
Optimal Activities
The pharmacist develops and implements
pharmacist and pharmacy technician
training programs for personnel working in
the ICU.
Optimal Activities
The pharmacist identifies and educates lay
groups and medical personnel in the
community about the role of pharmacists as
part of the multidisciplinary health care
team in the ICU.
Optimal
The pharmacist independently investigates
or collaborates with other critical care
practitioners to evaluate the impact of
guidelines and/or protocols used in the ICU
for drug administration and management of
common disease states.
Optimal
The pharmacist uses pharmacoeconomic
analyses to prospectively evaluate existing
or new pharmacy services and the place of
new drugs in critical care pharmacotherapy.
Optimal
The pharmacist is proactive in designing,
prioritizing, and promoting new pharmacy
programs and services.
Optimail
The pharmacist secures funds for
conducting research.
Optimal
The pharmacist reports results of clinical
research and pharmacoeconomic analyses to
the pharmacy and medical community at
regional and national meetings.
Optimal
The pharmacist publishes in peer-reviewed
pharmacy and medical literature as a result
of any of the following activities:
A. Clinical research or other original research
that qualitatively and quantitatively
evaluates drug therapy and the provision
of pharmacy services.
B. Investigator-initiated grants and contracts.
C. Pharmacoeconomic and outcomes
research.
Optimal
Drug use systems can do the following:
A. Create and maintain patient drug profiles. B. Interface with patient laboratory data. C. Alert users to drug allergies. D. Alert users to maximum dosage limits. E. Alert users to drug-drug and drug-
food/nutrient interactions.
Pharmacy and Hospital Services Fundamental Services
If manual drug administration records are
the only available drug administration
document, quality assurance1 systems are in
place to verify the accuracy of this process.
Pharmacy and Hospital Services Fundamental Services
A “ready to administer” (unit-dose) drug
distribution system is available in the ICU
with no more than a 24-hour supply for
each patient.
Pharmacy and Hospital Services Fundamental Services
Large- and small-volume parenteral products
are prepared in the pharmacy and delivered
at regularly scheduled times to the patient
care area 7 days/week.
Pharmacy and Hospital Services Fundamental Services
Pharmacy space and facilities in the ICU are
assessed routinely to determine whether
efficiency can be improved, where applicable.
Pharmacy and Hospital Services Fundamental Services
Procurement, storage, inventory, and
distribution of investigational drugs, where
applicable, are under the supervision of a
pharmacist
Pharmacy and Hospital Services Fundamental Services
The pharmacy department is represented on
the Institutional Review Board and/or
Scientific Review Board, as applicable.
Pharmacy and Hospital Services Fundamental Services
1. The hospital information management system is computerized, can comply with the requirements listed for drug use processes (see Fundamental Services, Item 1), and can do the following: A. Alert users to disease state-drug interactions. B. Provide intravenous admixture infor- mation (e.g., compatibility, stability, preparation). C. Provide online drug and poison information. D. Document clinical pharmacy patient care interventions.
Pharmacy and Hospital Services
Desirable Services
Computerized drug administration records
are generated. Manual records are used only
in emergencies
Pharmacy and Hospital Services
Desirable Services
An ICU satellite pharmacy with unit-dose
drug distribution and intravenous
admixture capabilities is open a minimum
of 40 hours/week.
Pharmacy and Hospital Services
Desirable Services
The computerized hospital information
management system serving the ICU has the following additional capabilities:
A. Direct physician drug order entry at
patient bedside. B. Interface with bedside clinical information
system.
Pharmacy and Hospital Services
Optimal Services
An ICU satellite pharmacy with unit-dose
drug distribution and intravenous
admixture capabilities is open 24 hours/day,
7 days/week.
Pharmacy and Hospital Services
Optimal Services
Pharmacotherapeutic, pharmacokinetic, and
nutrition consultation are available 24
hours/day, 7 days/week.
Pharmacy and Hospital Services
Optimal Services
