Mona Patel, BCCCP, PharmD, FCCM
Clinical Pharmacy Manager, Surgical ICU
NewYork-Presbyterian Hospital
New York, NY
Disclosure information not submitted.
Alana Ciolek, PharmD
Critical Care Pharmacist
NewYork-Presbyterian Hospital, United States
Disclosure information not submitted.
Amy Dzierba, BCCCP, PharmD
Critical Care Pharmacist
New York-Presbyterian Hospital
New York, New York, United States
Disclosure information not submitted.
Title: Characterization of Pharmacotherapeutic Interventions Made by Pharmacists in ICU Patients
INTRODUCTION/HYPOTHESIS: Critical care pharmacists are integral members of the interdisciplinary ICU team who help ensure safe and effective use of medications in ICU patients. The objective of this study was to characterize non-antimicrobial related interventions made for ICU patients by post-graduate year 2 critical care (PYG2CC) pharmacy residents during weekend shifts. We also sought to determine whether the interventions made during the weekends influenced the type and number of interventions made on Mondays by critical care pharmacists and residents.
Methods: This IRB-approved retrospective review conducted between August 2020 and May 2021 involved adult critically ill patients across nine ICUs at an academic medical center. Interventions for 39 Mondays associated with drug dose adjustment and optimization for non-antimicrobial medications, documented by critical care clinical pharmacists including PGY2CC residents were assessed. Weeks involving orientation, conferences, and holidays were removed. Descriptive statistics were used to characterize interventions. Wilcoxon Rank Sum test (Mann Whitney U) was used to compare the median number of interventions made on Mondays after PGY2CC residents worked versus did not work.
Results: Approximately 40% of interventions made by PGY2CC residents involved adjustments in pharmacotherapy regimens. Sixty-two percent of the interventions involved drug therapy discontinuation, initiation, or modification. There was no difference in the number of interventions made by critical care pharmacists on Mondays immediately following a PGY2CC resident weekend shift compared to Mondays after they did not work (median 38.5 vs 43.0, p=0.18). There was also no difference in the number of interventions per critical care pharmacist with drug discontinuation (mean 8.7 vs 9.6, p=NS), drug initiation (median 8.5 vs 11, p=NS), or drug modification (median 8.5 vs 9.0, p=NS) on Mondays after residents worked the weekend compared to when they did not.
Conclusions: PGY2CC residents are integral members of the critical care team and contribute to important interventions. Although numerically less interventions were made by critical care pharmacists on Mondays after residents worked compared to when they didn’t work, the differences were not statistically significant.