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Evolution & Validation of Practice Standards

Eric W. Mueller ~2 min read Module 1 of 20

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Evolution and Validation of Practice Standards, Training, and Professional Development

I.LANDMARK EVENTS IN CRITICAL CARE MEDICINE/PHARMACY

A.First ICU: Three-Bed Neurosurgical Unit in Baltimore, Maryland (1930s) (Ann Pharmacother 2006;40:612-8)

B.First Pharmacists Assigned to ICUs in a Limited Number of Hospitals – Occurred in the late 1960s (Ann

Pharmacother 2006;40:612-8)

C.Establishment of several Critical Care Pharmacists ICU Practices (in or around the 1970s; clinical research

conducted in a wide array of therapeutic specialty areas [e.g., pharmacokinetics, infectious diseases, nutrition

support, ACLS]) (Ann Pharmacother 2006;40:612-8; Practice of Critical Care Pharmacy, Rockville, MD:

Aspen Publications, 1985)

Cardiovascular ICUs

2Pediatric/neonatal ICUs

Medical ICUs

Emergency medicine

Trauma

Surgical ICUs

Neurosurgical ICUs

D.Formation of SCCM with 100 Members (1970)

Multidisciplinary model stressed by founding SCCM President Max Harry Weil, M.D.

2Subsequent inclusion of pharmacists as permanent members of the SCCM governing council

E.Emergence of Critical Care Specialty Journals and Publications

Heart & Lung (1972)

2Intensive Care Medicine (1972)

Critical Care Medicine (1973)

Critical Care Clinics (1984)

Critical care therapeutics column in Drug Intelligence and Clinical Pharmacy (1982)

First critical care pharmacy textbook: Critical Care Pharmacy (1985)

Formation of Critical Care Pharmacists Specialty Groups

SCCM Clinical Pharmacy and Pharmacology Section (1989)

2ACCP Critical Care Practice and Research Network (PRN) (1992)

Neurocritical Care Society (NCS), Pharmacy Section (circa 1999)

II.VALIDATION OF CRITICAL CARE PHARMACY AS A SPECIALTY

A.Chapter Titled “Role of the Pharmacist in Caring for the Critically Ill Patient,” Published in The Pharmacologic

Approach to the Critically Ill Patient, 3rd ed. Baltimore, MD: Williams & Wilkins, 1994:156-66.

B.Publication of “Position Paper on Critical Care Pharmacy Services” (Crit Care Med 2000;28:3746-50);

establishment of three levels of pharmacy services (fundamental, desirable, optimal) for the provision of

pharmaceutical care in critically ill patients; major update in 2020 with recommendations simplified to

essential and desirable. Statements and recommendations categorized as follows: Patient Care (n=34), Quality

Improvement (n=21), Research/Scholarship (n=9), Training Education (n=10), and Professional Development

(n=8) (Crit Care Med 2020;48:1375-82) (see Table 1 for details).

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