Protocol Development and Quality Improvement
such as:
In-service lectures
Medication alerts
Guideline development
Protocols
Policy and procedures
CPOE pathways, prescribing guides, or information or pop-up warnings
Patient Case
Which medication use process is best suited for an MUE?
Evidence of economic benefit and improvement in patient safety for clinical pharmacy services (CPS)
an ICU pharmacist as an essential component of the ICU team.
record. Pharmacist involvement directly optimizes the use of medications, decreases drug-related costs,
prevents adverse effects, improves quality and efficacy of care, reduces mortality, shortens length of
stay (LOS), and lowers overall patient care costs.
Clinical interventions that can be performed by a critical care pharmacist may include but are not limited
to:
Optimization of the correct drug for the disease process (inappropriate therapy, duplication of
therapy, therapy no longer needed, etc.)
Optimization of the correct dose based on the patient’s end organ function, including continuous
renal repacement therapy adjustments, hepatic dose adjustments, and dose adjustments needed
during extracorporeal membrane oxygenation
Anticoagulation adjustment
| d. | Antibiotic optimization (deescalation, bug-drug mismatch, duration of therapy, etc.) |
|---|
Intravenous to oral conversion
Transitions of care and/or medication reconciliation
Pharmacokinetic dosing
Adverse event management
Drug-drug or drug-disease management
Ensuring adherence to ICU medication therapy protocols (i.e., alcohol withdrawal, PADIS
management, neuromuscular blockade, etc.)
| k. | Drug and laboratory monitoring |
|---|