Specialized ICU pharmacy team cuts wait for meds at RWJBarnabas Health

RWJBarnabas Health System developed a specialized pharmacy team for its intensive care unit that has reduced medication wait times and potential drug errors in critical care settings, according to a new study published in the Journal of Clinical Outcomes.

Typically, ICU-specific pharmaceutical services are provided by a team of general practice pharmacists that consults with one pharmacist who specializes in critical care. Often, only the specialist is able to respond or offer suggestions on complex, ICU-specific issues. This means that when the pharmacist who specializes in critical care is off duty, patients often have to wait longer for medication interventions.

To help reduce medication adjustment wait times and boost nonspecialty pharmacist confidence in the ICU setting, pharmacists at the RWJ University Hospital in Hamilton, N.J., developed a first-of-its kind training program for nonspecialist pharmacists and established a specialized critical care pharmacist team.

The program, established in partnership with Rutgers University, offers six-months of intensive classroom and clinical training for nonspecialist pharmacists on common complications that emerge with patients in the ICU. The program taught best-practice interventions for patients who are on mechanical ventilators, those who have unique infectious disease risk as well as blood flow management for nonmobile patients.

The pharmacists that underwent the training became part of the critical care pharmacist team and can now provide a range of interventions previously limited to the critical care pharmacy specialist.

"Before we tried this model, the nonspecialty pharmacists in the ICU were often uncomfortable with clinical issues, which sometimes meant going to the bedside to assess the situation. As a result, relatively minor issues were frequently escalated with a call to the specialist, who was not always readily available," lead researcher Liza Barbarello Andrews, PharmD, the sole critical care pharmacy specialist at RWJ University Hospital Hamilton said. "Our new model effectively empowers all of our pharmacists to act as specialists."

The new model was established without significant costs and could benefit other hospitals, Dr. Andrews said.

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