Clinical Pharmacy Faculty Interventions in a Pediatric Intensive Care Unit: An Eight-Month Review

Abstract

The American Academy of Pediatrics and the Society of Critical Care Medicine have documented the importance of pharmacist involvement in pediatric care. Numerous studies have reported the impact of clinical pharmacy interventions in various adult care settings. However, in the pediatric critical care setting, the impact has not been well documented. The purpose of this study was to describe clinical pharmacy faculty interventions in a pediatric intensive care unit (PICU). A pediatric clinical pharmacy faculty member performed and documented clinical interventions in a level I, 18-bed, tertiary care PICU. Information gathered included medication name, specific intervention performed, basic patient demographics, and length of stay from May to December 2009. During the study period, there were 893 interventions performed on 159 patients over 66 days of service. (Average of 5.5 interventions/patient, and 34 interventions/100 patient PICU days.) Dosing recommendations and pharmacokinetics were the most common type of intervention (28.8% and 21.4%, respectively). Antibiotics and sedatives/analgesia were the most common drug classes in which interventions were made (34.4% and 20.3%, respectively). Ninety-eight percent of all interventions were accepted by the medical staff. The estimated annual cost savings from these interventions was $119,700. The average number of interventions per patient in this study was higher than that reported in the literature to date. Dosing recommendations and pharmacokinetics were the most commonly recommended interventions documented. Although this study showed considerable cost savings by a pharmacy clinical faculty member, further study of economic benefits is needed.