Pharmacist-driven respiratory syncytial virus prophylaxis stewardship service in a neonatal intensive care unit.

Abstract

The development and implementation of a pharmacist-driven respiratory syncytial virus (RSV) prophylaxis stewardship program in a neonatal intensive care unit (NICU) are described. An RSV prophylaxis stewardship service was created in the NICU at Brigham and Women's Hospital to align with the newly updated 2014 American Academy of Pediatrics (AAP) recommendations for palivizumab. The service comprised two NICU clinical pharmacists with oversight from the NICU medical director and the chair of the NICU infection control committee. Supervising physicians provided oversight for the identification of qualified patients on a weekly basis and assisted in the evaluation of controversial cases. The goals of the RSV prophylaxis stewardship service were to identify qualifying infants, improve adherence to the current AAP recommendations, educate staff and families on the recently updated AAP recommendations, streamline communication between providers regarding qualifying infants, and prepare and deliver palivizumab for administration in an organized and cost-effective manner. Twice-weekly "RSV prophylaxis days" were designated, with a set administration time on each day. Workflow was successfully streamlined between members of the healthcare team, including NICU pharmacists, prescribers, off-shift pharmacists, and nurses. Pharmacists involved in a multidisciplinary RSV prophylaxis stewardship service successfully identified qualifying patients for RSV prophylaxis while adhering to the latest AAP recommendations, educated staff and families regarding RSV, streamlined communication among healthcare providers, and ensured preparation of palivizumab in an organized and cost-effective manner.