The impact of clinical pharmacist in a cardiac-surgery intensive care unit.

OBJECTIVE To evaluate the clinical pharmacists' interventions in an intensive care unit (ICU) setting with regard to their acceptance by the medical team, frequency, clinical significance, and targeted patient's outcomes. METHODS This is a prospective, non-comparative, observational study evaluating the clinical pharmacist interventions in an ICU setting from December 2002 to May 2003. The study was conducted in a 19-bed Cardiac-Surgery ICU at King Faisal Specialist Hospital & Research Center, a tertiary-care hospital in Riyadh, Saudi Arabia. The clinical pharmacist performed daily multi-disciplinary team rounds, with documentation of all his interventions. On the same day, a physician, who is a part of the team, verified all interventions for validity and clinical significance. The institutional Office of Research Affairs approved the study. RESULTS The clinical pharmacist intervened 394 times on the 600 patients [0.66 intervention-per-patient]. The medical team accepted almost all interventions (94.3%). The main drug-related problems were the following: no drug prescribed for medical condition (33.2%), inappropriate dosing regimen (28.9%), and no indication for drug use (14.3%). Approximately 55.7% of the interventions targeted enhancing therapeutic outcomes, whilst 21.8% of interventions resulted in the prevention of an adverse drug reaction. The interventions that may have resulted in decreasing mortality, preventing, or reducing organ damage, or decreasing hospitalization, represented 8.1% of all interventions. CONCLUSION Participation of a clinical pharmacist in the daily multidisciplinary team rounds in an ICU setting significantly reduces unfavorable morbidities and enhances therapeutic outcomes.