Validity Evidence for FASTHUG-MAIDENS, a Mnemonic for Identifying Drug-Related Problems in the Intensive Care Unit.
نویسندگان
چکیده
BACKGROUND The mnemonic FASTHUG (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head of bed elevation, stress Ulcer prophylaxis, Glucose control) was developed by intensive care unit (ICU) physicians to ensure that key aspects of care are addressed during each patient encounter. Because this tool does not specifically target pharmacotherapy assessments, a modified version, FASTHUG-MAIDENS, was created, by changing the H to mean Hypoactive or Hyperactive delirium and adding M for Medication reconciliation; A for Antibiotics or Anti-infectives; I for Indications for medications; D for drug Dosing; E for Electrolytes, hematology, and other laboratory tests; N for No drug interactions, allergies, duplication, or side effects; and S for Stop dates. OBJECTIVE To validate the use of FASTHUG-MAIDENS as a tool for identifying drug-related problems (DRPs) in the ICU. METHODS This randomized, prospective validation study took place between January and May 2011 in the ICUs of 4 hospitals: 2 community-level ICUs and 2 tertiary referral ICUs. Each ICU had a dedicated ICU pharmacist and one or more pharmacy residents completing an ICU rotation as part of their pharmacy practice residency (total of 6 residents). The 6 pharmacy residents were randomly assigned to assess patients admitted to the ICU using FASTHUG-MAIDENS or standard monitoring practice. The mean proportion of DRPs per patient encounter identified by the residents (relative to DRPs identified by the ICU pharmacists) was the primary outcome, and the proportion of total DRPs identified in each group was assessed as a secondary end point. RESULTS Pharmacy residents using the FASTHUG-MAIDENS mnemonic identified a significantly greater mean proportion of DRPs per patient encounter (73.2% versus 52.4%, p = 0.008) and a greater proportion of total DRPs (77.1% versus 52.5%, p < 0.001) than those assessing patients according to standard monitoring practice. CONCLUSION In this sample, the mnemonic FASTHUG-MAIDENS was a useful tool to facilitate the capture of DRPs by pharmacy residents working in the ICU.
منابع مشابه
A Standardized, Structured Approach to Identifying Drug-Related Problems in the Intensive Care Unit: FASTHUG-MAIDENS.
Pharmacy practice in the intensive care unit (ICU) is complex, because of the high acuity of patients’ conditions and the large number of medications prescribed. Therefore, many pharmacists, especially those not familiar with ICU care, may feel overwhelmed and apprehensive in this setting. There is currently no standardized, structured approach to help pharmacists provide pharmaceutical care in...
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ورودعنوان ژورنال:
- The Canadian journal of hospital pharmacy
دوره 66 3 شماره
صفحات -
تاریخ انتشار 2013